The “Let down” technique was first defined in 1970s. It has been used in some clinics since then; however, it has gained popularity in recent years.
There are some basic differences between classical rhinoplasty and the “let down” technique. In classical rhinoplasty, the nasal arch is corrected by direct removal of the cartilages or bone. The archy appearance is corrected; however, the natural appearance of the back of the nose is lost. Following classical rhinoplasty, patients feel irregularities when they touch their nose; it is not a smooth nose anymore. Hence, in daylight or flash photography, the lights of the nasal dorsum are impaired giving an artificial appearance to the nose.
In “let down” rhinoplasty, correction of the archy part in provided, not by direct removal of the cartilages or bones, but by removal of the deeper structures. Therefore, the nasal dorsum lights are not deteriorated, and patients do not feel irregularities when they touch their nose.
The “Let down” technique necessitates surgical experience. It may be applied in revision rhinoplasty cases and also in crooked noses.