Preventing Elevated Radix Deformity in Asian Rhinoplasty with a Chimeric Dorsal-Glabellar Construct

Overview

Straight I-shaped implants used for Asian augmentation rhinoplasty can push the radix upward and flatten it, producing an unnatural profile. The authors developed a construct extending onto the glabella to control where the radix ends up, and compared it against the standard implant on standardised photographs.

Sections of note

• 49 patients had rhinoplasty with I-shaped implants between 2013 and 2015. Nineteen received the chimeric dorsal-glabellar implant and 30 did not.
• Mean follow-up 10.8 months, range 2 to 36 months.
• Nasal height increase was 113 percent without the chimeric implant against 107 percent with it, and bridge length increase 118 percent against 105 percent, both p less than 0.0001.
• The nasofrontal angle increased 6 degrees in both groups with no difference between them.
• The direction of radix movement was 26.1 degrees in the chimeric group against 63.4 degrees in the traditional group, p less than 0.0001, meaning a more horizontal shift.
• The technique did not significantly blunt the radix. Final radix position was determined by implant thickness and placement. Level of evidence 4.

What it means for a patient

• A straight implant can lift the top of the nose toward the forehead, which reads as unnatural in profile.
• The modified design moved the radix forward instead of upward, changing the direction of the correction rather than its amount.
• Final radix height still depends on how thick the implant is and where it is placed, so the technique controls direction, not overall size.
• Not randomly assigned, 49 patients at one centre, mean follow-up under a year, and outcomes measured from photographs rather than reported by patients.

Why this paper matters

Asian facial aesthetic surgery is framed here as enhancing rather than altering natural features, and an over-raised radix is a recognisable sign of an implant. Distinguishing forward from upward movement gives a measurable target. Long-term implant behaviour and patient satisfaction are not reported.

Terms

• Radix: the root of the nose, the deepest point of the bridge between the eyes.
• Glabella: the smooth area of the forehead between the eyebrows.
• I-shaped implant: a straight synthetic implant used to raise the nasal bridge.
• Chimeric construct: an implant combining two components serving different regions.
• Nasofrontal angle: the angle between the forehead and the bridge of the nose.