Reducing Nasal Bridge Height Without Looking Unnatural?

What techniques are used to slightly decrease bridge height/width of the nasal bony pyramid? Could the surgeon be over agressive and make it too narrow?

I'd also like to increase my nasolabial angle a little, would it be simple enough to just shorten the caudal part of the septum and barely overlap the lower lateral cartilages? Thanks.

Doctor Answers (13)

Rhinoplasty - Narrowing the Bridge

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If you are looking for a conservative change to your apperance then that can be performed by careful rasping of the dorsum of the nose. The question is - how much can the dorsum be reduced without looking too wide? At some point narrowing of the bridge by perfoming an infracture of the nasal bones will be necessary. As for the lip/columella relationship the answer depends upon factors such as lip length, anatomy of the nasal spine and the prominence of the septum as well as the tip position - everything is related and works best when in good proportion. However your requests seem quite typical and it just remains to find a surgeon with whom you can communicate and in whom you trust to make the changes you want. Best of Luck

 


Miami Plastic Surgeon
5.0 out of 5 stars 30 reviews

Reducing the nasal bridge and rotating the tip in rhinoplasty naturally

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A natural, harmonious result should be the goal. The specifics of how to achieve this will depend on your anatomy, facial features, and the experience of the surgeon. Thus, it is paramount to discuss options with someone who has experience and who can help guide you through the process. Computer imaging may help.

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Nasal bridge height reduction method

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Decreasing bridge height is attained by rasping and filing the nasal bridge down, however it can only be filed down approximately 2 or 3 mm before a square top or open roof deformity will result. If that results than osteotomies need to be performed to narrow the nasal bones and close the defect. It is possible to increase the nasal labial angle of the nose through a simple caudal septal margin resection of both membranous and cartilaginous septum. We do not overlap the lower lateral cartilages because that will result in a bulbous lateral tip, which is undesirable.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

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Natural result after rhinoplasty

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The ultimate goal of rhinoplasty, regardless of approach or technique, is a natural proportional result. The changes you describe are routine to an experienced surgeon, regardless of the techniques used by that individual.  Select the surgeon, not the approach.

 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
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Creating a natural nose with rhinoplasty.

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We pioneered the open rhinoplasty approach 35 years ago. Having said that, the skill and experience of the surgeon is what makes a natural, good rhinoplasty, not the approach. Look at the kind of noses the surgeon does, not computer imaging. Better yet see live patients the surgeon has done. That is your best chance of getting a very good nose.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
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An open rhinoplasty allows the most accurate correction for your nose

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An open rhinoplasty allows the most accurate assessment and correction of your internal nasal anatomy. The dorsum could definitely be lowered and the width narrowed. And yes, it is possible to overdo the changes, so discuss your goals with your plastic surgeon. Imaging is a good way to communicate. In my experience, it is usually not necessary to shave the caudal septum to achieve tip rotation. Rather, the tip can be fixed in the proper rotation with suture techniques, suturing the lower lateral cartilages to the appropriate level on the dorsal edge of the septum. Again, discuss with you plastic surgeon.

Michael D. Yates, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 3 reviews

You're asking for commonly performed Rhinoplasty maneouvers

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And this is good. Reducing the bridge is often done during rhinoplasty. The two commonest techiques are chiseling and filing. And sure too much can be taken off. Plus the bridge can be made too narrow (although that's less common a problem).

Rotating the tip is often the method used to open the nasolabial angle. Here there are many, many techiques. So many that its often a question on our specialty exams! Although the ways surgeons achieve the results are interesting, your task is to find one who will be able to make the changes you want. Good luck.

Oakley Smith, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

You can have your bridge lowered and your tip rotated with Rhinoplasty Surgery.

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If the bridge of your nose is too high, and if the angle of your nose and upper-lip is too small, then it sounds like you're a good candidate for Rhinoplasty Surgery. In fact, these are some of the most common conditions I treat with Rhinoplasty Surgery.

Obtaining a natural, un-operated result is dependent on the experience of your surgeon, the thickness of your skin, and the stiffness of your nasal cartilage. In that regard, you should consult several board-certified, experienced Rhinoplasty specialists to see if surgery is right for you.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 270 reviews

Subtle rhinoplasty (nose job) changes

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Clearly you have an  in depth understanding of the anatomy. I would meet with several qualified rhinoplasty surgeons to discuss your preferences and their solutions. A subtle rhinoplasty is possible. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Precisely Performed Rhinoplasty

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From the way this question is phrased you either spent a lot of time reading up on Rhinoplasty surgery OR you must be in the medical field.

What techniques are used to slightly decrease bridge height/width of the nasal bony pyramid? - Rhinoplasty should be done incrementally but WHAT is done depends on your complete presentation and cosmetic goals. While the dorsum can be lower minimally with some rasping, a real narrowing of the nasal pyramid would require in-fracturing.

Could the surgeon be over aggressive and make it too narrow? - Poor results can be achieved in Rhinoplasty. Pick your surgeon carefully and make sure he fully understands what you want done.

I'd also like to increase my Nasolabial angle a little, would it be simple enough to just shorten the caudal part of the septum and barely overlap the lower lateral cartilages? - This can be done in several ways, from repositioning and upward rotation of the tip complex, to, as you suggested, shortening the caudal septum and reducing columellar show.

Again - pick a Plastic surgeon who shares and understands your cosmetic goals.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

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.