Cartilage plays an important role in supporting the nose and giving it shape. If too much cartilage is removed during rhinoplasty, certain parts of the nose may eventually collapse. This typically occurs over several years. Patients may notice the dorsum (the bridge) develop a depression until it gradually collapses. Depending on the severity of the collapse, it may obstruct the inside of the nose and cause breathing problems. Bridge collapse can also occur after removing a dorsal hump, especially if it involved removal of dorsum cartilage.
To rebuild the supporting structure of the nose, Dr. Kotler can use cartilage grafting to restore form and function. In some cases, he can also use the permanent filler, Silikon 1000, to build up the nasal structure. Both techniques are also used in primary rhinoplasty if the patient has a naturally flat or low dorsum and is seeking a balanced profile.
In some cases, rhinoplasty patients end up with asymmetric nostrils. When altering the delicate structures of the nose, special care must be taken not to overcorrect or remove too much cartilage and bone. When certain parts of the nose lack support, these weak points may collapse in and protrude to the other side, causing nostril asymmetry from the frontal view. While a certain level of asymmetry is normal, it can be frustrating to be left with a nose that appears more crooked after rhinoplasty.
Dr. Kotler addresses nostril asymmetry by correcting the protruding cartilage and building up the foundational structure of the nose. This also helps prevent future defects from developing.
Like many post-rhinoplasty defects, a drooping or upturned nose is frequently caused by overcorrection. When the nose lacks proper support, the nasal tip collapses backward and becomes over-rotated. Conversely, the nasal tip may become under-rotated and droop forward without adequate support. This causes an upturned appearance. An upturned nasal tip can also be caused by the contracture of scar tissue, which essentially pulls the tip backward. Dr. Kotler can reverse this cosmetic defect by restoring the supporting structure of the nose and releasing scar tissue when needed.
In some cases, patients have not developed any defects of the nose, but are simply unsatisfied with the result. Dr. Kotler understands that cosmetic surgery is an emotional process, especially when performed on one of the most prominent facial features. For this reason, he closely collaborates with his patients to create a customized treatment plan that best achieves their goals. During the consultation, Dr. Kotler will discuss with you whether your desired look can be achieved and what techniques would be most appropriate for your unique anatomy.