Revision Rhinoplasty for Ethnic Patients

Hispanic, Asian, or African American patients who are active candidates for rhinoplasty or just thinking about having a nose job often have a similar complaint: My bridge is too low!

It is important to differentiate those ethnic rhinoplasty patients whose bridge and profile fit their other features and thus appear "natural" from those whose bridges are too low even for ethnicity. These latter patients' appearances can be greatly improved by augmenting or building up the bridge of the nose. Unfortunately, not every nasal surgeon is skilled at building the bridge up in a natural, long lasting, and attractive way. I often see ethnic rhinoplasty patients who have had surgery elsewhere and are not pleased with their bridge augmentation. Reasons range from visible or mobile implants, unnatural shaped implants, to poor bridge/tip proportion. It is very important to match the tip height (or projection) to the bridge height!

Revision rhinoplasty for ethnic patients can be complex due to the need to replace a pre existing implant, which may require dissecting through scar tissue around the implant. However, thick skin generally is a plus for allowing a smooth contour in the nose following the revision.


Silicone implants are a fairly common cause for revision bridge surgery in these patients. Silicone is difficult to sculpt, which can lead to noticable edges under the skin. In addition, it can sometimes form a capsule around itself, preventing the implant from sticking to the underlying bone and cartilage. Finally, silicone may occasionally extrude through thin skin especially if the implant is too long.

Endogenous cartilage from the nasal septum, ear, or rib can be used for bridge augmentation, however I have found gortex to be very useful in this capacity. Gortex tends to adhere nicely to the bone is very easy to sculpt and contour for a natural, long lasting appearance.