Flat Nose Rhinoplasty: How I Build a Natural, Defined Nasal Bridge

A flat or low nasal bridge is a common concern among patients of any race, but we often see this in revision rhinoplasty patients whos bridge was over resected, as well as in some Asian, African, Hispanic/Latino, and Middle Eastern backgrounds, as well as patients with trauma. The goal in treating a flat bridge is creating natural height and definition without looking artificial or overbuilt.

Here’s how I approach it.

Why Some Noses Have a Low or Flat Bridge

Common anatomical factors include:

  • naturally low dorsum

  • short and low nasal bones

  • congenital deformity

  • thicker skin

  • prior trauma

  • previous rhinoplasty or dorsal collapse

A flat bridge can make the nose appear wider or less defined from the front and profile views.

My Approach to Flat Nose Rhinoplasty

I use a structural, augmentation-focused approach to build a natural, stable bridge.

1. Cartilage Grafting

I use your own cartilage whenever possible to create durable, natural augmentation. Options include:

  • solid cartilage grafts

  • layered cartilage support for height camouflaged by soft tissue like perichondrium of fascia

  • Elevated or tall spreaders (my preferred technique)

2. Temporalis Fascia or Perichondrial overlay (when needed)

This provides a smooth, natural contour over grafts. Can also be used isolated for smaller increases in height.

3. Structural Support

Strong support prevents collapse or irregularities. I may use:

  • septal extension grafts

  • spreader grafts

  • dorsal support frameworks

  • Solid rib onlay

  • integrated tall spreaders.

4. Ultrasonic (Piezo) Bone Refinement

Used when narrowing or contouring the bones for precise shaping.

We also use this to allow for elevation along the entire length from radix to tip.

What Results Look Like

My goal is to create:

  • a natural, balanced bridge

  • improved definition from the front

  • a smoother, more refined profile

  • proportionate height that matches your facial features

The best result preserves your identity while enhancing harmony.

Who Is a Good Candidate?

  • patients with naturally low bridges

  • trauma-related flattening

  • prior surgery with dorsal collapse

  • patients seeking subtle, refined augmentation

Bottom Line

A flat or low bridge can be refined safely and naturally using modern structural augmentation. With cartilage grafting and precise structural support, I create long-lasting, refined results that look authentic and balanced.

Revision Rhinoplasty, ethnic rhinoplasty, asian rhinoplasty, Rhinoplasty, thick skin rhinoplastyARI HYMAN