When the size of the nose appears to be disproportionately small compared to the face or the nose shape is wider rather than prominent, building up the proportions of the nose is referred to as augmentation rhinoplasty. The operation is more common with some ethnic groups which has led to the popular use of the term ethnic rhinoplasty. Unfortunately, this term is rather confusing because every rhinoplasty intervention is in some way or another ethnic.
In some instances, following excessive reduction of the nose in previous surgery, an augmentation rhinoplasty is necessary to produce a better balance with the facial features.
The underlying anatomy for noses that are less prominent seems to be an under-development of the nasal septum and wider contours of the external nasal bones and cartilages. This means also that there is rarely enough cartilage within the nasal septum to use for additional prominence and contouring of the nose.
Augmentation rhinoplasty typically relies on bringing in grafts of cartilage from outside the nose, typically rib cartilage or ear cartilage to enhance the structural support and contour the nose closer to the patient's expectations.
The cartilage grafts can be used to build both support and projection to the bridge of the nose and the tip, to shape the profile of the nasal tip differently and if required to increase the length of the nose.
In a number of augmentation rhinoplasty procedures and alar base reduction is also potentially useful to bring more balanced to the proportions of the bridge of the nose and nasal tip.