Do dorsal onlay grafts help with borderline piggy noses?

Dorsal onlay grafts are typically used to increase the height of the dorsum (dorsal augmentation) or smooth out the dorsum. In your case, it sounds like you have a short nose and overrotation of the tip allowing for excess nostril show. If this is the case, you may require techniques that derotate the nasal tip and lengthen the nose (e.g., caudal septal extension graft, extended spreader grafts). Additionally, you may also need techniques that lower the nostril rims (e.g., lateral crural strut grafts, alar contour grafts). You would probably find it beneficial to consult with a board certified plastic surgeon that performs rhinoplasty frequently to discuss your concerns and possible options to address them.

A dorsal onlay graft alone would unlikely resolve the upturned nasal tip.  There will likely be need for caudal septal work and possible revision work on the lower lateral cartilages.  A consult with a local plastic surgeon that performs rhinoplasties will be your best option.  Good luck and be safe.John T. Nguyen, MD, FACS, FICSDouble Board Certified Plastic Surgeon

Dorsal onlay grafts can be placed on top of the nasal bridge to build it up. A stronger looking bridge will make the nasal tip look less up-turned. The grafts are usually cartilage take from the nasal septum and occasionally from another location depending on the need. The most important step is analyzing the nose and developing an appropriate treatment plan.  You should consult with a surgeon experienced in rhinoplasty.  Good luck,Dr. Kaniff