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Keeping my low scooped-out bridge. Will I have to use ear cartilage? (Photo)

I would like a less blobby & upturned nose – but with my dorsum untouched. (Fear of warping/rib removal/long-term effects of implants + I want subtlety & quite like button noses + There's always Juvederm!) I tried simulating 1) cephalic trim 2) tip rotation and 3) alar base reduction. Horrendous Photoshopping aside, would something to this effect look achievable to you? What physical factors would determine whether this is possible? Will I have to use ear cartilage? Thank you for your opinion!

Doctor Answers (7)

Non-surgical rhinoplasty is an excellent alternative.

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Dear Ffcx in Germany; I recently returned from Berlin and found that some physicians are aware of our current techniques in the United States for non-surgical rhinoplasty. Regarding the use of rib cartilage or ear cartilage: you're correct in being concerned about warping and other unforeseen consequences. I have been an advocate of using non-surgical injection techniques to correct deformities such as yours. Using a filler, particularly a permanent filler, is not appropriate for everyone and is often used for non-surgical revision rhinoplasty. For you, it might make sense.The illustration certainly fortifies the concept with respect to raising the bridge. Non-surgical rhinoplasty works because tiny drops of Silikon 1000 are injected just under the nasal skin. Over time, the body walls off those drops with new tissue which provides the plumping action and fills in divots or marks in the nose. The same effect can happen with plain salt water to provide a preview how the nose will look on completion of treatment. The Kotler Saline Demo lasts perhaps two hours, but long enough to take a photo of what the finished nose will look like. 


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

Rhinoplasty questions and de-rotation of the nasal tip

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Thanks for this question.  The best approach would be to use septal cartilage to reshape the nose.  This cartilage can be used to rotate the tip down as well as to build up the dorsum.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tip Derotation Rhinoplasty

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What you are striving for is to lengthen and turn down the tip of the nose. Such a maneuver will allow you most likely to get away without doing anything to the dorsum. However be aware that it takes a substantial driving force to rotate the tip downward with your thick skin. Using the septum for a columellar strut and onlay grafting of the tip with ear cartilage may be enough to achieved that objective. It is also possible that stronger and more substantative small grafts from the rib may also be needed for maximal support. 

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.5 out of 5 stars 32 reviews

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+1
Thank you for the photos and your questions and the straight forward answer is that Yes you can get the desired result without the use of ear cartilage 

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Low Scooped Out Bridge

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If you decrease tip rotation and projection and do not change the bridge as you morphed you will increase the width of your tip which will not be desirable. Some augmentation of the bridge ( I would use diced septal or ear cartilage wrapped in fascia) will give you more definition an improve nasal proportions.

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Rhinoplasty for upturned nose bulbous tip and low bridge can help achieve your goals. See a very experienced rhinoplasty surgeon. 

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Keeping my low scooped-out bridge. Will I have to use ear cartilage?

+1
   Extended grafts can be used to lengthen the nose and the tip can be refined.  Septal cartilage can be used if available for the grafts.

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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.