Augmentation Rhinoplasty Part 3 Showing Bridge Augmentation
Video transcript: The other thing that we did for her is we augmented her bridge and so you can see over here there is a grey bit of tissue here – this is actually Gore-tex. And the Gore-tex is inserted and lays right on top of the nasal bridge bones and cartilages and that augments this part of the bridge. The reason we use gortex here is because you probably need several millimetres of augmentation of the bridge and usually the septal cartilage is just not that thick so I think in most cases to get a substantial augmentation you usually have to use a synthetic material.
I like to use gortex because it is soft and I can carve it in a very custom way, it also has a low rate of complications so I think it is a good material to use for this purpose. In addition to the gortex graft that you can see that I have applied to the bridge I am also showing the cap and shield graft that I applied before on side view and you can kind of get the sense for how these cartilages project her existing cartilages further forward and therefore project her tip further forward and give it more definition.
This is before and this is after with the tip cartilages in place and the gortex graft on the bridge and then I will just show you her actual photos so that you can see that her tip has been projected a bit further forward and a very subtle augmentation of her nasal bridge. You will see on her base view that in addition to projecting the tip in a forward direction I have also narrowed her nostrils, so what I have done is make some small incisions just at the base or the nasal sil. Just at the floor of the nostril right around the corner I have removed some of the skin and then tucked it inwards so that you notice that on this view now her nostrils are much narrower. It has also changed the contour of the side walls a little bit and so these are a little straighter now than they were before so they were slightly flared and now they are a little straighter. So overall again this is a before and after of augmentation of the nasal bridge, the nasal tip and reduction of the alar base and these are her three quarter views.
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