Rhinoplasty to Treat the Saddle Nose

The term saddle nose describes the loss of height of the nasal bridge; this is also called “boxer’s nose” because it is often caused by trauma that leads to deformity, although some people have this due to inborn abnormalities, cancer surgery, botched cosmetic rhinoplasty, infection, and destructive diseases. 

Rhinoplasty, or more commonly called nose job, can correct the saddle nose.  Take note that if the condition leads to severe deformities and breathing difficulties, insurance reimbursement is possible.  By contrast, a surgery that is purely done for cosmetic reasons is not covered by health insurance.

In mild cases of saddle nose, many patients only have aesthetic problems and not breathing difficulty.  In order to treat them, augmentation rhinoplasty is often the most preferred choice; in this technique, plastic surgeons raise the nasal bridge and sometimes also the tip to create the most natural-looking result.

During augmentation rhinoplasty, plastic surgeons use different materials to correct the aesthetic problem or breathing difficulty.  For some patients, their own nasal cartilage and bone can be simply manipulated, or grafted from other body areas including the ear (behind it) and rib.

For slight defects, collecting cartilage behind the ear will usually suffice.  This is a relatively simple and safe procedure that does not impair the patient’s hearing and affect the ear’s appearance because the scar is hidden from plain sight.   But for large defects, rib cartilage is often a better choice.

Aside from natural grafts, plastic surgeons also use artificial implants such as Gore-Tex, Medpore, and Silastic when correcting the saddle nose.  But with this technique, there is always a concern of implant extrusion, infection, and implant shifting.

When there is a need to use artificial implants, many doctors in the US prefer Gore-Tex which has the lowest rejection rate among synthetic materials used in rhinoplasty.  Its notable characteristic can be attributed to its porous structure that allows nasal tissue to grow and develop inside until the implant becomes part of the nose.

The good thing about using Gore-Tex to treat the saddle nose is that it can be easily molded into the desired shape and various thickness, leading to a more natural-looking result after rhinoplasty.

However, patients should remember that severe saddle nose deformities are challenging problems because more often than not, the septum (tissue separating the left and right airways) has large perforation or in extreme cases even absent.  For this reason, perfect results are quite rare, though improvements are still possible.