Scooped bridge after rhinoplasty - What is the best way to correct a ski slope nose if fillers haven’t worked? (photos)

Question

About a year and a half ago, I had a septoplasty & rhinoplasty done. I now have a significant ski slope nose which has made me more self-conscious about my nose than I was pre-surgery. My plastic surgeon has injected fillers into my nose twice now. However, the filler only lasts about 1-2 weeks on me, and then I’m back to where I was. What would be the best way to correct this dip in my nose?

Steven M. Denenberg, MD · Answer

The bridge of the nose looks low because the tip projects forward away from the face, and the tip is somewhat long, or droopy.
Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_LuLu158.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.
I really didn't augment the bridge of your nose at all. I brought the tip back closer to your face, and I elevated the tip. those changes make the nose look smaller, less prominent, which is good, and they make the bridge no longer seem too low. You'll see this especially on the animation -- watch the bridge of the nose, you'll see that its height doesn't really change as the animation toggles back and forth.
See if you think the morph captured what you're looking for. The woman in the short video I posted with this answer had the tip of her nose elevated in a revision operation. 
I don't love augmenting the bridge if we can get away with it. Whatever is used, it'll show an edge, or won't sit exactly in the middle, or it'll be too wide, or something. Sometimes it's just necessary, but very often we can correct the problem by working on the tip. Or, by working on the tip, only a tiny tiny elevation of the bridge becomes necessary.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and read the essay on how to tell whether your previous surgeon should be performing your revision. Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. For most noses, it's better to not have surgery than to have inexpertly-performed surgery.
I'd love to hear what you think of the morph. Did it seem to address your main concerns? I could modify the morph to your taste if you wish.
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

Eric M. Joseph, MD · Answer

It is not clear why your temporary fillers only lasted 1-2 weeks...If you liked the appearance of your nose after temporary fillers while they lasted, Silikon1000 may be considered, depending on your examination. You would likely require several treatments at monthly intervals, or longer for a desired result. Hope this helps you! Dr Joseph

William Portuese, MD · Answer

Cartilage grafting techniques are usually required to build up the bridge line. It is important to know how much  Cartilage is left on the inside of the nose for potential grafting purposes, since you've already had a septoplasty.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,From the photos it looks like you have an over-resected bridge and an over-rotated and over-projected tip. Fillers are only temporary, so the only permanent solution is a revision rhinoplasty. The bridge can be augmented with cartilage grafts take from the septum, ear or rib and the tip reconstructed by reshaping the tip cartilages. Seek an experienced rhinoplasty surgeon to get it right next time around.Best,Dr.S.

Scooped bridge after rhinoplasty - What is the best way to correct a ski slope nose if fillers haven’t worked? (photos)

Answers (4)

Answer: Revision Rhinoplasty

Answer: Revision Rhinoplasty

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Everything you need to know about Revision Rhinoplasty

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Scooped bridge after rhinoplasty - What is the best way to correct a ski slope nose if fillers haven’t worked? (photos)

Answers (4)

Answer: Revision Rhinoplasty

Answer: Revision Rhinoplasty

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.