Semi-Structural Rhinoplasty

Semi-structural rhinoplasty combines an artificial implant for dorsum elevation with autologous cartilage (septal or ear cartilage) for columellar strut grafting and tip reshaping, while preserving the majority of the underlying cartilaginous framework. This technique is ideal for low noses with moderately bulbous, slightly short nasal tips that require projection; the level of surgical intervention and recovery time falls between cartilage-grafted rhinoplasty and full structural rhinoplasty.

Medically reviewed by BS.Ths.CKII Nguyễn Xuân Vũ — BonBoz Clinic

Where does semi-structural rhinoplasty stand among techniques?

Cartilage-grafted (traditional) rhinoplasty: only elevates the bridge and shields the tip—without altering the underlying framework. Full structural rhinoplasty: completely reconstructs the cartilage framework using autologous cartilage, often including rib cartilage. Semi-structural rhinoplasty: elevates the bridge with an implant, reinforces the columella, and reshapes the nasal tip using septal or ear cartilage while preserving the native framework—providing enough refinement and projection for a sleeker tip without the need for major surgical trauma.

What can it achieve?

A straight, elevated bridge; a more refined and projected nasal tip supported by a reconstructed columella; mild correction of a short nose; and a harmonious bridge-to-tip proportion that traditional cartilage-grafted rhinoplasty cannot deliver. What it cannot do: severely deformed or damaged noses, excessively short and upturned noses, or extremely thin or thick skin requiring a complete overhaul—these conditions necessitate full structural rhinoplasty.

Materials used

Bridge: custom-carved silicone or Surgiform. Columella and tip: septal cartilage (firm, straight, harvested intranasally without external incisions) or ear cartilage (soft, curved, ideal for tip-shielding). The surgeon selects the material based on your available cartilage supply and desired aesthetic outcome.

Recovery and expectations

Noticeable swelling and bruising for 1–2 weeks; tip swelling subsides slower than the bridge (taking 2–3 months), with the final result emerging within 6–12 months. The tip becomes significantly more refined, yet results remain limited by skin thickness: thicker skin yields a 'softer' tip definition compared to thin skin.

At BonBoz

Our surgeons assess facial proportions, skin thickness, septal and ear cartilage supply, and airway function; we recommend semi-structural rhinoplasty when appropriate and advise full structural rhinoplasty only when necessary. Surgeons perform the procedures directly and schedule follow-ups at key milestones to monitor swelling and alignment.

How is it performed?

Local anesthesia with conscious sedation or general anesthesia, depending on the case. Closed technique (endonasal incisions) or open technique (with a transcolumellar incision) when extensive tip reshaping is required. Septal/ear cartilage harvest, columellar strut grafting, tip cartilage suture reshaping, carved implant placement, tip cartilage grafting, closure, and splinting. 60–120 minutes.

Before the procedure

Undergo a clinical examination and basic lab tests; discontinue anticoagulants/blood-thinning medications for 1 week as instructed; refrain from smoking for 2 weeks; fast for 6 hours prior to the procedure if IV sedation or general anesthesia is administered; disclose any underlying medical conditions, allergies, history of previous rhinoplasty, or tendency to develop keloids.

After the procedure

Splint for 7 days; visible swelling and bruising in weeks 1–2; suture removal on days 5–7; take prescribed medications; apply cold compresses for 48 hours; sleep on your back with your head elevated for 3–4 weeks; avoid framed glasses and impacts for 6 weeks; avoid forceful nose blowing for 2 weeks; follow-up visits on days 2, 7, 30, and 90; nasal tip swelling resolves in 2–3 months; final results in 6–12 months.

Possible risks — your doctor explains them before treatment

Swelling and bruising for 2 weeks, nasal tip numbness lasting several weeks to months
Infection, hematoma (rare, treated early)
Dorsal or columellar deviation; temporary nasal tip stiffness
Implant visibility or erythema in patients with thin skin (lower risk compared to cartilage graft alone due to structural support and padding)
Columellar scar (in open rhinoplasty) — typically fades after a few months
Temporary nasal congestion due to septal swelling

Who should NOT have this?

Severely deformed, contracted nose from multiple previous surgeries (requires total structural revision with rib cartilage)
Bulbous, severely short, and upturned nasal tip (semi-structural rhinoplasty is insufficient)
Insufficient septal/ear cartilage with an unwillingness to harvest rib cartilage
Uncontrolled underlying medical conditions; coagulopathy; currently pregnant
Facial infection, severe cystic acne on the nose
Under 18 years of age

BS.Ths.CKII Nguyễn Xuân Vũ

Department of Plastic and Aesthetic Surgery

Master of Medicine and Pharmacy — Specialist Level I Surgical Resident, Hue University of Medicine and Pharmacy (2014–2017)
Specialist Level II Doctor in Plastic and Aesthetic Surgery
Specialist Level I in Plastic and Aesthetic Surgery — Pham Ngoc Thach University of Medicine; Specialist Level II in Healthcare Management — University of Public Health
Specialty Certificate in Orthopedics and Traumatology and Certificate in Plastic and Aesthetic Surgery (2017)
Medical Practice License No.: 007827/ĐL-CCHN — Issued by Dak Lak Province Department of Health on 04/12/2017
Over 15 years of experience, more than 20,000 surgeries
Specialist Level II Doctor in Plastic and Aesthetic Surgery at Ho Chi Minh City Hospital of Dermatology (2020–present); previously Lead surgeon for major and minor procedures at Sao Han Hospital (2018–2020)
Member of international humanitarian organizations Operation Smile and ReSurge International — performing pro bono reconstructive surgeries for patients with congenital deformities, cleft lip, cleft palate, and ptosis (2022–present)
Affiliated with Alcon Pharmaceutical (USA)
Member of the Korean College of Cosmetic Surgery (KCCS)
Medical Director of BonBoz Clinic

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Frequently asked questions

How does semi-structural rhinoplasty differ from cartilage-grafted rhinoplasty?

Semi-structural rhinoplasty reconstructs the columellar strut and reshapes the nasal tip using cartilage, resulting in a more refined and projected tip; cartilage-grafted rhinoplasty only augments the nasal dorsum and caps the tip.

How does semi-structural rhinoplasty differ from full structural rhinoplasty?

Semi-structural rhinoplasty preserves the underlying nasal framework and uses implants for dorsal augmentation; full structural rhinoplasty completely reconstructs the entire framework using autologous cartilage, involves a longer operative time, and is suitable for complex cases.

Is rib cartilage harvesting required?

Usually not; septal or ear cartilage is used instead. Rib cartilage is reserved for full structural rhinoplasty.

How long does swelling last?

Visible swelling and bruising last for 1–2 weeks; nasal tip swelling subsides more slowly, taking 2–3 months; the final shape stabilizes within 6–12 months.

Are there any external scars?

Closed approach: none. Open approach: leaves a small incision line across the columella, which fades after a few months.

Will the nasal tip be as small as desired?

It will be noticeably more refined, but results depend on skin thickness; thicker skin yields a softer tip definition. The surgeon will clearly explain these limitations beforehand.

Can a short nose be lengthened?

Semi-structural rhinoplasty can provide mild lengthening via columellar support; severely short or upturned noses require full structural rhinoplasty.

When can I resume exercising?

Light walking after 1 week; strenuous workouts and contact sports after 6 weeks.

How long do the results last?

Long-term and stable if no complications arise; the autologous cartilage in the columellar strut and tip integrates permanently with your body.

Who performs the surgery at BonBoz?

Dr. Nguyen Xuan Vu, MSc, Specialist Level II, personally conducts the consultations and performs the entire surgical procedure from start to finish.