Should a Premaxillary Implant Be Done Before or After a Rhinoplasty?

Q: Dr. Eppley, I am a female interested in custom facial implants and was wondering if you have ever created/installed nasal spine or premaxillary implants. Also, would it be better to get those implants put in before or after a rhinoplasty?

A: When you speak of nasal spine area, you are likely referring to what we call the premaxillary region which is the base of the nose. For that area numerous type of premaxillary implants are available for augmentation. If you are referring to the exact nasal spine to extend it up into the columella to also add to more nasal tip projection, then a cartilage graft is usually done to do so. By your midfacial pictures you could benefit by either premaxillary or direct nasal spine extension grafting.

Regardless of the type of base of nose augmentation used, it would most commonly be done as part of a rhinoplasty as they work in tandem for a better overall aesthetic result.

Dr. Barry Eppley
Indianapolis, Indiana