Septal Redirection Concept: Posterior Anchor–Anterior Rotation (PAAR) Technique for the Correction of Twisted Noses

OBJECTIVES: The Posterior Anchor-Anterior Rotation (PAAR) method is presented in this paper as a biomechanically and anatomically sound approach to correcting twisted nose abnormalities. By combining controlled posterior anchoring with focused anterior rotation, the PAAR method overcomes intrinsic cartilage memory and multi-vector deviation pressures, addressing the limitations of conventional septal repositioning techniques within the scope of the Septal Redirection Concept. METHODS: This study involved 48 patients undergoing primary rhinoplasty who received repair of a twisted nose deformity via the PAAR procedure. RESULTS: This method achieves long-lasting alignment by preserving structural integrity through the use of a sufficient L-strut and targeted graft-mediated torque. A high correction rate was achieved. CONCLUSION: This biomechanically sound method of long-term septal realignment is based on the Septal Redirection Concept and employs a dual-mechanism strategy: posterior anchoring to create a stable structural base and anterior rotation to overcome intrinsic deforming pressures. The PAAR procedure is a significant addition to the current literature on structural and preservation-oriented rhinoplasty because it is both effective and innovative in addressing complex septal abnormalities.