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Which Surgeon is Right: Should I Narrow my Bridge or Add Cartilage?

asked 1 year ago by cindy h california in Beverly Hills, California
Latest answer by Michael L. Schwartz, MD
Question viewed 564 times
Tags: bridge, female, cartilage, narrow, options

I originally had rhinoplasty to narrow my bridge and remove slight bump. It's been 1 1/2 yrs since surgery ..I love my profile but my nose doesn't seem any narrower. I really am unhappy with the results with a photo flash (looks like a hook nose. I discussed with my original surgeon. He agreed to correct but wants to add cartilidge to bridge to give appearance of a narrower nose. I met with a second surgeon. He said my profile great and would go in and narrow more def not add anything to nose

15 answers to Which Surgeon is Right: Should I Narrow my Bridge or Add Cartilage?

Revision of the pollybeak nose with a wide lower bridge.

Revision of the pollybeak nose with a wide lower bridge can be done. I would not add to your bridge. Make sure you see an experienced revision rhinoplasty surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Nose wide

Getting that frontal view to not looked washed out in photos is all about shadows and contour. If your bones are wide then osteotomy may help, but often a small onlay graft can create the shadow and look. You might even need both. You could try some filler as onlay and see how you like the change. This would not be permanent and would not be very invasive but might help you decide what you like. Otherwise you have a nice result.

Michael L. Schwartz, MD
West Palm Beach Plastic Surgeon

www.palmbeachface.com

Adding Cartilage vs Narrowing Bridge

Dear Cindy: I would narrow the upper portion of your nose but I would not add cartilage to your bridge. You do have a depression in your profile above your tip which should also be corrected. Make sure you select a physician experienced in revision surgery whose results you like.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Narrow the nasal bones or add cartilage during Revision Rhinoplasty

From these photos (no proper profile shot), I can't tell if your nasal bridge is low or not. If the bridge is low and your nasal bones are short there is minimal room for further narrowing by rasping the sides of the bones or by breaking them and moving them closer together. An onlay dorsal implant would be required. If, on the other hand, the nasal bones are not short, osteotomies to fracture the nasal bones towards the midline would make the nose more narrow and would not require any... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Treating wide nose after rhinoplasty

I agree that your profile looks good in which case adding cartilage to it may be counter-productive. It looks like performing osteotomies to narrow the nasal bones would be a good course of action. If this was done during the first surgery it may not have produced adequate nasal bone narrowing.

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Nose to wide after rhinoplasty

From what i can see in you pictures, I would opt to revise your ostotomies and not graft cartilage. Cartilage grafts can be wonderful but, also cause problems

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Should I Narrow my Bridge or Add Cartilage?

From your profile view, your radix appear quite high and further addition of cartilage graft to your dorsum will adversely affect this. Your nasal width has not changed and one has to assume that your osteotomy if you had one, was not successful. A low lateral osteotomy should correct this.

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon

Video Rhinoplasty: You can add to your bridge to make it normal or just narrow what you have

I would really have to see more pictures form the side. But you should be able to narrow your nose through shaping the bone. Yes adding structure to your nose can narrow the nose but you have already had it taken down. I think just narrowing your nose would be sufficient. Also adding to your nose won't always make your nose thinner. You have to know what you are doing to achieve that. I've seen cartilage added that keeps the nose the same thickness! Thanks for reading... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

Wide dorsum

AS you take down the dorsal height, it can give the illusion of a widened dorsum and if you had osteotomies, it is often difficult to narrow it any more. A dorsal onlay graft may or may not givet he illusion of a narrower nose with the lose of the lower nasal height that you achieved from your previous rhinoplasty.

Steven Wallach, MD
Manhattan Plastic Surgeon

I would suggest digital morphing for both procedure before surgery

You have nice result and your nasal base is little wide in relation to your tip. I would suggest that you find a plastic surgeon who offers morphing. You can try both procedures virtually and see which one fits your face better. The combination of narrowing and cartilage graft may be the solution.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Should I narrow or add?

If you have a breathing issue I definitly would not do any more osteotomy without also adding some support, like a spreader graft. think of the dorsal onlay graft as improving the "line" of the nose making it cast a shadow more consistent with a "narrow nose". I do think the left osteotomy was less than originally needed. choose your surgeon and let him/her choose the plan. both may be required and sometimes doing one maneuver creates the need for a... more

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Which surgeon is right

You have two options. If you do not want to have slightly larger nose your surgeon can "rebreak" and reset your nasl bones tilted more toward the midline ( lateral osteotomies) .However if do not mind to have slightly larger nose a "dorsal" cartilage graft (crafted delecately ) is another proper option.

Fereydoon S. Mahjouri, MD
Minneapolis Plastic Surgeon

You may require osteotomies, without cartilage grafting, to narrow your nose.

I read your concern and reviewed your photos. Your before photo is very helpful. It seems like your profile looks great, but your nose looks too wide on your frontal view after your bump was removed. That widening is usually improved with osteotomies to bring your nasal bones closer to the midline. You should consult several reputable, certified rhinoplasty specialists to help determine what might be best for you. I hope this is helpful. Regards from NJ. see video

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

A higher bridge will look narrower

Your experience is a common one. When the nose is reduced by removing any skeleton, the skin has to go somewhere. If it cannot contract as much as patient and surgeon wish, the nose may look wider. Unless your surgeon did not do osteotomies to narrow your nose, fracturing it again won't accomplish much. I think that his suggestion of adding a thin dorsal graft is right. By the way, you otherwise have a very nice result.

Mark B. Constantian, MD
Nashua Plastic Surgeon

Either Solution Can Work

We often times may augment the dorsum of the nose (add cartilage or other material to the top of the nose) to give it a thinner appearance. However, in looking at the photos provided, it appears that the middle third of the nose is wide relative to the tip. If you are satisfied with your profile and with the width and shape of your nasal tip, I would agree with making the nose more narrow by resetting the bones (in-fracture, breaking the bones) to make them less wide from the front... more