Do You Use Implants Or Cartilage For Paranasal Augmentation?

Q: Dr. Eppley, I wanted to know if a paranasal or premaxillary augmentation would help add volume to the area around my nose. Its sunken in and people always tell me I look sad when I’m not sad. Do you do this procedure using an implant? Or do you use rib cartilage?

A: The Asian midface is a common area in which I perform paranasal and premaxillary augmentation. With a genetic predisposition to a more flat facial profile (or even a concave profile), ‘pulling’ the base of the nose out by bony augmentation will certainly add volume to the base of your nose for more midface projection. The usual amount of augmentation is in the range of 6 to 8mms. I have used both implants and rib cartilage for paranasal augmentation depending on the patient’s request. The vast majority of patients opt for implants because it does not require a donor site. The few patients in which I have used rib grafts for midface augmentation is when they were also having rib taken for a rib graft rhinoplasty so they were having a donor site anyway and the paranasal augmentation was a coincidental byproduct of the other procedure.

Dr. Barry Eppley

Indianapolis, Indiana