Revision Rhinoplasty: Augmentation with Dorsal Implant Graft

Nuances of Profile Management- The Radix


Rhinoplasty: Case Example 4- Cartilage Grafts for Balanced Nasal Profile

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Case Examples

Case 4

A 35-year-old female presented for revision rhinoplasty requesting reduction of her “large” nose.

Analysis of the nasal profile revealed an inadequate height of the bony dorsum including the radix. This inadequacy was accentuated by excessive projection of the cartilagenous dorsum and nasal tip. The surgeon performing the original rhinoplasty had oversected the cephalic portion of the dorsum while failing to address the over-projected nasal tip and caudal dorsum.

Augmentation of the radix and cephalic dorsum was achieved with an alloplastic (Gore-Tex) extended radix implant. The caudal dorsum was then aligned to the level of the implant, and the tip was retro displaced. Two year postoperative views demonstrate a more ideal nasal profile (Fig. 10). The radix and dorsal implant reduced the nasofacial angle, lengthened the nose, and restored dorsal height.

Nasal augmentation with an artificial nasal implant.

Figure 10A: Over resected cephalic nasal dorsum. Under projected radix. Over projected caudal dorsum. Cephalic dorsum and radix augmented using alloplastic (Gore-Tex) extended radix implant.

Before and after photos of an augmentation revision rhinoplasty

Figure 10 B-G: Preoperative and 1.5 years postoperative photographs.


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7. Johnson CM Jr, Alsarraf R. The radix graft in cosmetic rhinoplasty. Arch Facial Plast Surg. 2001 Apr-Jun;3(2):120-1


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