Safe and Integrated Practices in Rhinoplasty: A Contemporary Perspective on Function, Aesthetics, and Patient Safety.

objectiveTo present an integrated, evidence-based view of current rhinoplasty practices, emphasizing patient safety, functional preservation, and interdisciplinary collaboration.

methodsWe reviewed the literature published between 2019 and 2025, including systematic reviews, meta-analyses, and official documents from the International Society of Aesthetic Plastic Surgery (ISAPS) covering functional, structural, and preservation approaches. Studies regarding the pre-, intra-, and postoperative phases were analyzed to identify associations with patient safety and satisfaction.

resultsA global shift from reductive techniques to structural and preservation approaches prioritizing anatomical respect and functional integrity was observed. Evidence supports team planning, psychological screening, and standardized protocols applied across the operative pathway to reduce complications. In addition, technological advances have improved predictability and surgical training. Despite advances, substantial variability in techniques and protocols persists, underscoring the need to strengthen a shared culture of safety through standardized perioperative workflows, structured documentation, and validated outcome assessment, rather than standardizing operative techniques.

conclusionsRhinoplasty should combine esthetic precision with preservation of nasal function and ethical responsibility. Establishing a global culture of safety requires more than protocols; it demands empathy, collaboration, and the surgeon's active role as a technical and ethical mediator at all stages of care. While not an official ISAPS guideline, this article offers a critical reflection on current evidence and discussions within the ISAPS Patient Safety Committee. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .