Struggling with a Low Nose Bridge or Bulbous Nose? (feat. Rib Cartilage Rhinoplasty and Osteotomy) by Dr. Yooyoung Moon, Vibe Plastic Surgery, Sinnonhyeon Station

Hello.

I am Dr. Yooyoung Moon, director of Vibe Plastic Surgery.

Today's case involves a woman in her 20s whose biggest concerns were a ‘low and wide nose bridge, and a blunt nasal tip (bulbous nose)’.

While her overall facial features were attractive,

her nose lacked definition in the center of her face, giving a somewhat plain impression,

and the bluntness of her nasal tip prevented a sophisticated image from shining through.

For this surgery, we planned a design that considered the overall facial proportions and harmony, not just simply raising the nose bridge,

but also performing bulbous nose correction and osteotomy together.

The most crucial aspect of a primary rhinoplasty is ‘accurately identifying the cause’.

Many people considering their first rhinoplasty

simply think, ‘I’ll look prettier if I just raise my nose bridge.’

However, when a low nose bridge and a bulbous nose coexist,

it's difficult to achieve satisfactory results by only raising the nose bridge.

In some cases, the bulbous nose might even appear more prominent if only the bridge is raised while the tip remains blunt.

Therefore, in such cases, it's important to accurately identify and address each cause.

Why rib cartilage was used for bulbous nose correction

A bulbous nose isn't simply caused by excessive fat;

it often results from widely spread nasal tip cartilage,

thick skin,

or a lack of sufficient structural support for the nasal tip.

In these situations, merely tying the nasal tip together

might not maintain the desired height and shape as it could spread out again over time.

Therefore, in this case, we used ‘rib cartilage’ to provide ample support for the nasal tip.

Rib cartilage has significant advantages:

✔ It can stably raise the nasal tip in the desired direction.

✔ It can create a more defined line even in bulbous noses with thick skin.

✔ It offers excellent shape retention over time.

Especially for a primary surgery, it's not always necessary to use only ear cartilage;

it's crucial to comprehensively assess the patient's skin thickness, nasal tip structure, and desired degree of change

to select the most appropriate material.

Why osteotomy is necessary

This patient not only had a low nose bridge but also a somewhat wide one.

In such cases, simply inserting an implant would add height but leave the wide appearance unchanged.

That's why osteotomy was performed concurrently.

Osteotomy involves bringing the bones of the wide nose bridge inward,

✔ Naturally reducing the width of the nose bridge.

✔ Creating a more defined straight line for the nose.

✔ Allowing the entire face to appear much smaller and more sophisticated.

This surgical method brings a particularly significant change when viewed from the front,

and plays a crucial role in improving the nose line to a smooth and feminine look.

Implants for natural dimensionality

For the low nose bridge, an implant of appropriate height was used,

tailored to the patient's facial proportions.

Instead of simply raising it excessively,

the design ensured a natural connection from the forehead to the nose and nasal tip,

completing a dimensional nose line that wasn't overdone even from the side profile.

For primary rhinoplasty, the surgical plan is crucial.

The first surgery is an opportunity to achieve the best results because it's performed on the best tissue condition.

Therefore, rather than simply addressing one problem,

a surgical plan that considers all factors:

✔ The cause of the bulbous nose

✔ A low nose bridge

✔ A wide nose bridge

✔ Nasal tip support

will determine satisfaction.

This patient also underwent bulbous nose correction (rib cartilage) + nose bridge implant + osteotomy,

achieving a slim and sophisticated nose line from the front, and natural dimensionality from the side.

Primary rhinoplasty is not just about raising the nose;

it's most important to accurately analyze the patient's nasal structure and appropriately combine the necessary procedures.

If you are concerned about a bulbous nose and a low, wide nose bridge, a customized surgical plan that improves the nasal structure itself, rather than just a simple height change,

can lead to more satisfactory results.

Frequently Asked Questions

Why is rib cartilage used for bulbous nose correction?

Rib cartilage is effective for bulbous nose correction because it can stably raise the nasal tip in the desired direction, create a defined line even in bulbous noses with thick skin, and offers excellent shape retention over time.

When is osteotomy necessary?

Osteotomy is necessary when the nose bridge is not only low but also wide. Since an implant alone might leave a wide appearance, osteotomy helps to naturally narrow the bridge by bringing the nasal bones together and creating a more defined straight line for the nose.

What is the most important consideration for primary rhinoplasty?

For primary rhinoplasty, it is most important to accurately analyze the patient's nasal structure and create a customized surgical plan that considers all factors, including the cause of the bulbous nose, a low nose bridge, a wide nose bridge, and nasal tip support.

What are the advantages of using rib cartilage?

Rib cartilage offers significant advantages: it can stably support the nasal tip and create the desired shape, achieve a defined line even with thick skin, and maintain the nasal tip's shape well over time after surgery.

What effects can be expected from osteotomy?

Osteotomy can naturally reduce the width of a wide nose bridge and create a more defined straight line for the nose, leading to the effect of a much smaller and more sophisticated-looking face from the front.

Can a low nose bridge and a bulbous nose be improved simultaneously?

Yes, it is possible. When a low nose bridge and a bulbous nose coexist, satisfactory results can be achieved by combining nose bridge implant insertion with bulbous nose correction using rib cartilage, and osteotomy if necessary.