Is it possible to strengthen the radix? Rhinoplasty + tissue graft (Photo)

Question

I have a radix which is too thin for my liking and would like it strengthened to match the width of my nasal bone, to have continuity. One surgeon confidently suggested using a fascia graft as a viable, permanent solution. Whilst another surgeon recently told me that it would look unnatural with visible edges, leaving me very disappointed. I would like to know what else could be done and am open to other permanent alternatives, whilst aiming to look natural. Please let me know.

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination. Yes it is possible

John Michael Thomassen, MD · Answer

Fat grafting would be an easy way to widen your radix without the risk of osteotomies or cartilage grafts which could leave palpable irregularities in this area.

Ronald J. Edelson, MD · Answer

You might try fillers before even having a surgical rhinoplasty. Otherwise the fascia  could work well

Zoran Potparic, MD · Answer

Placement of fascia graft in the area, if properly done, is a very good option to augment narrow radix. One can also think of crushed cartilage or even bone grafts. The easiest solution would be a filler; that may be the way to start with, just to see the effect of radix augmentation. Good luck.

Eric M. Joseph, MD · Answer

Based on your photos, I can see that the upper nasal bone area is a bit narrow, and on profile, the root of your nose is a bit deep. Depending on your examination, microdroplet Silikon-1000 injections may be considered for widening the narrowed area on front view, and camouflaging your bump on profile. Several treatments at monthly intervals are longer might be necessary for a desired result. I hope this helps! Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

The radix is a bony structure with a skin covering. It looks like your radix is significantly compressed. An alternative would be bone grafting to smooth it out. Another alternative, since you already have an upper forehead incision, would be to to turn down a flap of deepithelialized skin after the outer surface is removed and lay that in there. This would be viable skin and could fill in the defect. Tissue graft is another alternative and a fascial graft should not leave visible edges if done properly.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Steve Laverson, MD, FACS · Answer

Good question with photos.  Your first step (my opinion) should be temporary solution with high G prime hyaluronic acid (HA) filler on sides and possibly top of radix, Juvederm, Perlane/Restylane, or other.  You'll develop an understanding of what result to expect and the exact look you like and/or dislike.  Filler can be easily adjusted.  Calcium hydroxyapatite (Radiesse) is another suitable alternative filler that eventually resorbs but isn't easy to reverse as HA is. Once you know what you like, diced cartilage in fascia, porous polyethylene (Medpor radix), silicone, or other implantables can be fabricated for a permanent result.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a radix graft consisting of diced cartilage wrapped in fascia. This can be designed to have a smooth contour. With good surgical technique, you could have an outstanding result. 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

Is it possible to strengthen the radix? Rhinoplasty + tissue graft (Photo)

Answers (8)

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