Hey, I was wondering if I could benefit from a radix graft rather than hump removal? I'm afraid that removing the hump alone will give me too low a bridge and I'd prefer a stronger bridge.
Hump Removal or Radix Graft? (photo)
Doctor Answers (19)
Hump reduction or radix graft for smooth profile
Most patients consider only hump reduction to improve their profile. Your photograph demonstrates the potential benefit of a radix graft, where a small piece of cartilage is placed in the "valley" just above the bump. Another alternative to plastic surgery is a non-surgical rhinoplasty, where a facial filler (ie. Restylane, etc) is placed in the same area.
Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Best of luck.
Radix graft and hump removal are often combined.
Without examining you directly, I can say that probably you need both. Your radix is very deep, but the hump should probably also come down a bit. I usually put the graft in first to determine how much of the hump should come down. Your tip may also over-project a bit, but that may be an issue of personal taste that you should discuss with your surgeon with morphed images in front of you and your surgeon. There is a link below to a patient of mine who had both a radix graft and a hump removal. It also shows an 8 year follow up.
Radix graft or hump removal, what is the answer.
You definitely need a radix graft. If your hump where removed you would worsen the appearance. I usually discuss this with patients while I do a computer imaging. You can definitely see the profile with the radix augmentation vs the hump removal. I have also used Radiesse injections with a blunt cannula to augment the the radix successfully. It usually lasts a long time in that area but may need to be repeated every couple of years.
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Radix graft versus hump reduction
You are correct - you need a radix graft rather than a hump reduction. My preference for augmenting the radix (and/or dorsum) is using a diced cartilage and fascia graft (DCF graft). The cartilage used for this is very finely diced, and wrapped in a thin fascia typically harvested from the deep temporalis fascia (small incision in the hair above your ear). The cartilage used for this can be from your septum, ear, or rib. The DCF graft avoids the warping that is more common with a solid block of cartilage, gives a natural looking appearance, and uses your own tissue.
Is it really a nasal hump or a low radix?
I continue to be impressed with the questions posed on RealSelf. Your accurate assessment of your nose is that you do not have a big hump, rather you have a low radix. Occasionally I add a radix graft (septal cartilage, typically) and lower the dorsal hump just slightly.
It appears that a radix graft would be the preferred way to go for you based on this limited exam. A consult with imaging would be very helpful to you in visualizing the change and deciding if that is your goal.
Radix Augmentation for the Low Bridge Nose
I think there is no question you need radix augmentation. That is best done with a cartilage graft. Hump reduction would be an aesthetic disaster for you. You may 'test-drive'a radix augmentation first by injectable fillers so see if that produces the look you desire. I would also have some computer imaging done to test-drive that look although that would be limited to just the profile view.
Based on your photos it appears that you would be a good candidate for rhinoplasty using a radix graft, such as the example in the link below
You may be a candidate for a Non-Surgical Rhinoplasty to fill your deep nasofrontal angle.
It is impossible to advise you based on the single profile photo you posted, but you appear to have an acute naso-frontal angle. You may wish to consult a surgeon experienced in the delicate art of using fillers for nasal augmentation. My personal preference is to use Silikon-1000, an off-label filler for permanent results. With Silikon-1000, you may require 3 treatments, spaced at monthly intervals or longer, for a desired result.
If you would require rhinoplasty surgery, I may suggest removing the hump. Placing cartilage grafts under thin skin may lead to a visible graft.
Hope this is helpful for you.
Radix graft rhinoplasty
The photo shows a very low radix. Augmentation of this radix with a cartilage graft taken from the internal portion of the nose will fill this in. Any other minor adjustments ( rasping) of the nasal bridge can be performed at time of rhinoplasty. Computer imaging will also help you visualize the anticipated result
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