Who is a good candidate for rhinoplasty (nose bridge augmentation)? Considering low nasal bridge height, skin thickness, and concerns about the nasal tip

Rhinoplasty is most suitable for people whose primary concern is a low nasal bridge (dorsum) and who want to raise it. If the roundness of the nasal tip or nasal tip height is your main concern, raising only the nasal bridge with an implant (prosthesis) may not produce the desired change.

Is a low nasal bridge your primary concern?

Rhinoplasty is surgery to raise a low nasal bridge. For people with an underdeveloped nasal bridge, surgery to raise it is described as appropriate for restoring both shape and function[1].

Asians commonly have insufficient nasal bridge height and nasal tip height, and silicone implant (prosthesis) rhinoplasty is reported to be one of the widely performed surgeries in Asia[2]. There are several methods and materials available, and it is important to choose what suits each individual[1].

Is it suitable even for people with thick skin?

Regarding the nasal bridge, it can be suitable even for people with thick skin. Textbooks state that even in Asians with thick skin, raising the nasal bridge with an implant (prosthesis) can yield safe and satisfactory results[3].

However, whether the result looks natural depends on the height of the implant (prosthesis), the thickness of the skin over the nasal bridge, and the skin tension created by the heightening[3]. If raised too much, skin tension increases, so it is advisable to discuss your desired height in advance.

What if you are also concerned about nasal tip roundness?

People with significant nasal tip concerns often consider surgery to the nasal tip as well. It is reported that in people with thick, firm, round nasal tips, even if the shape of cartilage and bone is refined, the desired shape is not always achieved[4].

In that report, a method of partially removing nasal tip skin and soft tissue was added for 22 women[4]. Also, avoiding excessive tension on the nasal tip with the implant (prosthesis) is reported as one of the strategies to reduce complications[5].

How often do complications occur?

In a report of 1,019 people treated over approximately 30 years by one surgeon, the most common complication was implant (prosthesis) displacement, occurring in 37 people (4%)[5]. Revision surgery due to unsatisfactory appearance was performed in 43 people (4%)[5].

Implant (prosthesis) extrusion through the skin occurred in 9 people (less than 1%), and infection in 4 people (less than 0.4%)[5]. However, this is a report compiled from one surgeon's experience, and the same figures may not apply at other facilities[5].

What if you have had an implant (prosthesis) placed before?

Revision surgery is more difficult than the initial procedure. After silicone implant (prosthesis) placement, the nasal skin becomes thinner, and a capsule forms around the implant (prosthesis)[2].

When this capsule contracts, the nose may appear shorter, or the implant (prosthesis) may become bent or displaced[2]. If you are considering revision surgery, inform your surgeon about the timing and details of your previous surgery.

What else to confirm besides appearance

For nasal surgery, it is recommended to confirm three things: harmony with the overall face, psychological readiness for surgery, and nasal airway patency[6]. If you have nasal congestion, it is reassuring to mention that as well.

The appropriate height for your nose and whether nasal tip surgery is necessary cannot be determined from an article alone. Have the shape from the front and side, as well as skin thickness, examined during consultation.