Does Radix Reduction Require a Very Specialized Surgeon? (photo)

This can be done by a very experienced rhinoplasty surgeon. The reason you see few of these is there are few Grecian noses with a full radix.  Be carefully since the revisions I do for this is where the surgeon took too much off. 

Radix reduction and radix augmentation are routinely incorporated portions of the rhinoplasty procedure, and there are photos of both on our website gallery.  As other responders suggest, bone at the radix is thick, and can be most expeditiously reduced with a power burr.  The maneuver is quite successful when carefully performed.  Radix augmentation can be accomplished with cartilage, porous polyethylene, teflon, silicone, deep temporal fascia, diced cartilage, and by injectables (Aquamid, Radiesse, Hyaluronic Acid).

Any surgeon that competently performs rhinoplasty should be able to do this. There is a curved rasp commonly used to do just that, file down the radix. The desired radix should be at the level of the upper eyelid crease and the deepest part should usually be 10 to 12mm from the plane of the outer surface of the cornea on a side view.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Most of what you need to know has been well said here by others. It's possible technically, and not all that difficult, to reduce a radix.

But you need a careful and expert consultation. In rhinoplasty, every part of the nose you change has a secondary appearance effect on another part of the nose.

If your radix were reduced in the profile view, which you want, it will make the base of your nose look wider on the front view. So despite your being happy with the rest of the nose, it may be necessary to narrow the dorsal width as well to maintain nasal harmony.

In summary:  You can achieve your goal, keep an open mind and see the local experts for an evaluation.

 

Good luck.

You have an interesting  but reasonable request. Your surgeon will need to use a power burr with protection of the overlying skin. Good luck.

Radix reduction should be a fairly standard procedure. This is sometimes facilitated by special power instruments which will remove the excess bone in that region very easily. Even without power instrumentation that should be something that the surgeon can do with hand tools such as osteotome and rasps. You are correct that this will improve the appearance of your nose considerably.

It is absolutely possible to reduce the height of the radix.  This could be accomplished with powered instruments (drills, microdebrider) or with the use of special, so called glabellar rasps.  Any experienced rhinoplasty surgeon is very capable to do this.

It is not very common to have a request for reduction of the subglabellar are ( the highest point of nasal bone) without reduction of the radix and/or " hump removal ". This could be performed by an experienced plastic surgeon who does good number of rhinoplasties. The procedure is done through closed technic usind a roud rasp " glabellar rasp ".

Radix reduction, the portion of the hump right up between the eyes, is actually not that uncommon, just not discussed very often. There is no particular difficulty in planning a hump or dorsal reduction which begins up at the radix. Make sure you goals are discussed and part of the planning, and computer simulation can help make the goals clear.

 Reducing the Radix to the proper aesthetic naso-frontal angle of 135 to 140 degrees is certainly within the ability of an experienced Rhinoplasty Surgeon who understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally more attractive nose and face.  This often requires removal (reduction) of nasal bone as well as some Procerus muscle.  Hope this helps.