I had my first rhinoplasty 5 months ago (1st pic). I got reduction of the nasal bones, supra-tip and tip but my nasion was not touched. As I had an overall big nose, after refining the nose, I feel it not longer fits the bones that falls next to the eyes and that look wide to me. Check an example of what I'd like to get for myself in the 2nd pic: the bridge is defined and the lines are continuous at the nasion area. What's the best procedure to address this and am I a good candidate?
How to Get a More Defined Nassion/radix Area in Rhinoplasty?
Doctor Answers 8
Making the pyramid taller will make it look narrower
The nose sits on the face like a triangular pyramid. The taller (more projected from the face) it is, the narrower it will appear on the frontal view. Now this may not be a good idea if your bridge is already quite projected as it could make your profile more prominant. It then can become a value judgment of priorities: narrowness on the front view vs. a favorable profile. An experience surgeon should be able to guide you on this. Morphing software can be helpful to make this clearer.
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Revision rhinoplasty and the radix
From the photos you provided, it appears that you have flattening in the radix region and widening of short nasal bones. You may need a combination of grafting to narrow the radix region and selective osteotomies to bring the nasal dorsum and middle third of the nose more in line. I would seek the advice of a board certified facial plastic surgeon or other rhinoplasty expert as your nose represents more of a challenge and should be evaluated by someone with epxerience in revision rhinoplasty surgery.
Narrowing the bridge
It would be helpful to see your profile views but your best option is likely placement of a narrow graft (rib cartilage) or implant (Goretex) on the bridge of the nose
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Getting more definition for the upper part of the nose may require an implant
Sometimes, its not reducing or narrowing the dorsum, or upper part of the nose, that creates definition, it is by adding height. Radix grafts placed in the upper part of the nose help separate the eyes and makes that area more defined. From the photos sent, you appear to have almost a "washed out" appearance. Further narrowing already short nasal bones don't help. Adding a radix graft will make the nose actually appear narrower. Potential sources for this graft are your own cartilage (nasal septum or ear), covering from a muscle called fascia or an artificial implant made of Gortex. I suggest you seek a skilled revision rhinoplasty specialist in your area for a personal opinion.
Wide nasal bones and Rhinoplasty
From the front view, your nasal bones and tip are wide however, there's no profile view to see the dorsal, nasal height which appears to be quite low. A combination of osteotomies to break and move the nasal bones closer together as well as increasing the dorsal height for thinner definition could be done during a Rhinoplasty.
How to Get a More Defined Nassion/radix Area in Rhinoplasty? I
From your photos, it appears that to get a more defined nasion, augmentation of that area needs to be done. There are different materials that can be used, but mainly they fall into two categories-synthetic and non-synthetic ones.
Different doctors prefer different materials, so the choice of material will be up to him and whether you agree with what he wants to use.
Michel Siegel, MD
Getting more definition to the upper third of the nose
It is a bit counter-intuitive but often the best way to improve nasal definition is to build it up rather than take away. Grafting can be done to the radix area to achieve this. It may be advantageous to also narrow the nasal bones at the same time. Assessing your nose from more than the frontal view would allow for a better idea of how to improve the area.
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