When there is too little tissue along the top of the nose, the middle appears caved in or crushed. This condition is especially prevalent in people of Asian or African origin, and is almost always treated by taking cartilage from the inside of the nose and using it to build up the affected area. This condition can also result from removing too much tissue during other types of rhinoplasty or septum surgery.

Some doctors prefer using silicone implants (not injections) or bone grafts from the patient's hip or rib to create the same kind of change; these are acceptable alternatives.