Is it Possible to Narrow Nose W/ Short Nasal Bones? (photo)

Your posted photos show a typical thick skinned, wide bridge nose with a polybeak due a bit of excess septal cartilage at the lower front aspect of the cartilage. You say the general plastic surgeon referred to a rhinoplasty specialist because of anatomical concerns but you do not say if you saw the specialist or what he/she said.

The nasal bones are considered short when the lower edge is less than half the distance from the radix to the septal angle. The outer lower ends of the lines you drew is below the half way point therefore you do not have short nasal bones if the extent of the line is correct. The concern with short nasal bones (which you do not have) is if you have an open roof, separated lateral cartilages from the septum and an infracture you will get airway collapse. Spreader grafts are required in those instances to prevent the collapse.

Secondly you write that within the outline is cartilage and outside of it is bone. That is not normal human anatomy and is not consistent with your photos that show a keystone area (cartilage bone junction) almost at the midpoint of the bridge.

What your post does corroborate is the danger that a little knowledge in the wrong hands can be warped into something that it is not and that this situation is more come in a world with an internet. Your case is not so much out of the ordinary and I think any of the surgeons responding to this post could achieve a good result with normal rhinoplasty modalities.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

I read your concerns and reviewed your photos:

I doubt that the outline you drew on your nose is accurate. Only an examination could determine the extent of your nasal bones, but I doubt your entire nasal bridge is cartilaginous.

Consider consulting several rhinoplasty specialists to see what you might expect to achieve after well-performed Rhinoplasty Surgery. My hunch is that you might achieve adequate narrowing and tip refinement.

I hope this is helpful.

Dr. Joseph

Revision rhinoplasty for the wide nose can be done even if you have short nasal bones. The bridge, mid vault and tip can be narrowed and properly supported even if you have underdeveloped nasal bones.

For 35 years I have done noses like yours with the open approach which allows the surgeon to have a better view of the problems and suture grafts in place, etc.