Asian Rhinoplasty

(Asian Nose Job)

Asian Rhinoplasty (Asian Nose Surgery)

As with all of the surgeries we perform at our facility, the goal of Asian rhinoplasty is not to create a Caucasian nose, but to create a nose that is compatible with the Asian face. While the goal of Caucasian nose surgery is usually to make the nose smaller, Asian rhinoplasty typically involves making the nose larger.

Asian rhinoplasty seeks to reshape the nose by altering the structure of the bone and cartilage beneath without undue external scarring. Some techniques are more commonly used for ethnic patients, though.

The flatter noses possessed by many non-Caucasian individuals can be addressed by grafting in extra cartilage from elsewhere in the body and shaping the skin of the nose tip more finely.

Up to three incisions (at the base of skin outside each nostril and in the columella between them) may be used to narrow the base of a wider nose. Artificial implants may be inserted into the bridge of the nose to give it better definition as well.

Small amounts of bone can be removed to eliminate humps. If you have a nose with typically ethnic features and would like to change its shape, discuss with our surgeons  about which of these Asian rhinoplasty surgery techniques would be right for you.

Whatever the patient’s race or gender, the goal is usually the same: change the nose to give the face a better sense of balance, symmetry, straightness. Asian  rhinoplasty surgery techniques allow the highly experienced to perform this for all  patients

How Asian Rhinoplasty techniques differ from Caucasian Rhinoplasty?

With our large volume of Asian rhinoplasty patients, we have had the opportunity to observe what works and doesn’t work when Caucasian rhinoplasty techniques are used on Asian noses:

1. Inadequate Tip Projection

Most commonly, surgeons not familiar with Asian rhinoplasty techniques attempt to perform a Caucasian rhinoplasty on an Asian nose. Typically, tissue is removed from the tip area in an attempt to narrow and sharpen it. Sometimes suture techniques are used to fold the cartilage into the right shape. Our experience is that these techniques are inadequate for giving the right shape.

Because Asians typically have weaker cartilage in the tip area, attempts to manipulate the shape of the cartilage fail. We advocate buttressing the tip structure with additional cartilage either from the inside of the nose – the septum, which separates the left and right air passage – or from the ear, through a hidden crease behind the ear.

This cartilage is used to reinforce and project the tip upward, somewhat akin to a pole propping up the tent. The cartilage should have adequate length and strength to properly fulfill this function. The correct way of placing the cartilage is to make it into a buttressing pillar. We do not advocate laying cartilage on top of the native weak tip cartilage, because the foundation is too weak to support an “onlay” graft at the tip.

2. Overly Large Bridge

This problem relates to an inadequate understanding of Asian nasal aesthetics. The Asian nasal bridge should start approximately at the level of the eyelashes or lower.

The important thing is that a slight break should exist between the forehead and the starting point of the bridge. Otherwise, a Greek nose results, which is not ethnically compatible on an Asian face.

This is an easy trap for a surgeon to fall into if the procedure is labelled as “Westernization”, rather than an ethnically consistent beautification.

3. Inappropriate Material for the Bridge

In Caucasian rhinoplasty, it is almost sacrosanct that natural tissue from one’s own body be used in the nose. Typically rib, skull or other bone is used. Our experience with patients who have undergone such procedures elsewhere is that these materials tend to be too bulky and difficult to shape. The edges are frequently visible or can be felt, and the top of the bridge does not blend well with the nose, resulting in an overly large bridge.

We have frequently been asked to remove these materials due to patient dissatisfaction with the aesthetic results. Many surgeons experienced in Asian rhinoplasty have found silicone plastic (SIlastic) to be well tolerated in the thicker skin of the Asian nose. Other materials such as Gortex ™ or Alloderm™ have been used without any clear consensus on their superiority. Generally our surgeons prefers implants due to their proven effectiveness.

4. Inappropriate Nostril Narrowing

The need for nostril narrowing varies depending on the country of origin. Contrary to popular opinion, nostril narrowing is not generally required for patients whose ancestry traces to Northern Asia – perhaps 15% need narrowing. The need for narrowing is more common in Southern Asians. Narrowing should only be performed when necessary in order to avoid unnecessary scars. Some narrowing effect is seen with tip projection alone. When narrowing is performed, the outside curvature of the nostrils must be maintained in order to avoid a “pasted-on” appearance.

5. Implant Extrusion

This becomes problematic if a silicone or other foreign body implant is placed into the tip area. This technique is more commonly performed in Asia. The preferred location of the implant is along the bridge only. Because the nose tip is mobile, any firm material in this area will begin to erode the overlying skin and the implant will become visible. The preferred material for the tip area is cartilage, which is soft and pliable.

6. Breaking the Nasal Bones

This procedure is frequently performed in Caucasian rhinoplasty as part of reducing the nose size. In Asians, this is not frequently necessary. Perhaps 10% of Asian patients undergo this step. Adding an implant to the bridge has a narrowing effect so that additional narrowing of the bones is rarely needed. Performing this step on an Asian nose can lead to airway blockage, as well as uneven bone position.

7. Anaesthesia for Asian Rhinoplasty

Because the bones are not usually fractured as part of an Asian Rhinoplasty, our surgeons do not perform this procedure under general anaesthesia with intubation (breathing tube). The common preference is intravenous sedation (“twilight anaesthesia”). By experience with Asian rhinoplasties has allowed him and his team to become very time efficient, with most cases taking between 1 to 3 hours, with minimal bleeding. Most people are able to return to work in 7 days.

How much does it cost?

The cost of the Asian Rhinoplasty procedure is between $7,700 to $8,800 The cost for a revision asian rhinoplasty procedure can for approximately $15,500.

Please keep in mind not all patients are alike and some will require a slightly different operation than others. Rest assured, you will receive a specific price quotation during your consultation visit. Our staff are always happy to discuss these matters with you in more detail.

The Esteem Cosmetic Studio website provides general information about cosmetic surgery. General information is not a substitute for professional medical advice and treatment, and should not be accepted in place or in preference to a consultation with a surgeon.
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