What Are my Options for Building Up the Bridge of my Nose?

Question

From the side, the bridge of my nose is lower than the tip. From the front, my tip is rather round (take a look at my other post for a front-view photo). I'd like to make my tip look thinner from the front while building up the bridge slightly, just so my nose makes a straight line from the tip to between my eyes. Which is the best option - using nasal cartilage, ear cartilage, or a silicone/Gore-tex implant? Also, will thinning the tip increase the spread of my nostrils (which I don't want)?

Aaron Stone, MD · Answer

You have the typical Asian nose. If you just want the bridge elevated withoiut any changes to the tip that is easily done. That would involving placing something under the skin of the bridge. You can choose from silicone, goretex, porex medpor and your own cartilage. Each material has its own pros and cons. Silicone is easy to place or remove but can slip, become infected our push out/extrude because its shape memory may not match the nasal contours. Goretex is soft easy to place and molds better to the surface contour but can become infected. Your own cartilage is the cheapest and less likely to shift or slip but can warp years later. It also involves an incision somewhere else on the body and if ear cartilage is used in an Asian in my experience you will need cartilage from each ear in order to get enough cartilage. Medpor is less likely to shift if it becomes incorporated and can be temporarily softened threw heat to be form fitted to the patient's surface contours. Once it cools to body temperature it will retain the shape it has been molded into. It's cons are the surgeon has to be used to working with it, if the molding is inadequate it can then rock in position and if it does not get incorporated it can shift in position or become infected just like silicone.

	If you augment the bridge you need to know it will affect the look of the area between the inner corners of the eye so some of your ethnic look may change.This bridge work can be done through incisions inside the nose but if you wish tip work as well that can most reliably approached with an open approach using an incision on the strip of skin between the nostrils.

Otto Joseph Placik, MD · Answer

Although the silicone implant would be easiest with the quickest recovery and least amount of surgery, it presents with the least long term reliability. In reality, you would likely need BOTH ear (for the bridge) and nasal (for the tip) cartilage grafts to achieve the results you seek.

Jeffrey Marvel, MD · Answer

I do not recommend synthetic materials in nasal augmentation.  Long term results are unreliable.  If they extrude they result in tissue loss and severe scarring.  I prefer the use of diced auricular cartilage in milder cases, or in more severe cases rib cartilage.

What Are my Options for Building Up the Bridge of my Nose?

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What Are my Options for Building Up the Bridge of my Nose?

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