Adding Height for Flat Asian Nose

Hello,
Initially, I would set the projection of the nasal tip, then increase the dorsum. There are always limitations. I don’t stack rib. I use diced cartilage and inject it along the dorsum. Hope this helps answer your question. Thank you and best of luck.
Dr. Nassif

A considerable limitation in obtaining additional nasal bridge height is the skin. Furthermore, adding a thick graft may compromise the ability of the blood supply to provide nourishment to the deepest portions of the graft. Ulimately, this may result in death of the cartilage and possible loss of height thereby defeating the intial goal.

 This can be done many ways. Over the past 30 years I have almost always used septal or ear cartilage and not rib. Silastic can be used but can become infected since it is a foreign material. See an experienced rhinoplasty surgeon who can show you before/after photos of his work with noses similar to yours.

Building up the bridge on a flat Asian nose, as you described is limited by the aesthetics and limits of the skin envelope of your nose.

Injecting sterile water is one way to simulate the appearance and your surgeon may be able to do this procedure for you. Rib grafts are an option, but there are other options as well.

Most Asian rhinoplasty procedures involve inserting synthetic or natural tissues in the bridge of the nose to give more dorsal height. Cartilage from the nose, the ear, and/or rib, can be used. However, triple-stacking is sometimes necessary and uneven edges can occur due to this.
The smoothest, most effective, and simplest is to use a Silastic implant. These can easily be removed and replaced, upsized or downsized, with minimal downtime. There are some limitations to how high a flat Asian nose can be augmented. Stretching of the skin can leave a very shrink-wrapped effect when too much implant is placed, and synthetic implants can then become infected.

The limitation on augmenting the nasal profile is establishing proper proportion and balance with the tip and other facial structures. I rarely use rib cartilage, prefering septal or ear cartilage, but this is one alternative.
Silicone products are popular in Asia, but problems with infection or extrusion are possible. An experienced rhinoplasty surgeon with good aesthetic taste will guide you in the decision-making process.

The best way to raise the height of the nasal bridge is to use autogenous septal, ear or rib cartilage from your own body. Tissues from another person or artificial or foreign materials carry a much higher complication rate.


Septal cartilage comes from inside the nose but the supply is limited, so it is used mainly when a mild increase in height is needed.

Ear cartilage which also has a limited supply can be used but it is difficult to obtain a straight piece because it has a convoluted surface. After the swelling has subsided, these convolutions can cause the bridge to appear and feel irregular.

Rib cartilage has an abundant supply and can be carved into the same shape as a normal appearing bridge. Its biggest problem is that it has a tendency to warp. To keep it from warping, a small stainless steel straight pin can be buried in the cartilage to keep it from warping which in an excess of over 500 rib cartilage cases, there has been no warping or extrusions.

Hi,
The short answer is, no there is no limitation to the height of the nasal bridge augmentation. Personally, I like to use a custom carved silastic implant. Silastic implant will not warp and can be fashioned to fit the right height and shape.
Best,
Dr.S.