Raising Both the Nasal Bone and Septal Profiles with Implants, Candidate for Rhino? (photo)

I am ethnic Chinese and want to raise my entire dorsal profile, including that of the nasal bone( with a nasal bone implant). The conventional dorsal augmentation methods such as adding columella strut and silicone/gortex augmentation to the caudal septum would not raise it high enough. Is there a method of replacing my septal cartilage with a "taller" implant? Thanks in advance.

Update: 4/17/12:

I've asked this question on this Q&A before but did not get the answer, perhaps because I was not clear. Just to recap, I am ethic Chinese and want to raise my nasal profile higher up. I've studied the common techniques of placing implants on top of the existing nasal bone and cartilages and don't think they could raise it high enough. So I am wanting to know if there is a procedure of pusing the nasal 'roof' up by increasing the height of septum INSIDE the nose. Pls see diagram.

Doctor Answers 7

Augmentation Rhinoplasty: Options for making your nose bigger

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This is a great question, and thank you for posting. The procedure you are describing is an augmentation rhinoplasty -- making the nose bigger.  In people of Asian heritage, the bridge of the nose is often somewhat flat and a common request is to give it more height.  While implants are possible, these come with an increased risk of infection and extrusion (where the implant material erodes through the skin), which generally require medical treatments or another surgery.  A great option is a procedure sometimes called the "Turkish delight" graft. This is basically an implant made from your own tissue: cartilage (often from the ribs) which is diced into very small pieces and then placed in a protective layer of fascia (connective tissue).  In my opinion, this is a great option.  Please consider asking your rhinoplasty surgeon about this procedure.

Raising Both the Nasal Bone and Septal Profiles with Implants, Candidate for Rhino?

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 I think there may be some confusion.  The nasal septum is inside the nose and a dorsal implant is placed on top of the existing nasal bones and cartilage.  A standard, straight, silastic dorsal implant would build up the nasal bridge through a closed Rhinoplasty.  The nasal tip height may need to be adjusted appropriately to maintain the proper nasal aesthetics.  

  IMHO, calvarial bone, rib cartilage, rib bone and banked cartilage/bone all have issues with dissolution unevenly over years and as such are not my preferred method of dorsal augmentation during Rhinoplasty.  Be sure the Rhinoplasty Surgeon, you choose, understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally, more attractive nose and face.  The chin appears weak and the profile can be balanced and strengthened using a silastic Chin Implant placed through sub mental incision under the chin.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Raising Both the Nasal Bone and Septal Profiles with Implants, Candidate for Rhino?

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In order to get adequate shape and elevation of the bridge, I would recommend a custom carved silicone implant. Several recent studies have shown that silicone implants work best to elevate the nasal bridge in Asian noses. Remember you want  the right shape and elevation. Gortex is a good implant but does not address the naso-frontal angle ( angle where your nose meets your forehead. Cartilage grafts will not be enough to give you the shape and elevation that you need. Most surgeons are not comfortable using silicone implants. I have used silicone implants for over 10 years with good results with very few problems. Your surgeon has to be comfortable using silicone implants.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Rhinoplasty for Asian noses is usually about tip support grafts and raising the bridge

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There are a number of ways to enhance the look of an Asian nose. I prefer to add strength to the nasal tip and enhance the shape using both a strut and graft called a shield graft taken from your own septum. I do not like artifical implants in the nasal tip. The bridge can be built up with either Gortex or diced cartilage (taken from your ear) in a layer of natural tissue called fascia (DCIF). This fairly new procedure of DCIF allows us to completely enhance a small Asian nose without needing to use your rib.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Raising Nasal Profile and Increasing Tip Projection

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You can augment your profile line and increase your tip projection with rhinoplasty surgery. I do not like implants because of the complications that can occur when they are used. I prefer to use the patient's own cartilage to mold the nasal contour.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nasal implants

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Increasing the dorsal height and adding nasal projection can be achieved with nasal implants. My preference is with autologous( your own) tissue.  This can best be achieved with cartilage grafts such as from the  rib.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Asian Rhinoplasty - Diced Cartilage in Fascia

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For my asian rhinoplasty patients, I prefer to stay away from implants as I have seen too many problems caused by their use.  I prefer to use your own cartilage from your septum or ear wrapped in fascia to raise the bridge of your nose.  Please consult with a board certified specialist who can better assist you in achieving the results you desire.

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.