Can my Nose Be Widened and the Dorsum Raised 2-3 Mm After Revision?

Question

I've had one revision using a rib spreader graft and ear for the tip. My nose was broken and made skinnier but it totally changed the proportions of the nose. If my skin is okay with this change, can my dorsum be widened again? What way is most likely best (grafts, technique) if possible? Can I get a raised dorsum too?

Sam Naficy, MD, FACS · Answer

Yes - the dorsum can be both raised and widened.  It would likely require use of another rib graft - but this time not as a spreader but as an onlay graft

Thomas A. Lamperti, MD · Answer

Without seeing your nose it's hard to say whether dorsum elevation and widening is possible (or advisable). It may be possible to do using additional graft material (or possibly even with injectible filler).

	Wait until you're at least a year postop to discuss your options with your surgeon.

Steven J. Pearlman, MD, FACS · Answer

It is impossible to render an opinion in a Q&A format on line when someone has had a primary then revision rhinoplasty, especially one that required rib cartilage for reconstruction. I suggest you see a specialist in revision rhinoplasty to see your best options. It would be helpful to bring the operative notes and photos as well.

Eric M. Joseph, MD · Answer

I read your concern. In my practice, Silikon-1000, an off-label permanent filler, may be used to raise the height of the bridge of your nose, and widen the bridge of your nose. This may be a better option for you than a third rhinoplasty surgery. Procedures are performed with topical anesthetic, and there is no downtime.

	Feel free to email or post your photo, and I'll be happy to share my thoughts with you.

Peter E. Johnson, MD · Answer

All that you ask for, a higher bridge and some widening can come true, however considering a third revision in one who is running thin on graft material, you should carefully consider the risk. A rib graft may again be needed for a well shaped and straight nasal bridge. Try out the result with computer imaging to be sure the effort is worth it.
	Best of luck,
	peterejohnsonmd

Richard W. Fleming, MD (retired) · Answer

You can widen and raise the nasal bridge with a revision rhinoplasty. Consider the use of temporalis fascia or fillers to accomplish your goals - see an experienced nasal revision surgeon.

Can my Nose Be Widened and the Dorsum Raised 2-3 Mm After Revision?

Answers (6)

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