What Needs to Be Done when the Bridge Doesn't Fit with the Rest of the Nose? (photo)

I've always thought my bridge didn't fit with my face in general or my nose. The bridge is the only part that protrudes and it feels wide so when i smile it makes the rest of my nose quite wide too. I feel it takes up too much of my face. Would a doctor have to shave the sides of the bone down? and if so would that drastically alter my face? I just wish it would complement my overall look rather than make me self conscious. I attached some pictures to give you a better idea. What do you think?

Doctor Answers 9

Nose and facial proportion.

Dear Howl.
You have raised an excellent point.  One of the key points in facial and specifically nasal aesthetics is proportion.  Specifically, the nose needs to be appropriately sized to the remainder of the face in order to achieve the best possible aesthetics.  In your particular situation, I agree that perhaps your nose is slightly large (in all 3 dimensions: length, width and projection) relative to the rest of your face. 
The size of the nose is determined by 3 main features:
  1. Nasal Length.  The distance from the nasion to the tip.  The nasion is the deepest point at the breakpoint between the forehead and bridge of the nose.
  2. Nasal Projection.  The distance that the nose extends beyond the adjacent facial structures.  This can be measured at three main points a) nasion - the deepest point at the angle between the forhead and bridge of the nose, b) rhinion - approximately midway down the bridge of the nose where the nasal bones meet the nasal cartilages, c) tip - the most proturding point at the lower third of the nose.
  3. Nasal Width.  The width across the nose from right and left.  Nasal width should be assessed at several points on the nose:  a) basal vault with - the width across the base of the middle vault of the nose, b) dorsal vault width - the distance across the bridge of the nose, d) nasal base width - the distance across the nostrils, e) tip width - the distance between the tip defining points.
There are several methods to individually measure and analyze nasal length, projection and width within the context of the remaining facial measurements for each patient.  By doing this we determine if the persons' nose is meets the ideal proportions to the rest of the face.  It is also a useful tool to quantify the changes that need to be made during surgery.
I would encourage you to visit a qualifed and experienced surgeon to review in detail an analysis of your nasal-facial proportion and to explore what changes are possible.  In the vast majority of patients, predictable changes can be made to all of the measurements described above. 
Good Luck, Mario J. Imola MD, DDS, FRCSC. FACS

Denver Facial Plastic Surgeon
4.8 out of 5 stars 116 reviews

Treatment of wide nose with rhinoplasty

From your photographs you appear to be an ideal candidate for rhinoplasty . This would narrow and reduce the nasal hump. The tip of the nose also needs to be narrowed to help reduce the overall bulk of the nose and provide a smooth transition from tip to base. I would find a plastic surgeon who specializes in noses and go over some computerized imaging with him/ her prior to your surgery to make sure you are both on the same page.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 40 reviews

Rhinoplasty and Nasal Proportions

While you are understandably focused on the bridge component of your nose, the reality is that you nose lacks overall proportion between the tip and the bridge. There is not a flowing and smooth transition between the three major elements of your nose. If there were, you would not notice the bridge at all. You really need a more complete rhinoplasty to achieve your goal of a more balanced and proportioned nose. This can be shown to you through computer imaging as to what would happen if you just did the bridge alone versus doing the entire nose. That would be a very important part of any rhinoplasty consultation.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

What Needs to Be Done when the Bridge Doesn't Fit with the Rest of the Nose?

From the photos, the nasal bones appear to create a dorsal hump and the junction of these bones with the upper cartilages is quick thick and pronounced.  You have two choices in dealing with this situation during a closed Rhinoplasty.  You can break the bones and remove the bony hump or they can be rasped sown slightly without breaking the bones.  The latter will give less thinning than breaking the bones.  You should be able to discuss this during your Rhinoplasty consultation and if you're under 18, be sure to bring your parents to the consultation.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Good candidate for a rhinoplasty

Thank you for your inquiry!

It seems that you are a good candidate for a rhinoplasty that will improve the way your nose looks to complement your facial features in a natural fashion. Based on the pictures provided, the surgical approach has to include the different aspects of your nose to obtain a harmonious result. However, without a physical examination it is not possible to provide you with specific details. I highly recommend that you schedule a consultation with a well-experienced surgeon.

It is important to mention that the finest cosmetic results in any particular case are based on a variety of factors, including: the unique anatomy of the patient, realistic expectations, a well-informed and detailed discussion with your plastic surgeon concerning the best options for you especially covering a deep understanding of the pros and cons of any given choice you will adopt.

Please keep in mind that following the advice from a surgeon online who offers to tell you what to do without a physical examination covering the nature and the status of the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative solution would not be in your best interest. With that in mind, it is the safest and for your best interest to find a plastic surgeon with solid experience and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.

Good luck!!!

Ali Sajjadian, MD FACS

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 195 reviews

When nasal bridge does not fit remainder of nose

According to the picture shown, the tip and the bridge are both exceedingly wide and asymmetrical.  Narrowing of the tip can be performed along with osteotomies to narrow, straighten and realign the nasal pyramid.  Any hump can be removed at the same time so as to give a symmetrical natural looking nose, but still breathes properly.  Significant narrowing of the midthird of the nose and the tip can improve the aesthetic look to the nose through a closed rhinoplasty procedure.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Bridge refinement in rhinoplasty.

You are correct. Your nose is too wide and it can be narrowed to look better without drastically changing your face. In addition, you need upper lateral cartilage grafts for your inverted V deformity.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews


In general a full exam needs to be done in person, but it looks like from the photos that you have thick skin, and wide features.  It looks like more than just the bridge.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Nasal Bridge

Every nose is different and needs to be customized to achieve the goals you desire.  I would recommend that you seek out a consultation with a board certified specialist in the face who can address your concerns in a more private setting.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 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.