Want a Higher Bridge For the Tip and More Projection? (photo)

I want a higher bridge and for the tip of the nose to be more projected, and for the nostrils to be tucked in for a smaller appearance. I find the tip of my nose to be rather bulbous. What types of work needs to be done to my nose? Will I just need to have a bridge with performing an alar base reduction or will the alar surgery be needed? Thank you!

Doctor Answers 8

The best way to create more tip shape in a nose with thick skin is with cartilage grafts

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A soft bulbous tip in a patient with thick skin can actually be made to look smaller and more refined by adding a graft to the tip of your nose using your own cartilage. To raise the bridge we also use grafts. Since the skin is more forgiving along the bridge, we can use your own cartilage and sometimes inert implants such as Gortex.

New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Nasal Augmentation Options

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To increase the height of the bridge with more tip projection, you will need either cartilage grafts or implants to achieve a visible amount of augmentation. There are advantages and disadvantages with either and these need to be reviewed in detail. At your young age, cartilage grafts are a better choice long-term. You will also need nostril narrowing/alar reduction of which the techniques to do so are standard and non-controversial.

HIgher bridge for nose

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Thank you for your question. Rhinoplasty surgery is very delicate and must be done by a board certified specialist in this area. I do lots of these and I can tell you there is no nose that is easy. Ethnic noses are even more challenging. Your photos are difficult to assess becaus to really comment I need a better side view and a view from below. I will speak in general here for patients like yourself. To address the bridge of the nose issue like yours I have found that placing a fascia graft possibly filled with diced cartilage graft raises the dorsum quite well. The maneuvers to modify your tip are countless and I would need to really evaluate you for comments on this. I usually do use a combination of suture techniqes and a cartilage graft to support and project the tip (Columella Strut Graft and Tip Graft). You have thick skin so you have to be realistic about what is and what is not possible with repect to the size of your nostril openings. You need to have the correct diagnosis for the correct procedure. Your consulting surgeon should be able to tell you if your nasal base is wide or if you have flared nostrils or both. It will affect what can be done for the nostrils. Best of Luck! Choose a good surgeon.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

How to get a highr bridge?

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The only thing that can be said for sure from your limited photos and goal description is that you will need augmentation rhinoplasty as opposed to pure reduction. YOU WILL NEED TO ADD STRUCTURE TO SHAPE THE THICK SKIN AND PROFILE>

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Goals of Rhinoplasty Surgery

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You can augment you can augment your bridge and improve tip definition and projection. However,  if you decrease the alar base you will have an abnormal contour of your nostrils.

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

Rhinoplasty, cartilage/silicon implant

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In order to improve an ethnic nose in an indivdual who likes to imprve the bridge of the nose, to have better projection of the tip and to have a better alar base a combination of dorsal and septal strout is necessary. My preference is a bone graft harvested from iliaqe bone which need to be sculptured to augment and reshape the nose. Most often, after achieving the desirable projection of the tip it would not be necessary to reduce alar base. Cartilage grafts harvested from septum or patient's ear is my second choice. I do not recommend prosthetic implants.  

Rhinoplasty augmentation of the bridge, etc.

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Tha bridge and tip should be augmented with your own cartilage.  You do not need nostril narrowing since the alae are vertical. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews


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Your posted photos are an oblique (not true side view) and frontal of only the nose. These are inadequate to make any specific recommendations. To make the bridge higher you can use cartilage graft from the ears or ribs or an implant. To change the shape of the tip cartilage grafts and/or shaping sutures can be used. Based on these limited photos it is impossible to say whether an alar base reduction is indicated. The desired alar base width is equal to the distance between the inner and outer corners of one eye.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles 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.