Reduction Rhinoplasty's Bad Wrap—Is it Time to Forgive and Forget?... Or at Least Get a Rebrand?

Destigmatizing reduction rhinoplasty in a structural preservation era.Transition from the classic Joseph rhinoplasty to modern emphasis on structural preservation has imparted negative connotations to the term reduction.Anatomic features that predispose patients to functional compromise must be recognized and addressed in all approaches to ensure successful surgical outcomes.Piezo ultrasonic instruments provide a safe and precise way to reduce the bony framework and can be applied to all styles of rhinoplasty.Patients with no concomitant functional issues, reasonable and conservative cosmetic expectations, and strong cartilage framework, who are managed by a thoughtful surgeon can expect excellent results regardless of the approach.Reduction rhinoplasty techniques are some of the most enduring in rhinoplasty and safe limits are described.Patients should be followed for functional and/or quality of life performance.Precision recommendations regarding thresholds for resection and grafting, as well as standardized preoperative evaluation methods are required.Rhinoplasty techniques exist in a continuum as do features of the nose. A one-style-fits-all approach is not appropriate and leads to avoidable postoperative failures and revision surgery. Reduction rhinoplasty may not be the "buzz" but it still has a place in contemporary conservative cosmetic surgery.