How Can a Low or Flat Nasal Bridge Be Raised?

My bridge is really low, kind of flat. Can we make it bigger, or I guess they mean higher, with surgery? Of course, yes, you can. There are people that put in implants: silicone implants, Gore-Tex implants, Medpor implants. We don't like that. Most rhinoplasty surgeons don't use implants. We use cartilage, and you can use a variety of cartilages.

You can take a rib and carve it into a shape that looks like an upside-down canoe and put it up in the bridge. That can be done. As it heals, if it veers off center even just a little bit, you notice the asymmetry more, and the sides can become a little bit too sculpted. But that is a classic way of doing it, and it's been done for many years. If you have adequate septal cartilage, it can be stacked into multiple layers, so that can be used.

There's also something called a diced graft. Essentially, the surgeon is taking either ear cartilage, through an incision from the front or an incision on the back, and it doesn't really change the shape of the ears much at all, and then dices it into tiny little pieces, almost like a chef dicing onions, and then uses a tissue glue to create a shape similar to that upside-down canoe, and then puts it in that location. That could also be done with your septal cartilage. It could also be done with your own rib cartilage. So those are options, or frozen rib, or donor rib, basically from tissue donors. That can be done as well. You can't do the diced cartilage with donor rib, but you can use an onlay. So there are many techniques. There are also ways of taking diced cartilage and wrapping it in fascia, which is the lining of the muscle right here, almost making a little hot dog out of it.

So a variety of techniques can be done, but honestly, my favorite technique for raising the bridge is liquid rhinoplasty. It's the best technique. It's customizable. If you want to go higher, go higher. If you don't want to go higher, stop. It's reversible. It goes away. If you don't like it, it's super smooth, there are no edges, it's very symmetric. Yes, it requires upkeep, but you've got to see what type of person you are. If you're somebody who's taking care of yourself, doing some Botox a couple of times a year, doing some fillers elsewhere, seeing your plastic surgeon for some facials and things like that, then doing a liquid rhinoplasty is not a big deal.

But if you want to be one and done, or you live in a place where you're not close to anybody good that can do the liquid rhinoplasty, a surgical approach is appropriate. You just have to know that surgically, when you raise the bridge, it's never going to be as smooth or as symmetric as liquid rhinoplasty. Lowering the bridge, you can get it much smoother. Raising it, you don't know how much you're raising it exactly. It's not as precise, but regardless, it can be done, and we do it all the time.