Flat Nasal Bridge
Flat Nose Bridge: Below are images of a before and after demonstrating an augmentation of an Asian nose using silicone at the bridge and ear and septal cartilage for the tip. Notice how the eyebrows and mole is the same size. The enlargement of the nose can be more confidently judged based on knowing these other anatomic areas have not changed in size. Below we will explain how we do this in more detail.
Solutions for Nasal Bridges that are Flat: there are many options for raising the bridge: 1. You can use silicone; 2. You can use Medpor; 3. You can use your own rib cartilage; 4. You can use cadaver cartilage; 5. You can use ear cartilage; 6. You can use goretex; 7. Fillers are a temporary option; 8. Fat injections are another method.
Alloplastic Material: Silicone is probably the most common method world wide. In the United States, the use of silicone is less favored given the rate of extrusion and infection which is low (<5%). One important way to avoid this is to not use foreign substances in the tip area. The tip can be augmented by using natural septal and ear cartilage. Medpor is less commonly used versus silicone. It is a hard substance and is less moldable or pliable. You have to carve this more accurately and the base that it rests on needs to be flatter and more contoured to accept the medpor without tilting or rocking. Some people feel that medpor has more chance of infection given the pores that it has. In the nose, the rates are just as low as silicone. And if given time to heal (usually 12 weeks), Medpor becomes incorporated in the body. The tissue can grow into medpor and it can start acting like your own tissues. Goretex is another option. This is less common. The infection rates are comparable to silicone and medpor. Goretex is softer and can conform more than silicone and medpor. It doesn't incorporate tissue like medpor. There is less experience with goretex from a world wide scale.
Cartilage Implants: Rib Cartilage: you can use your own rib to augment the Nasal Bridge that is Flat. What this entails is an incision on the chest wall just under the breast tissue. Ribs 6-9 are usually considered. The benefits is that you use your own cartilage. Rejection is negligible. Rib has a bountiful amount of cartilage that can be used to augment and support the nose. The drawbacks are that it requires an extra incision and starts to involve larger parts of your body, your chest and lung tissue. Hence, there are more risks present. Cadaver Cartilge: uses cartilage that is taken from someone who has passed away and has donated his tissue to help people. Some rhinoplasty surgeons believe that this type of cartilage absorbs more than native cartilage or your own cartilage. Another option with cartilage is the use of ear cartilage. Ear Cartilage can be harvested and then diced into small pieces and wrapped with the tissue called fascia that is taken from above your ear behind the hairline in the temple. Temporalis fascia is what this is called and is used to wrap the cartilage into a cigar shape (albeit small and narrow) that is then used to augment a flat bridge. In the Rhinoplasty world this technique has been called the Turkish Delight. Below is a before and after we did for someone for a revision where this diced ear cartilage is used. This person did not want the unnatural bridge she had that appeared operated on. Also the tip was too pointy and unnatural. You can click here to see more Before and After Rhinoplasty Images: