There are many different types of flat nose, so it’s wrong to think that there’s just one type with one surgical solution. The nose can be flat at the top because you’re born with broad, wide nasal bones and you have to work out whether you have to bring the nose together at the base where it meets the face, or you have to bring it together the bridge, or do you have to do both? There are different techniques for either of those. You will also have to work out is it the cartilage bit, that’s the lower half the nose, that’s flat?This is often what we might call a boxer’s nose or a saddle nose because when you look from the side there is a dip in the bridge of the nose, just above the tip and this is often because of septum injury.So in these cases a surgeon needs to be able to know how to rebuild and reconstruct a saddle nose, these can be really quite complex operations. It’s not unusual for me to have to use rib cartilage and even scalp lining to rebuild the nose in these difficult cases. These aren’t cases for everybody and I often have other surgeons referring me these difficult cases.