The bridge of my nose appears flat from the front. What can I do to help? Looking from a straight profile, the bridge of my nose appears flat. Also, from each side profile there are bumps either side. This happened whilst playing soccer. I want to know what kind of treatment would be involved in order to re-shape the bridge of my nose?
What Can Be Done About Flat Nose Bridge?
Doctor Answers 11
Dorsal line improvements
There are a wide variety of means by which an experienced rhinoplasty surgeon can improve the dorsum of your nose. Without a photo it is hard to be definitive but it sounds as though rather than the usual bump removal, what you are looking for is an onlay graft to build up and shape your bridge. Commonly and preferentially, these can be from your own septal, ear and rib cartilage but they also make prosthetic implants which can be used. More recently, injections have been performed to build up the dorsum but these have specific risks and should not be done by anyone other than a rhinoplasty surgeon if they feel it is best for you.
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What to do for a flat Nasal bridge in rhinoplasty
If the flat bridge is from fractures, then osteotomies can be done to narrow a wide nose. If congenital then osteotomies may not be enough and dorsal onlay grafts may be necessary.
Options for improving a flat nasal bridge
A flat bridge can be due to several different reasons, such as previous surgery, a fracture, or congenital. Bony bumps on the corners of the bridge can be filed down to give the illusion of more of a triangular-shaped pyramidal nose. Wide nasal bones have to be narrowed through medial and lateral osteotomies, which will address a flattop nasal bridge.
If the bridge is too low, cartilage grafts can be placed across the bridge to give the illusion of higher height and narrowness depending upon how wide the cartilage grafts are fashioned.
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Surgical and non-surgical correction of the bridge of the nose.
Your description of the bumps on the sides of the nose may be the nasal bones or the nasal process of the maxilla. This can sometimes be re-set with lateral osteotomies (bone cuts along the side of the nose). As for rebuilding the bridge, I tend to prefer cartilage from the patient's septum or, in more severe cases, from the patient's rib.
For more subtle corrections, surgery may not be required. Injectable fillers such as Radiesse or Artefill can often take care of this problem. This is usually a quick, in-office procedure with little to no downtime.
All the best,
Treating a flat nasal bridge
A flat nasal bridge can be treated by augmentation of the dorsum. This can be achieved by using septal cartilage, rib cartilage or even synthetic products.
Treating a flat nasal bridge with nose job (rhinoplasty)
It is difficult to make any recommendations without an evaluation. However, from your description, I would guess that you would benefit from placement of a graft to the nasal dorsum. This can be obtained from your septum, ear, rib, hip, skull or from a cadaveric source or use of an implant material.
"Building a Bridge" in Rhinoplasty
Traumatic injuries to the nose are one of the leading reasons why patients decide to pursue a rhinoplasty. Many patients were happy with their original nose, but a traumatic event caused the nose to either change its appearance OR how well it functions - both should be primary concerns in any rhinoplasty surgery.
Improving a depressed or collapsed bridge/dorsum is a challenge and must be carefully evaluated in your physicians office. If this is slight, the cartilage/septum from the inside of the nose can be used and folded on itself to "build" the height of the bridge. Unfortunately, this cartilage is thin and supple and can only make small changes. For more severe cases, we need to harvest cartilage from other areas in the body - such as the ear or rib. This allows us more raw materials and flexibility in correcting the depressed bridge. The down side is that there is a second operative site and scar where the cartilage is taken. However, this is your own tissue and you will not react to this unfavorably.
Two other options exist: a silicone implant and irradiated cartilage. Two issues you ned to be aware of: silicone implants have a tendency for displacement as well as infection and there can be resorption (loss of cartilage) from the irradiated cartilage since it is not your own tissue.
No matter what you choose, select a surgeon who is experienced in this surgery as this is one of the most technically challenging operations plastic surgeons offer.
Vince Marin, MD
Several options for narrowing nasal bridge
Depending on the extent of the width of your nose there are several options. Sometimes a simple osteotomy can narrow the nasal bridge. However, in very wide dorsums, the patient may need a custom dorsal implant. The implant should be custom carved and placed through an open approach rhinoplasty.
Rhinoplasty for the Flat Nasal Bridge
Well, one thing that you can do if you are still active is soccer is to have your nose hit from each side and push your nasal bones back up medially...just kidding, there are less traumatic methods with rhinoplasty.
Get a few consultations for a diagnosis. There are various methods of building up the bridge using either your own nasal cartilage or bone, or if necessary, synthetic materials.
In any case, it is essential that you choose your rhinoplasty surgeon most carefully. Good luck in the upcoming soccer World Cup against that upstart United States team.
Good luck and be well.
Repair of the flat nose bridge depends on several factors
If you have the right amount of height of the bridge, you may only need filing of the bumps. It is difficult to say without a photo of your nose. See an experienced rhinoplasty surgeon and let him guide you to what is needed for a natural, attractive nose.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.