Can the radix of someones nose be lowered/flattened?

Question

Can the radix be lowered to create more separation between the forehead and nose? And if the radix is reduced, would that limit how much of a curve/slope the nasal bridge can have?

Semih Yildiz, MD, FEBOPRAS · Answer

A high or prominent radix can sometimes be lowered during rhinoplasty by carefully reducing the upper nasal bones. This may deepen the nasofrontal angle and create more visual separation between the forehead and nose. The amount of reasonable reduction depends on bone thickness, skin and soft-tissue thickness, the position of the eyes and brows, and the underlying frontal and nasal anatomy.

Lowering the radix need not eliminate the possibility of a curved or sloped bridge. It changes the starting point of the dorsal profile, so the surgeon may need to blend the bony and cartilaginous bridge into a continuous line. Depending on your anatomy and goal, other parts of the dorsum may require reduction, preservation, or grafting to reduce the chance of a step-off or an overly scooped appearance.

This area can be less forgiving than adding height to a low radix. Excessive reduction may create contour irregularities, a harsh nasofrontal angle, thin soft-tissue coverage, or an unnatural break between the forehead and bridge. Standardized profile photographs and computer imaging can help define the desired starting point and slope, while the final contour still depends on healing.

Consult a rhinoplasty surgeon experienced in bony vault and radix work. Examination or appropriate imaging can help determine how much reduction is anatomically reasonable and how it may affect the rest of your profile.

Eric M. Joseph, MD · Answer

Radix is the angle between the top of the nose and the forehead bone. We have found that the bone of the Radix can be very thick, like the forehead. In that regard, filing it can sometimes lead to limited results. Please consider meeting with several reputable rhinoplasty specialists who offer computer Imaging, so you could see what to expect. I hope this helps! Sincerely, Dr Joseph

Ramin Behmand, MD, FACS · Answer

Yes, the radix can be lowered to create more separation between the forehead and nose, which often softens the profile and improves facial balance. It doesn’t limit how much slope the bridge can have, but it does need to be done carefully—too much reduction can make the nose look scooped or unnatural.

Also, lowering the radix naturally widens that part of the nasal bridge—not because the surgeon is widening it, but because of the pyramidal shape of the nasal bones. As you move lower down the nasal pyramid, the bones flare out more. That subtle widening, along with the lowered radix, can create the illusion that the eyes are slightly farther apart. It’s just an optical effect, but it’s noticeable.

-DrB

Kyle Kimura, MD · Answer

This is a great question! 
The radix can be both lowered or raised during a rhinoplasty based on your goals. These changes can make fairly substantial differences to the appearance of the length and profile of the nose. For example, if the radix is raised/elevated it can give the nose a slightly longer appearance (beneficial in some) as it changes the "starting point" of the nose. Similarly, you can lower the radix during surgery to give the appearance of a slightly smaller nose or to change the overall profile. 
There are certainly many nuances of this part of surgery and is best discussed during a consultation with your rhinoplasty surgeon via photo simulations to show how this would change the overall apperance of the nose. 
Hope this helps and best of luck! Kyle Kimura, MD

Ajaya Kashyap, MD · Answer

Thank you for your query. As you have rightly suggested, the nose should start from between the eyes and not the brows, so lowering of the radix is often important and is done frequently. This will not limit correction of other aspects of the nose. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Guray Yesiladali, MD, FEBOPRAS · Answer

Yes, the radix (nasal root) can be lowered surgically to create a clearer separation between the forehead and nose, especially when the radix is naturally high or blends too smoothly into the glabella.
Here’s what to know:
Radix reduction involves shaving or reshaping the upper nasal bone and adjacent cartilage to create a more defined starting point for the nasal bridge. This can enhance facial balance and improve the overall nasal profile.
However, lowering the radix does influence how much slope or curvature can be created in the bridge:
A lower radix leaves less room for a deep concave slope without risking an unnatural or over-resected appearance.
Surgeons often find a balance &mdash; lowering the radix just enough to create separation from the forehead, but not so much that it restricts a harmonious dorsal aesthetic line.
In expert hands, the radix can be carefully lowered while still allowing for an elegant, natural-looking bridge contour. It’s a matter of proportion, anatomy, and planning.
A thorough consultation with a rhinoplasty specialist &mdash; ideally with digital simulation &mdash; can help clarify how your radix position affects your ideal profile.
&mdash; Güray Yeşiladalı, MD

Philip S. Schoenfeld, MD, FACS · Answer

In a nose with a high dorsum often times there is no clear ending of the forehead and beginning of the nose.  Lowering the radix will create a more acute naso frontal angle and actually give the appearance of not only reducing the hump but also shortening the nose.  The amount that the radix can be lowered is substantial and you can have whatever slope to the dorsum you would like.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Depending on your individual anatomy, the radix can usually be lowered. A lot of this will depend on your facial proportions and goals. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Zoran Potparic, MD · Answer

Reduction of radix is very useful procedure to lower and shorten the nose visually. The extend of reduction may depend of dorsal height, forehead prominence, frontal sinus expansion and overall facial balance. In person consultation with a board certified plastic surgeon with expertise in rhinoplasty is recommended. Good luck.

Steven M. Denenberg, MD · Answer

Google "Roman statue face" for images to see a very high radix. The radix is made of bone, but can be lowered substantially in a rhinoplasty. It doesn't change how the rest of the bridge is handled: we do some morphs to make a plan, and then follow that plan during surgery.

Can the radix of someones nose be lowered/flattened?

Answers (14)

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