The Ideal Glabellar Position and How to Modify It
During consultation with my rhinoplasty patients, I assess the nasal anatomy, including the position of the glabella (the space between the eyebrows, above the nose) and the bridge. When the glabella is too far back, or appears to be too far back because of the bridge height, there are different options for either augmenting the feature or changing the angle. For example, if the naso-frontal angle is deep as a result of a high bridge, then I will often perform a hump reduction, which improves the naso-frontal angle. When the bridge is in an ideal position and the deep naso-frontal angle is a result of a receding glabellar, then there are other treatment possibilities, including grafts of fillers.
Changing the naso-frontal angle with hump reduction
Reducing a large hump is one of the most common requests from my Vancouver rhinoplasty patients. While reducing a hump may be the primary objective of surgery, there are secondary changes to the overall nasal and facial aesthetic that need to be considered. First of all, hump reduction may improve a deep naso-frontal angle, but can also make the tip of the nose appear to be lower than before. Tip rotation is therefore a common part of any hump reduction rhinoplasty. Computer imaging is incredibly helpful in communicating to my patients how changes to one feature will change the way other features appear.
Glabellar augmentation with grafts
If the bridge is in a good position and the deep naso-frontal angle is caused by a recessive glabella, then this area can be directly augmented during rhinoplasty surgery through the use a radix graft. The type of graft used is chosen carefully to ensure it is well hidden below the skin. Grafts are mainly used when the patient requires modifications to other areas of the nose and not just the glabella. If the glabella is the only part of the nose to be modified, then surgery is often not necessary and augmentation can be achieved with fillers.
Glabellar augmentation with fillers
Today, various safe options are available for augmenting the glabella. Filler materials last from 3 month to 12 months depending on what material is used. The treatment is quick and involves very little discomfort. While uncommon, some patients experience bruising following a filler treatment and should therefore plan to have the procedure performed a week before any major event.
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