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.

Age range for Rhinoplasty

A lot of our rhinoplasty or nose job patients fall between the ages of 25-40, have been thinking about it for years, and have reached a point in life where they are ready to move forward. These patients are generally mature in their thinking, and know what they want. They usually have realistic expecations and goals, and when they see their imaged photos in my office they will often smile and say "Yes- that's exactly what I want." Other patients, however, require more education and guidance as to what the surgery can accomplish, and what may look best for them.



Teenagers are often terrific candidates for nasal surgery. They are young, heal quickly, and a great rhinoplasty result can be a tremendous psychological boost for them. However, these patients may be too young to appreciate the risks of surgery (however minimal they may be), and sometimes are being led into the office by a parent who wants the surgery more than they do. My favorite scenario for teenage patients is when they are accompanied to the consultation by a loving, supportive parent who lets the teen express their own desires, but asks me a lot of questions and wants to be involved. These families are a pleasure to work with, and the patients do very well. What is the minimum age for rhinoplasty? Ideally, when the patient has stopped growing. For girls, this may be as young as 15 or 16, for boys usually 17, 18 and up. A good question to ask oneself is "Has my shoe size changed in the past year?" If that answer is no, then you may be ready to proceed.


Somewhere in between the teen and "adult" years are those patients just out of college and looking to change their image before hitting the workforce. These patients generally also benefit from bringing a parent or spouse to the consultation, but can also be great candidates. I like to see that they have been thinking about surgery on their nose for at least 6 months before coming in for the consultation.