Nasal Dorsal Surgery is a surgical procedure designed to adjust the width, shape, and alignment of the nasal dorsum to achieve proportions that complement the face. It may be considered for individuals with a wide nasal bridge, a broad-looking dorsum, widely spaced nasal bones, or an unbalanced dorsal contour.
At Dr. Gorn Aesthetique, nasal dorsal surgery is not simply about making the nose smaller. Physicians assess nasal bone width, nasal alignment, dorsal contour, nasal tip, and facial proportions to determine the appropriate degree of correction based on each individual's anatomy.
What Is Nasal Dorsal Surgery?
The nasal dorsum refers to the bridge of the nose, extending from the upper nose toward the nasal tip. Its shape is determined by both bone and cartilage.
For individuals with a wide nasal bone structure, adjusting only the height of the nasal bridge may not be sufficient. The surgeon may therefore consider modifying the underlying bone structure to achieve a more proportionate dorsal width and contour.
The objectives of nasal dorsal surgery may include:
- Narrowing a broad-looking nasal bridge
- Adjusting nasal bone width
- Refining the proportions of the nasal dorsum
- Correcting certain types of nasal dorsal asymmetry
- Aligning the dorsal line with the nasal tip
- Improving overall nasal proportions in relation to the face
What Causes a Wide Nasal Bridge?
A nose that appears wide from the front may result from several factors, including:
- Wide upper nasal bones
- A broad nasal bone base
- Asymmetry between the left and right nasal bones
- Deviation of the nasal dorsum
- A broad bony and cartilaginous dorsum
- Associated widening of the nasal tip or alar base
Before surgery, it is therefore important to identify whether the apparent width originates from the nasal bones, cartilaginous dorsum, nasal tip, or alar base, as each structure requires a different corrective approach.
How Can a Wide Nasal Bridge Be Narrowed?
If the width is caused by the underlying bone structure, the surgeon may consider repositioning the nasal bones to change the width of the nasal bridge.
One technique that may be used is osteotomy, which involves creating controlled bone cuts to allow the nasal bones to be repositioned according to the surgical plan.
Different osteotomy techniques and incision patterns may be used. The appropriate approach depends on the width, shape, symmetry, and structural characteristics of each patient's nose.
What Is Nasal Osteotomy?
Nasal osteotomy is a surgical technique used to modify the nasal bones by creating controlled bone cuts along planned locations, allowing their position or width to be adjusted.
It may be considered in situations such as:
- Wide nasal bones
- A need to narrow the bony dorsum
- An open roof deformity following dorsal hump reduction in selected cases
- Nasal bone asymmetry
- A need to improve nasal bone alignment in relation to other nasal structures
However, not everyone seeking a narrower-looking nose requires an osteotomy.
How Is Nasal Dorsal Surgery Different from Alar Reduction?
Both procedures can change the apparent width of the nose, but they address different anatomical areas.
Nasal Dorsal Surgery focuses on the nasal bridge and dorsum, particularly the bony structures of the upper and middle portions of the nose.
Alar Reduction Surgery, on the other hand, focuses on the nasal base and nostril wings to address wide nostrils, a broad alar base, or nostril shape.
Individuals with both a wide nasal bridge and a broad alar base may require assessment of both areas to achieve balanced nasal proportions.
How Is Nasal Dorsal Surgery Different from Dorsal Augmentation?
Dorsal Augmentation primarily aims to increase or modify the height and shape of the nasal bridge.
Dorsal Narrowing, in contrast, focuses on reducing structural width and may involve adjustments to the nasal bones.
Some patients may need only dorsal augmentation, while others may require nasal bone narrowing or a combination of both procedures.
Who May Be Suitable for Nasal Dorsal Surgery?
Individuals with the following concerns may consider a surgical assessment:
- A wide nasal bridge when viewed from the front
- Broad nasal bones along the bridge
- A nasal dorsum that appears large or thick in relation to the face
- Nasal dorsal asymmetry
- Certain types of crooked nose
- A desire for a narrower and more proportionate dorsal line
- A desire to adjust nasal bridge width as part of rhinoplasty
- Previous nasal surgery with concerns about nasal bridge alignment or shape
Can Nasal Dorsal Surgery Be Performed Alone?
It may be considered as a standalone procedure if the main concern is the width of the nasal dorsum and the other nasal structures already have suitable proportions.
However, for individuals with several concerns, such as a wide nasal bridge combined with a large nasal tip, nasal deviation, or a broad alar base, adjusting the dorsum alone may not be sufficient to achieve balanced overall nasal proportions.
The surgeon should therefore evaluate the nose from frontal, oblique, and lateral views before determining the appropriate surgical scope.
Can Nasal Dorsal Surgery Be Combined with Rhinoplasty?
Yes. In some cases, dorsal correction forms part of a broader Structural or Preservation Rhinoplasty plan.
The surgeon may combine dorsal correction with adjustments to the nasal tip, septum, or alar base to maintain balanced proportions from the upper nose to the nasal base.
The specific techniques depend on individual anatomy and treatment goals.
Does Nasal Dorsal Surgery Make the Entire Nose Smaller?
Not necessarily, because a nose may appear large for several different anatomical reasons.
Nasal dorsal surgery primarily focuses on the bridge and central nasal structure. If the nasal tip or alar base is also wide, additional techniques may be needed to address those areas.
The objective should therefore be to achieve balanced nasal proportions rather than make every part of the nose as small as possible.
How Long Is Recovery After Nasal Dorsal Surgery?
When nasal bone adjustments are performed, temporary swelling, bruising, or tightness may occur around the nose and eyes during the early recovery period. The severity of these symptoms depends on the surgical technique and extent of correction.
These symptoms gradually improve as healing progresses, while the shape and apparent width of the nose may continue to change as swelling subsides.
Patients should avoid impacts, pressure on the nose, and strenuous activities for the period recommended by their surgeon.
