Narrowing Wide Nose, Where Nasal Bones Don't Connect over Bridge & Nose is Mostly Cartilage

I consulted a Surgeon who told me that my nose is abnormal in that it is made up mostly of cartilage and the nasal bones connected to my cheeks do not connect over the bridge (they are almost like "wings"). He referred me to a surgeon dealing solely with rhinoplasty; however, I'm curious if there are known complications associated with narrowing (which potentially involves breaking) a nose with these characteristics. Any specific questions/concerns I should voice to my new surgeon?

Doctor Answers 12

Short Nasal Bones

It sounds like you are describing a nose with short nasal bones and an open roof deformity. If these bones are broken and repositioned  during Rhinoplasty, there is a potential for a collapse of the middle of the nose immediately below the nasal bones unless grafts are placed to support this area. You are doing the right thing by selecting a very experienced rhinoplasty surgeon for your consultation

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Narrowing wide nose when nasal bones do not meet on nasal bridge

If the nasal bones are not connected to the midline at the top of the bridge, then by definition that is an open roof deformity.  The only way to correct this is to perform osteotomies, which is when the nasal bones are surgically broken.  It is important to go to a very experienced rhinoplasty surgeon who has successfully operated on many noses similar to yours. 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Narrowing wide and short nasal bone

It is difficult to render an opinion or even suggest a treatment without physical examination or at least reviewing some of your facial pictures. However, based on your descriptions you have a short nasal bone that requires an expert rhinoplasty surgeon to correct it. Good luck. Dr. Kevin Sadati

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Rhinoplasty for short nasal bones

without photos   it is very difficult to offer a good answer:

  1. choose a very experienced surgeon
  2.   an open rhino may be needed
  3. grafts may be needed
  4. there is always a solution

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Wide nose with absent cartilage

Your question illustrates what the challenge is to be a true rhinoplasty surgeon. Rhinoplasty is not a cookbook procedure and you can't use the same technique on every patient. An experienced rhinoplasty surgeon is comfortable with many techniques and can apply them to different situations as they present themselves. You are describing short nasal bones with a possible open roof. Yes if not recognized and prepared for there are specific complications that can occur with this situation. A surgeon with interest, dedication and experience with rhinoplasty will recognize this and be prepared.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Narrowing Wide Nose, Where Nasal Bones Don't Connect over Bridge & Nose is Mostly Cartilage

I have performed Rhinoplasty for over 20 years and have seen patients with very short nasal bones but never one without any nasal bones.  IMHO, you should have a couple of consultations, for Rhinoplasty, with experienced Rhinoplasty Surgeons.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Narrowing Wide Nose, Where Nasal Bones Don't Connect over Bridge & Nose is Mostly Cartilage

I recommend enclosing a frontal and profile pictures in order to be able to give a rather partially informed comment. Otherwise, we will have to speculate on what the problem is which will not help at all. 

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Rhinoplasty and nasal bones

Syndromes and/or birth defects wherein the nasal bones do not fully develop are very rare.  I suspect there is something lost in the translation and you probably don't have one of these more significant issues.  Regardless, a Board-Certified Facial Plastic surgeon has likely seen most variations in the nasal bone and cartilages.  If there is something more substantial, make sure your surgeon has seen your variation.  Also, it would be useful if you surgeon has sat on a Cranio-Facial panel before.    

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews


Your doctor's description doe not make sense. However, it seems as though he is describing an open roof deformity seen after poorly done rhinoplasty. lateral osteotomies should correct this

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Rhinoplasty issues

It is hard to say what may or may  not be an issue without an exam. In general the nose is about 1/3 bone and 2/3 cartilage for the dorsum. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.