Noses

Augmentation Rhinoplasty What is it and how is it performed?

12 June, 2024 · Updated on 7th October 2026

Updated on 7th October 2026 • Reviewed by Dr. Gustavo Sordo, plastic surgeon

Augmentation rhinoplasty is a complex and highly specialized procedure that aims to restore or enhance nasal volume to achieve harmonious aesthetics and optimal function. This type of intervention is primarily performed in cases where a previous rhinoplasty, whether traditional or classic, has excessively reduced the nasal structure, resulting in a disproportionate profile or a "slide effect."

If you are considering nose surgery, on the rhinoplasty page in Madrid you can find how we work, real cases and the price (from €10.040).

What is augmentation rhinoplasty?

We speak of augmentation rhinoplasty when, after a primary rhinoplasty, there has been a decrease in the volume of the nose that , from an aesthetic point of view, is unacceptable.

This situation often occurs when traditional or classic rhinoplasties , known as reduction rhinoplasties , are performed . In these rhinoplasties, the bridge is removed without subsequently reconstructing the bridge or mid-nasal third. As a result, the structures collapse, creating a sloping or excessively low profile. This type of rhinoplasty is complex and requires a source of cartilage to be performed.

Advanced Techniques for Augmentation Rhinoplasty

At Dr. Sordo's clinic , when we perform rhinoplasty augmentation, we use rib grafts as an alternative source of cartilage. To obtain this rib graft, we make a small incision above the rib , similar to the one used for breast implant placement. The incision will be as inconspicuous as possible and aesthetically acceptable.

Once the rib graft has been harvested, there are several options for augmenting the bridge of the nose . The most common and effective technique involves using cartilage chips wrapped in the patient's own muscle fascia . This muscle fascia can be taken from either the abdomen or the temporal region, leaving a minimal and virtually invisible scar. The fascia wraps around the cartilage, creating a malleable tube that can be precisely positioned over the bridge of the nose.

This technique replaces the full, unwrapped, uncrushed rib grafts. It also solves one of the main problems that arose when we used full rib grafts: their deformation over time. When the rib was placed on the nasal dorsum without crushing or wrapping, after a time, it would bend and generate asymmetries or a curved profile.

Currently, the technique with the best results when performing an augmentation rhinoplasty is the placement of the rib graft, crushed and wrapped in muscle fascia.

In augmentation rhinoplasty, the key decision is what material is used for augmentation , and our position is clear: whenever possible, with the patient 's own tissue . When the septum provides little cartilage—which is common in these noses—we use laminated costal cartilage , shaped in a balanced way and integrated with techniques such as Taştan's oblique split, precisely to reduce the risk of the graft curving over the years (Taştan et al., 2013, JAMA Facial Plast Surg ).

Synthetic dorsal implants provide a very attractive immediate result, but it's important to be aware of their downside: a higher risk of extrusion, infection, and long-term displacement, especially in noses with thin skin. With autologous grafts, the surgery is more complex and the results take longer to fully develop—often more than a year—but it is living tissue that integrates. In these cases, we also use hyperbaric oxygen therapy post-operatively to improve oxygenation and promote successful graft take.

Advantages of this technique

• An moldable graft that does not deform over time.
• Lets do consistent dorsal increases.

In addition to placing the graft, during augmentation rhinoplasty, we will perform a structural rhinoseptoplasty , as we always do. This technique involves placing grafts and sculpted cartilage segments in strategic areas of the nose. This gives the entire structure the necessary strength to withstand the passage of time and the inevitable skin contraction that occurs. Only in this way can we achieve the desired result, which the patient has previously been able to visualize using the computerized rhinoplasty simulator.

Furthermore, at Dr. Sordo's clinic in Madrid, we combine the techniques described above, such as rhinoplasty and ultrasonic rhinoplasty . This cutting-edge technique is performed using a piezoelectric or ultrasonic scalpel. This scalpel is used to obtain rib grafts in a minimally traumatic manner, as well as to modify the nasal skeleton and cartilage using ultrasound technology. Ultrasonic rhinoplasty allows for a much faster recovery while also increasing the precision of the surgical maneuvers.

For more information on rhinoplasty, contact plastic, cosmetic and reconstructive surgeon Dr. Sordo.