Q: Hello, I got my first revision about 3 months ago to fix pinching, but the sides of the bridge is still pinched. The tip looks great but the bridge still looks pinched. Not as bad as before, but it is still pinched. How can this be fixed? Thanks.
A: A number of approaches can be used to improve the appearance of this “pinching” along your bridge (dorsum). The best option as mentioned is probably with revision rhinoplasty with placement of spreader grafts – which will address the underlying collapse of your middle vault which is creating the pinched appearance. Another approach, which is reasonable if nasal obstruction is not a major complaint, is to camouflage the depressed “pinched” areas. This could be temporarily with a dermal filler, or more permanently with a cartilage graft – either an onlay graft or diced cartilage.