The augmentation can be done at the level of the radix, the nasal dorsum or both.
Flat Nose (Dorsal Augmentation) Rhinoplasty
Dorsal augmentation focuses on enhancing the bridge of the nose, creating a more defined and balanced profile. Whether using natural cartilage or 3D-printed implants, this procedure is tailored to each individual’s facial features and goals. The aim is always to achieve a harmonious, natural-looking result that complements your unique beauty.
Dr Terence Goh
MBBS
MMed
MRCS
FAMS
Dorsal augmentation creates the ideal line and angle
Dorsal augmentation enhances facial harmony by refining contours and angles. A higher nose can:
- Refine facial lines and angles
- Create a smooth, balanced appearance
- Provide the illusion of closer-set eyes
- Enhance the overall silhouette
- Add structure to the face
High Doesn’t Always Mean Better
Many Asians have a low nose bridge and a bulbous tip, which can make the face appear flat, wide, and lacking dimension. A defined, elevated nose bridge can add depth and create a slimmer appearance. However, it’s not just about raising the dorsum. The bridge must be augmented in harmony with a well-defined tip to ensure the nose complements the face and enhances its natural features.
Who Should Consider Dorsal Augmentation?
A low nose bridge can contribute to a flat, featureless appearance. Dorsal augmentation may be suitable for:
- Patients with a low nose bridge or Binder’s Syndrome
- Those with a wide nose caused by a low or absent bridge
- Patients seeking tip rhinoplasty who require dorsum elevation for facial balance
- Those with a deviated implant from previous rhinoplasty surgery
- Individuals whose nose bridge is lower than the tip
Dorsum Augmentation – Changing the angles
Here is an overview of how we can alter the bridge of your nose.
Augmentation can be done at the radix, which is the area between the eyes. Rolled fascia or diced cartilage is suitably used to augment this area.
The nasal height can be increased by insertion of an alloplastic implant such as silicone (including customised 3D-printed implants) or an autologous graft such as diced cartilage and fascia, or dermis.
3D Implants for Revision Rhinoplasty
3D custom implants offer an effective solution for addressing complications from previous rhinoplasties involving implants. For patients experiencing nasal deviation or structural irregularities, these implants provide several key advantages.
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Enhanced Precision and Accuracy
3D implants are custom-designed based on the patient’s unique anatomy using specialised imaging technology. This ensures an optimal fit and accurate correction of specific deviations that occurred with previous implants.
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Improved Structural Support
When previous implants have resulted in deviation or structural compromise, 3D implants provide targeted support exactly where needed. Their customised nature allows for varying densities and contours to counterbalance existing asymmetries.
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Reduced Risk of Recurrent Complications
The precise fit of 3D implants reduces the likelihood of shifting, rotation, or migration—common issues with standard implants that often lead to deviation. This stability results in more predictable, lasting outcomes and decreases the need for additional revisions.
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Seamless Integration
3D implants can be designed to integrate harmoniously with existing nasal structures and any remaining previous implant material. This creates a more natural appearance and feel while effectively correcting complications from earlier procedures.
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Consult our MOH-accredited plastic surgeon for a personalised treatment plan.
3D Simulation
Crisalix 3D simulation provides a realistic preview of your potential rhinoplasty results, helping you visualise changes before surgery. Using a 3D model of your face, your surgeon can demonstrate adjustments such as refining the tip, narrowing nostrils, or modifying the bridge, all customised to suit your facial structure. This collaborative process ensures you are informed and confident in your decisions, aligning your goals with your surgeon’s expertise.
Customised 3D-Printed Implants for Rhinoplasty
3D-printed silicone implants offer a personalised approach to rhinoplasty, ensuring a precise fit tailored to your unique anatomy. These implants, created with advanced 3D imaging, allow for enhancements to the bridge, tip, and overall nasal structure that complement your facial features. This technology eliminates the need for generic implants, resulting in natural, balanced outcomes.
Rhinoplasty Materials
Here is an overview of the range of materials available for nasal dorsum augmentation.
Silicone
is the most commonly used and longest-standing implant material for rhinoplasty. It retains its shape over time and is ideal for creating smooth, curved lines along the dorsum. However, proper skin coverage is necessary for safe use, as capsular contracture can lead to a shortened nose in the long term.
Gore-Tex
integrates well with natural tissue due to its porous structure, making it suitable for patients with thin skin. It offers a soft, natural look post-surgery. However, its tissue integration can make it harder to remove, and slight lowering may occur over time.
Diced Cartilage + Glue
Finely diced cartilage, taken from the septum or ear, is mixed with tissue glue to form a bioactive paste. This paste is used to smooth minor irregularities or create mild dorsum elevation. As only a small amount of cartilage is required, additional incisions are often unnecessary. However, due to resorption, some loss of dorsal height may occur over time.
Diced Cartilage + Fascia
Diced cartilage is wrapped in fascia harvested from the scalp through a hidden incision. This technique maximises the use of cartilage from the septum and ear, allowing for full dorsal augmentation. Wrapping the cartilage in fascia reduces resorption rates and minimises the risk of irregularities or deviation.
Fascia Only
Fascia-only grafts are ideal for augmenting the radix or increasing skin thickness in noses with very thin skin.
Dermal grafts can be harvested from various parts of the body, with the back of the buttock being a preferred site due to its discreet scar placement. Both skin and fat from the graft can be used to augment the nose, providing a natural appearance without the need for implants. However, a resorption rate of 20-30% should be considered.
Rib cartilage provides a large volume of material that can be used either as a single piece (en-bloc) or diced and wrapped in fascia. En-bloc rib cartilage is primarily used in reconstructive surgeries where substantial cartilage is needed, while diced cartilage is ideal for augmentation. Although versatile and effective, rib surgery typically requires an overnight stay and is the most expensive option.
Getting Augmentation Rhinoplasty Right
Facial Harmony and the Nasal Tip
Creating a natural, beautiful nose involves aligning the dorsum and nasal tip. Concurrent tip-pasty is often a preferred choice. In some cases, rhinoplasty alone may not be enough. Additional procedures like eyelid or philtrum reduction surgery can enhance overall facial harmony.
Choice of Materials
Various materials are available for nasal dorsum augmentation, each with its pros and cons. Consult us to find the best option for your needs. We offer a full range of materials to achieve safe, natural results. Autologous techniques (using your tissues) are the gold standard, eliminating implant-related complications, even though implants are generally safe.
Considering Facial Angles and Proportions
With 3D imaging software, we can simulate potential outcomes, helping to design ideal facial proportions and create a symmetrical, natural, and sophisticated look.
Rhinoplasty Tailored to Asian Noses
Dr Terence Goh
Choosing to combine the intricate skills of microsurgery with aesthetic surgery, Dr Goh specialises in gynaecomastia, surgery of the Asian face, particularly Asian eyelid surgery and rhinoplasty.
Blending the precision of microsurgery with the artistry of aesthetic surgery, Dr Goh has a special interest in gynaecomastia, facial procedures, including ptosis and eyelid surgery, as well as rhinoplasty.
He also offers a full range of body contouring procedures such as mummy makeovers, breast augmentation, liposuction, and body sculpting—designed to help patients feel more confident and comfortable in their own skin.
Beyond aesthetics, Dr Goh remains active in reconstructive microsurgery, with expertise in breast reconstruction, head and neck reconstruction, and lower limb salvage—restoring both form and function where it’s needed most.
- Bachelor of Medicine, Bachelor of Surgery, National University of Singapore
- Master of Medicine, National University of Singapore
- Member of the Royal College of Surgeons
- Fellow of the Academy of Medicine, Singapore (Plastic Surgery)
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