Can Premaxillary-Paranasal Augmentation Avoid the Need for a Rhinoplasty?

Q: Dr. Eppley, I am writing to inquire about a standalone paranasal/premaxillary implant procedure.

My situation: I have a recessed premaxilla with no support at the nasal base, a flat philtrum, and an acute nasolabial angle. This creates the appearance of a dorsal hump and a downward-rotated nasal tip, which I believe are largely optical illusions caused by the lack of skeletal foundation rather than true nasal deformity.

I am specifically interested in a standalone paranasal or combined premaxillary-paranasal implant (peri-pyriform) to address this — without rhinoplasty at this stage.

I have researched your work extensively and believe you are one of the few surgeons with deep expertise in this specific procedure

.A:Thank you for your inquiry and sending your pictures. I would agree with you that there is some skeletal deficiency around the nasal base. And such deficiencies can create the appearance of a dorsal hump and a decreased nasolabial angle. As a result there is merit to a combined premaxillary-paranasal implant augmentation in which hopefully that would be enough to avoid the desire later for any desire for rhinoplasty changes.

Dr. Barry Eppley

Plastic Surgeon