Options for Raising Nasal Bridge Slightly?

Question

I have been thinking about getting nose surgery to elevate the bridge of my nose slightly. I am not looking for a significant change, as my nose is fairly staight, small and not too wide, but not very defined. I feel like from some angles, it makes my face look a bit too flat and I would like more definition. What type of procedure would be ideal for me? Also, I live in the Vancouver, BC area now, so I was wondering if anyone could tell me how much I should look to be spending as well?

Jonathan Kulbersh, MD · Answer

There are a few options available if you wish to augment the nasal dorsum:

	1) Implants
	2) Filler
	3) Using your own natural cartilage and tissue

	 

	Implants are still widely used by surgeons, but I prefer to use your natural cartilage if possible.  I believe there are less risks using your own cartilage compared to using an implant. Risks associated with implants may include asymmetry, rejection, and infection.

	Filler may mildly lift a drooping tip, and may be used to augment the nasal dorsum.  Using filler to change the appearance of the nose is referred to as non-surgical rhinoplasty.  Only a small amount of filler may be used, and it must be injected slowly to limit the associated risks which include irregularities and necrosis (death of the skin).  I would see a surgeon that is comfortable with these injections.

	 

	An option I frequently use is dicing your natural cartilage into a filler like material and wrapping it in deep temporalis fascia, which is harvested from the scalp.  This can produce a natural augmentation of the dorsum that  is readily accepted by the body. 
	Cost can vary from surgeon to surgeon, and I would recommend having consultations with a few.  This will enable you to get a feel for which surgeon may best help you achieve your goals. Thanks and good luck!

Eric Pugash, MD · Answer

There are a number of options for raising the nasal bridge.

	These include injectable fillers such as Radiesse, nasal implants and cartilage. The last two options require a trip to the operating room.

	I could discuss your situation more completely if I had access to photos.

	I suggest you arrange a consultation with an experienced rhinoplasty surgeon in your area to explore what will work best for you.

	Good luck!

Thomas A. Lamperti, MD · Answer

It's pretty common to need to raise the bridge slightly. You could consider using your own cartilage versus using a silicone implant. I prefer using a patient's own cartilage when possible.

	Without seeing your nose it's hard to say if anything separate would need to be done to your tip to further help with defining that area.

	 

	Cost vary a bit depending on how much work needs to be done exactly. I could give you a better idea after seeing several photos of your nose/face from all angles.

Toby Mayer, MD · Answer

There are many ways to raise the bridge but which way depends on other parts of the nose. Therefore,see an experienced rhinoplasty surgeon for a proper evaluation and answer. Cost varies depending on how much work is involved,etc.

Sam Naficy, MD, FACS · Answer

This is a fairly common problem, especially in the Asian population. The options are using your own cartilage vs.using an implant and there are pros and cons to each. it would be hard to give you more detailed information without seeing you in person or at least seeing photos of the nose from all angles.

Eric M. Joseph, MD · Answer

I read your concern. Many patients with low nasal bridges may benefit from an injectable filler treatment, and this may be a welcome alternative to rhinoplasty surgery. My experience is with Silikon-1000, an off-label filler for permanent results.

	Hope this helps.

	Dr. Joseph

William Portuese, MD · Answer

The rhinoplasty procedure will refine the look of the nose. Further height to the bridge will also make it look less flat in appearance and give more definition. Elevation of the bridge can be performed with a dorsal onlay graft of nasal septal cartilage if needed. The cost of a rhinoplasty is typically between $7000-$8000 which includes the operating room, anesthesia, and the surgeon’s fee for performing the procedure. Rhinoplasty surgery is performed as an outpatient procedure under general anesthesia usually in an ambulatory surgery center setting.

J. Charles Finn, MD · Answer

You may want to try something before surgery. A small amount of artfully placed filler can give you a nice 9-12 month result. Find a local doctor with experience with rhinoplasty AND fillers to see if this would be an option for you

Mia E. Skourtis, MD · Answer

There are definitely a few straightforward approaches to raising the height of the nasal bridge.  This can be permanently accomplished by using your own cartilage harvested from your nasal septum or an inconspicuous spot on the back of your ear.  Your own tissue tends to have the best healing characteristics.  Another approach may be the use of a silicone nasal implant, but these are typically only used to raise and define the entire nasal dorsum including the bridge.  A non-permanent solution would be the carefi; use of a filler such as Juvederm (hyaluronic acid) by a board certified plastic surgeon to increase the thickness of the tissue over your nasal bridge.  Juvederm lasts from 9-12 months, and if 2 syringes of Juvederm are used to achieve this goal, that would typically cost somewhere in the neighborhood of $1,000 US dollars.

	All the best,

	Dr. Skourtis

Francis R. Palmer, III, MD (retired) · Answer

Aesthetically speaking it's best to see photos of your nose, front and profile shots, in order to make an evaluation. The nasal bridge can be raised by either breaking the bones and moving them together, if the nose is also a bit wide, or by placing a dorsal graft on top of the nasal bones and cartilage during Rhinoplasty.

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