I had a previous rhinoplasty consisting of osteotomies to narrow and raise the bridge. I now find that after months of healing, that I now have a pinched appearance. I have heard of two methods to correct this: place onlay grafts along the side walls of the nose to widen, or to re-break the nasal bones again to rewiden them. Do both techniques create the same cosmetic results? Thanks for your help!
Do These Two Procedures Result in the Same Cosmetic Result for Rhinoplasty Bridge Work?
Doctor Answers 6
Revising a "pinched" nose
I am sorry that you are not satisfied with your results.
However, without physical examination it is not possible to recommend one procedure and not the other.
Both procedures will lead to similar results depending on where the pinched area is located, but the outfracture method could be more inclusive.
I encourage that you consult with board certified surgeons of extensive experience in that field.
Best of luck to you and thank you for your inquiry.
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Pinched nasal bones correction
If the nasal bones look pinched along the top of the dorsum, than outfracture (this will require rebraking) and placement of spreader grafts should fix the problem. If the bones are pinched at the nasofacial junction, then either the outfracture or onlay grafts should provide you with similar results. I would probably recomment oufracture as onlay grafts in that area are not easy to secure.
Pinched nasal deformity
A pinched look can mean a lot of different things and each requires its own treatment. This can mean the tip of the bridge or middle vault. An exam in person is key. Good luck.
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Pinched Nasal Bridge after Rhinoplasty
You may need both procedures. Medial osteotomies will open the nasal bony vault, to keep this open, you may require spreader cartilage grafts. The spreader graft can span the nasal bony vault to the upper lateral cartilages.
Theoretically these will do the same thing. I think it is more difficult to move the nasal bones out in a predictable fashion. I prefer cartilage with fascia grafting. Donald R. Nunn MD Atlanta Plastic Surgeon.
Procedures for Revision Rhinoplasty Bridge Work
Both of these procedures may achieve the same results depending on who is doing the work. You are frustrated at this time because you had an unfortunate experience with your previous surgery. However, pick the surgeon not the technique to achieve the best results.