What are my options if I feel I want to achieve more dorsal height post op?

I am at day 13 post op from an open rhinoplasty where a Gore-Tex implant was used to increase the height of my bridge . My cast has been removed, but I still wear tape. At this time I can assert that the bridge height is unsatisfactory to me. I don't suspect this will change with time, but rather would decrease as swelling subsides as I continue to heal. What are my options to reach my goal of a higher bridge? I wish my surgeon and I had discussed this aspect of my procedure in terms of millimeters.

Doctor Answers 6

More dorsal height post-op

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Dear EsmeA,

Thank you for your clinical post and sharing your concerns. In substantial dorsal height augmentation requires interventional procedures, however, you are still very early post-operatively and allowing time for swelling and surgical stiffness to resolve is critical period. In general, most surgeons would recommend you wait one year prior to doing any other dorsal augmentation surgery. Dorsal augmentation options would include Silastic implants or otogenous tissues such as your own rib cartilage. Significant height can be achieved with these techniques but they are invasive and require a second surgery.

Another option would include soft tissue filler injection to temporize until at least one year has passed since your first surgery. Soft tissue fillers such as Juvederm Voluma can been injected generally at approximately six months relatively safely.

I think you can ultimately achieve the dorsal height that you seek, however, seek out carefully the device of surgeons with a lot of secondary rhinoplasty experience and dorsal nasal otogenous and Alloplastic augmentation techniques.

I hope this information has been of some assistance and best of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

Early post op dorsal height concerns

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In the early post op period the final appearance of the nose cannot be adequately assessed.  The height of the nose is also relative to the tip so the final balance of the nose is not yet determined. It is best to allow things to settle before considering other options.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon

Higher bridge

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At this point you probably need to allow things to heal.  But you are right, it will not get any higher. Best to discuss with your surgeon.

13 days postop- requesting more dorsal augmentation

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At 13 days postop, it is too early to make any decisions about additional treatments to the nose. You likely have swelling throughout the nose which makes it very difficult to see the final result. Most surgeons will recommend waiting about a year before revising any aspect of the nose. It is extremely important that you followup with your rhinoplasty surgeon throughout this time so they can monitor your nose for any changes and address any concerns you have along the way.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon

Changes after rhinoplasty

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Global nasal swelling may be camouflaging the true increase in dorsal height.  It is important to be patient at this point, you may not see your final result for 9-12 months.  It is important to communicate your concerns with your surgeon.

Achieving more dorsal height post op

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Hi EsmeA!

The clinical situation which you are currently describing indicates that you are EXTREMELY EARLY in the post operative healing phase following your augmentation rhinoplasty.   Most rhinoplasty surgeons do not consider a nasal profile a "final result" until the 1 year follow-up interval.  Therefore, you're liable to experience significant changes in the nasal soft tissue envelope moving forward in your recovery period.  Without having the opportunity to directly examine you, I cannot specifically council you regarding these anticipated changes.  That is why it is critically important for you to discuss your concerns with your operating surgeon so that he can put your current clinical status in perspective with anticipated changes and, if appropriate, following complete healing, make any revisional recommendations.

Best of luck with your rhinoplasty recovery!   

Robert M. Kimmel, MD
Reading Plastic Surgeon

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.