Reducing Nasal Bridge Height Without Looking Unnatural?

Without photos or an in person exam, it is hard to know what specifically you need.  The appropriate amount of nasal reduction and narrowing varies from patient to patient.  This is where skill, experience, and artistry come into play in rhinoplasty.  Selection of the right surgeon us critical to a satisfactory outcome.  I recommend going on a few consults with  surgeons in your area experienced with rhinoplasty.  Good luck!

We pioneered the open rhinoplasty approach 35 years ago. Having said that, the skill and experience of the surgeon is what makes a natural, good rhinoplasty, not the approach. Look at the kind of noses the surgeon does, not computer imaging. Better yet see live patients the surgeon has done. That is your best chance of getting a very good nose.

And this is good. Reducing the bridge is often done during rhinoplasty. The two commonest techiques are chiseling and filing. And sure too much can be taken off. Plus the bridge can be made too narrow (although that's less common a problem).
Rotating the tip is often the method used to open the nasolabial angle. Here there are many, many techiques. So many that its often a question on our specialty exams! Although the ways surgeons achieve the results are interesting, your task is to find one who will be able to make the changes you want. Good luck.

If the bridge of your nose is too high, and if the angle of your nose and upper-lip is too small, then it sounds like you're a good candidate for Rhinoplasty Surgery. In fact, these are some of the most common conditions I treat with Rhinoplasty Surgery.
Obtaining a natural, un-operated result is dependent on the experience of your surgeon, the thickness of your skin, and the stiffness of your nasal cartilage. In that regard, you should consult several board-certified, experienced Rhinoplasty specialists to see if surgery is right for you.
I hope this is helpful for you.

Clearly you have an  in depth understanding of the anatomy. I would meet with several qualified rhinoplasty surgeons to discuss your preferences and their solutions. A subtle rhinoplasty is possible. 

Hi,
Great question, sounds like you can almost perform the surgery on yourself.
Depending on the extent of the correction required to slightly decrease the bridge height/width of the nasal bony pyramid, rasping can be performed with or without osteotomies (depending on the individual nose).
Yes, if a surgeon either misdiagnoses the problem, does not recognize short nasal bones, or "misses" on the location of the osteotomies then it is possible that too narrow of a nose can be created. It is also unfortunately possible that a surgeon may have a "cookie cutter" method of rhinoplasty that is used on all noses, resulting in many post-op patients who look alike.
Taking 2 to 3 mm of the caudal septum and overlapping the lower lateral cartilages will both result in upward rotation of your nasal tip, increasing your nasal-labial angle. If just a little rotation is needed, hold off on the lateral crura overlay.
See the web reference below on the Subtle Rhinoplasty.
Good luck and be well doctor.
Dr. P

The specific techniques will vary from patient to patient, but they include rasping (filing) of the bridge of the nose and osteotomies (bone cuts) to reduce width, height, or close an "open roof." To aggressive a reduction can make a nose look pinched or scooped or take on other unnatural angles.
As for increasing the nasolabial angle, this is also done in a number of ways depending on the rest of the anatomy that will be affected. Caudal setbacks, lateral crural overlays, lateral dome division, cephalic trimming, etc. are all possible.
From a patient's perspective, though, the imporant point is not so much how it's done, but who is doing it. Choose your surgeon wisely and get it done right the first time if you can.
All the best,
--DCP

If you are looking for a conservative change to your apperance then that can be performed by careful rasping of the dorsum of the nose. The question is - how much can the dorsum be reduced without looking too wide? At some point narrowing of the bridge by perfoming an infracture of the nasal bones will be necessary. As for the lip/columella relationship the answer depends upon factors such as lip length, anatomy of the nasal spine and the prominence of the septum as well as the tip position - everything is related and works best when in good proportion. However your requests seem quite typical and it just remains to find a surgeon with whom you can communicate and in whom you trust to make the changes you want. Best of Luck

 

A natural, harmonious result should be the goal. The specifics of how to achieve this will depend on your anatomy, facial features, and the experience of the surgeon. Thus, it is paramount to discuss options with someone who has experience and who can help guide you through the process. Computer imaging may help.

Decreasing bridge height is attained by rasping and filing the nasal bridge down, however it can only be filed down approximately 2 or 3 mm before a square top or open roof deformity will result. If that results than osteotomies need to be performed to narrow the nasal bones and close the defect. It is possible to increase the nasal labial angle of the nose through a simple caudal septal margin resection of both membranous and cartilaginous septum. We do not overlap the lower lateral cartilages because that will result in a bulbous lateral tip, which is undesirable.