Which Surgeon is Right: Should I Narrow my Bridge or Add Cartilage?

I originally had rhinoplasty to narrow my bridge and remove slight bump. It's been 1 1/2 yrs since surgery ..I love my profile but my nose doesn't seem any narrower. I really am unhappy with the results with a photo flash (looks like a hook nose. I discussed with my original surgeon. He agreed to correct but wants to add cartilidge to bridge to give appearance of a narrower nose. I met with a second surgeon. He said my profile great and would go in and narrow more def not add anything to nose

Doctor Answers 15

Nose wide

Getting that frontal view to not looked washed out in photos is all about shadows and contour. If your bones are wide then osteotomy may help, but often a small onlay graft can create the shadow and look. You might even need both. You could try some filler as onlay and see how you like the change. This would not be permanent and  would not be very invasive but might help you decide what you like. Otherwise you have a nice result.

West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Adding Cartilage vs Narrowing Bridge

Dear Cindy:  I would narrow the upper portion of your nose but I would not add cartilage to your bridge. You do have a depression in your profile above your  tip which should also be corrected. Make sure you select a physician experienced in revision surgery whose results you like.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Narrow the nasal bones or add cartilage during Revision Rhinoplasty

From these photos (no proper profile shot), I can't tell if your nasal bridge is low or not. If the bridge is low and your nasal bones are short there is minimal room for further narrowing by rasping the sides of the bones or by breaking them and moving them closer together. An onlay dorsal implant would be required. If, on the other hand, the nasal bones are not short, osteotomies to fracture the nasal bones towards the midline would make the nose more narrow and would not require any graft or dorsal implant.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Treating wide nose after rhinoplasty

I agree that your profile looks good in which case adding cartilage to it may be counter-productive. It looks like performing osteotomies to narrow the nasal bones would be a good course of action. If this was done during the first surgery it may not have produced adequate nasal bone narrowing.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Revision of the pollybeak nose with a wide lower bridge.

Revision of the pollybeak nose with a wide lower bridge can be done. I would not add to your bridge. Make sure you see an experienced revision rhinoplasty surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Nose to wide after rhinoplasty

From what i can see in you pictures, I would opt to revise your ostotomies and not graft cartilage. Cartilage grafts can be wonderful but, also cause problems

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Should I Narrow my Bridge or Add Cartilage?

From your profile view, your radix appear quite high and further addition of cartilage graft to your dorsum will adversely affect this. Your nasal width has not changed and one has to assume that your osteotomy if you had one, was not successful. A low lateral osteotomy should correct this.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Video Rhinoplasty: You can add to your bridge to make it normal or just narrow what you have

I would really have to see more pictures form the side. But you should be able to narrow your nose through shaping the bone.  Yes adding structure to your nose can narrow the nose but you have already had it taken down. I think just narrowing your nose would be sufficient. Also adding to your nose won't always make your nose thinner.  You have to know what you are doing to achieve that. I've seen cartilage added that keeps the nose the same thickness!

Thanks for reading, Dr Young

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Wide dorsum

AS you take down the dorsal height, it can give the illusion of a widened dorsum and if you had osteotomies, it is often difficult to narrow it any more.  A dorsal onlay graft may or may not givet he illusion of a narrower nose with the lose of the lower nasal height that you achieved from your previous rhinoplasty.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

I would suggest digital morphing for both procedure before surgery

You have nice result and your nasal base is little wide in relation to your tip. I would suggest that you find a plastic surgeon who offers morphing. You can try both procedures virtually and see which one fits your face better. The combination of narrowing and cartilage graft may be the solution.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 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.