Ethnic Rhinoplasty: would an osteotomy, alar, and tip plasty create an illusion of high nose? (Photos)

Question

Hi, I was wondering if osteotomy + alar + tip would create an illusion of high nose. I am afraid I do not have enough ear cartilage. Is it also possible after the surgery to get a filler for a high nose bridge? Or, what would you recommend?

Tanveer Janjua, MD · Answer

The combination of alarplasty to narrow the nostrils, osteotomies to narrow upper half and tip plasty to lift up the tip will make the bridge look stronger and higher. There is no need for using ear cartilage. RegardsDr. J

Ronald J. Edelson, MD · Answer

Your nose can be narrowed with osteotomies and your nostrils narrowed with alar wedge excisions.  I’m not sure that a dorsal bridge graft is going to be necessary.  It really complicates the procedure considerably and it is difficult to get it to look natural.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty which can be performed by trimming, suturing, and reshaping the cartilage in your lower nose. You may also benefit from soft tissue debulking of your nasal tip and alar base reduction.  Dorsal augmentation can be performed with diced cartilage wrapped in fascia (DCF).  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon.
 
 Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Victor Manuel Agudelo, MD · Answer

Hello,
In cases as yours, a dorsal augmentation is  definitely necessary, in combination with tip lifting, narrowing and alar plasty. The dorsal augmentation can be done with your ear cartilage (diced cartilage and fascia), which will provide the required height with natural looking results.

Barry L. Eppley, MD, DMD · Answer

While all of the rhinoplasty maneuvers you have mentioned may be beneficial in your case, they will not create a high nose. You will need to build up your nose using etude a rib graft or an implant. Only some form of dorsal and tip augmentation is going to raise the height of your nose throughout its length.

Ethnic Rhinoplasty: would an osteotomy, alar, and tip plasty create an illusion of high nose? (Photos)

Answers (5)