1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Closed rhinoplasty to build up the nasal bridge

A Closed rhinoplasty procedure can accomplish building up the nasal bridge. In many cases patients are born with a low bridge profile and would simply like to build up the height of the bridge for better facial aesthetics and balance. Other patients, have had an over-resection of the dorsal hump, and are left with a residual ski-slope deformity. In addition, some patients have received a traumatic injury to the nose and are left with a saddle nose deformity. When performing a revision rhinoplasty, it’s important to know how much cartilage as left on the inside of the nose for potential grafting purposes. A cartilage graft is the preferential way to build up patients own bridge line with their own natural tissues. If there is a cartilage-depleted nose, ear cartilage can be considered. In rare cases, rib cartilage may be needed. Once the nasal cartilage or ear cartilages have been harvested for potential grafting, they are then fashioned in the proper shape and inserted through a small incision along the bridge line of the nose. Most of the time the grafts are placed in a precise pocket, but they also can be sewn in place if needed. Alternatively, some patients require a significant amount of augmentation and they have no cartilage left on the inside of the nose and do not wish to have a rib cartilage taken out. For these patients, a Flowers Silastic nasal dorsal implant is used. These are also inserted in a small anatomical pocket along the bridge line. These implants are composed of Silastic, and can be custom carved when necessary. These implants are not the typical L- strut used in Asia. The L- strut implants can cause a lot of problems and many times have to be removed. In addition to building up the bridge of the nose, many patients require osteotomies placed in the nasal bones to narrow a pre-existing wide bridge line in addition to adding height to the bridge. This also helps to give added height to the bridge as well. Both medial and lateral osteotomies of the nasal bones are required to narrow them. It is also important to evaluate the status of the nasal tip to make sure it is in balance with the new and higher bridge line. Some patients require a reduction in the size of the tip with a conservative cartilage removal, while other patients require augmentation of the tip to of balance with the bridge. Tip cartilage grafting techniques are sometimes required to make sure the tip balances with the entire new bridge line. Dr. Portuese performs nasal surgery at The Seattle Facial Plastic Surgery Center, a state-of-the-art licensed and certified outpatient surgery center in Seattle Washington.

rhinoplasty before and after photo
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The nasal bridge plays a crucial role in facial aesthetics, and for individuals seeking to build up or augment their nasal bridge, closed rhinoplasty offers an excellent solution. Closed rhinoplasty, also known as endonasal rhinoplasty, is a surgical technique that allows for precise modifications and enhancement of the nasal bridge without visible external scarring. Let’s delve into the details of closed rhinoplasty and how it can help achieve a harmonious and balanced nasal profile.

Targeted Nasal Bridge Augmentation:

Closed rhinoplasty enables surgeons to access and modify the nasal bridge through internal incisions made within the nostrils. This technique allows for precise reshaping and augmentation of the nasal bridge using various methods, such as cartilage grafting or implant placement. Whether you desire a higher bridge, smoother contour, or correction of a nasal hump, the closed rhinoplasty approach allows surgeons to sculpt and build up the nasal bridge to achieve your desired aesthetic outcome.

Minimized Scarring:

A key advantage of closed rhinoplasty is the absence of visible external scarring. With all incisions made within the nostrils, there are no external sutures or incisions to be concerned about. This benefit is particularly appealing for patients who wish to avoid noticeable scars or prefer a discreet approach to their rhinoplasty. By utilizing internal incisions, closed rhinoplasty provides an opportunity for nasal bridge enhancement without leaving visible traces of the procedure.

Reduced Surgical Time and Faster Recovery:

Closed rhinoplasty typically involves less extensive dissection and modification of nasal tissues compared to open rhinoplasty. With a shorter surgical time, patients can benefit from reduced anesthesia duration and potentially faster recovery. The technique is generally associated with less post-operative swelling, minimal nasal trauma, and a shorter healing period. Consequently, patients often experience a quicker return to their daily activities following closed rhinoplasty.

Preservation of Nasal Support Structures:

Closed rhinoplasty allows for precise modifications to the nasal bridge while preserving the integrity of the nasal support structures. By accessing the nasal bridge through internal incisions, the surgeon can make targeted changes to enhance the bridge height or contour without compromising the underlying nasal structures. Preserving these structures helps maintain the strength, stability, and long-term functionality of the nose.

Suitable for Selected Cases:

Closed rhinoplasty is a suitable option for patients seeking nasal bridge augmentation or refinement in cases where the desired changes are minor to moderate. The closed technique offers excellent results for individuals who require limited modifications or who have relatively good nasal anatomy. It is an effective approach for patients seeking to build up the nasal bridge, correct a dorsal hump, or achieve overall nasal balance and proportion.

If you are considering nasal bridge augmentation, closed rhinoplasty can be an ideal choice. It offers the advantages of precise nasal bridge modifications, minimal scarring, reduced surgical time, and a potentially faster recovery. Consultation with a skilled and experienced facial plastic surgeon will help determine if closed rhinoplasty is the right technique for your unique needs, ensuring a successful outcome and a harmonious nasal profile that enhances your facial aesthetics.

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self