Use of a Surgical Microscope for Subperichondrial–Subperiosteal Dissection in Preservation Rhinoplasty: Ergonomic Considerations

Preservation of anatomical components in rhinoplasty has gained increasing popularity over recent years. Given that elevation of the soft tissue envelope in a continuous subperiochondrial–subperiosteal dissection preserves soft tissues, vessels, nerves, and lymphatics, this procedure may result in faster healing time and less swelling and scarring. However, the technique requires a learning phase and can be challenging to perform because it typically requires meticulous dissection under surgical loupes. The dissection may thus be time-consuming and a burden for surgeons, especially in secondary rhinoplasty cases. Further, the potential risk of musculoskeletal discomfort and injury to the surgeon should not be overlooked; consideration for surgical ergonomics is needed to prevent injuries and enhance surgical performance. To address these issues, we propose the use of a surgical microscope for subperiochondrial–subperiosteal dissection in preservation rhinoplasty. A microscope enables clear visualization of the surgical field and allows surgeons to make precise and delicate manipulation maneuvers. Moreover, it may also enable surgeons to maintain an ideal ergonomic posture and neutral positioning of their joints, thereby reducing physical strain. A surgical microscope may thus be a useful tool for subperiochondrial–subperiosteal dissection by providing clear visualization of the surgical field and improved surgical ergonomics for surgeons.