Asian Rhinoplasty Expert

While the goal for every surgeon who preforms Rhinoplasty is to create harmony of the patients facial features, asian rhinoplasty requires special consideration of surrounding structures for balance to be established.

Asian noses sit flatter and deeper on the face than caucasian noses do.  Due to this lack of projection-an augmentation of the nose is often required.

  • The masseter muscles are typically thick creating the appearance of a wide jaw.
  • The cheeks can have minimal projection adding to the flatness of the face.
  • The skin is usually thick and sebaceous.
  • The nasal tip is commonly bulbous with minimal definition present and the tip is underprojected.
  • The bridge of the nose sits low and flat and the columnella (the area just under the tip) is short and minimal, often appearing hidden.
  • The nostrils tend to flare and the base of the nose is wide.

As with all rhinoplasties Dr Azizzadeh's goal is to create a beautiful nose that enhances a patients unique ethnic features.

Structural Rhinoplasty techniques are utilized to create a more attractive nose.

Finally, it is extremely important to consider that there is a significant amount of difference among the Asian countries.  Dr Azizzadeh focuses on avoiding radical changes that will create an unwanted and unnatural facial/nasal appearance.

Asian Rhinoplasty: Less is More Babak Azizzadeh, MD, FACS

Ethnic rhinoplasty is a growing field in modern medicine and continues to evolve at a rapid pace as more sophisticated customers demand increasingly sophisticated results. As a new generation of physicians become more and more experienced with ethnic rhinoplasty, the number of procedures being done on various ethnic groups grows accordingly each year. One such popular procedure is Asian Rhinoplasty; in this article you will learn: • What Asian Rhinoplasty is • How it is performed • What to know during the consultation • How long recovery time might last What is Asian Rhinoplasty? Asian Rhinoplasty concerns itself with patients who want their features to align in a more proportionate flow to not only match their current American lifestyle but also to preserve the appropriate ethnic features of their ancestral origin. As the modern view of beauty continues to grow and evolve, patients want to stand out less and feel more comfortable; Asian patients are no different.

Many rhinoplasty procedures are done to make the nose smaller but with Asian Rhinoplasty this is not always the case; by adding definition to the bridge of the nose, for instance, the nose actually gains prominence but in a more natural, cumulative way that carefully aligns with adjoining facial features. The goal, as ever, is to simply make the resulting nose more proportional to the patient's face.

The following issues are of particular concern to most of our Asian patients:

  • Nostrils may be wider than the patient wishes
  • The patient may wish to alleviate some of the flatness of his or her nose
  • Steps can be taken to elongate or lengthen the nose tip

How is it performed?

Once upon a time doctors performed Caucasion Rhinoplasty on all their patients, failing to address or ignoring completely the specific needs of each ethnicity. Today Ethnic Rhinoplasty demands specific results for specific ethnicities. For instance, the Asian Rhinoplasty procedure is specifically designed to address the three features directly above.

Nostrils can be narrowed by reorienting the base where the nose meets the upper lip. Repositioning the nostrils narrows the gap that often creates the elusion of "width" in some Asian patients.

Noses can be made to appear less flat and with more definition through the use of a variety of techniques. For instance, Silicone and Gore-tex can be utilized to create definition and elevation of the nose bridge to make such every day concerns as wearing eyeglasses easier, as well as a more defined appearance. An individual's own cartilage can also be grafted to the bridge of the nose and then smoothed out to make it more prominent. Although in Asia most rhinoplasty surgeons use silicone, I prefer to use cartilage with "fascia" to elevate the bridge. This reduces the risk of infection and also limits the shadow on the side of the bridge that can be prominent when silicone is used.

Finally, many Asian-Americans will also have significantly short noses that are a normal anatomic variation. The nasolabial angle, which is the angle between the upper lip and nose, is typically 95 to 105 degrees for women and 90 to 95 degrees for men. The treatment of the overturned nose is perhaps one of the most challenging components of primary (ethnic) or revision rhinoplasty procedure. Typically, multiple cartilage grafts are required to reverse the overturned short nose to create better aesthetics. Oftentimes this will require harvesting of additional cartilage grafts to obtain the necessarily structural support that is going to be required for lengthening the nasal tip as well as reducing the upturn of the nose. Silicone and other synthetic material should not be used in the tip area as the chance of problems significantly go up.

An external/open rhinoplasty approach is utilized to identify the cartilages of the nasal tip and the middle nasal vault, which is the middle portion of the nose. Cartilage tip grafts and extended spreader grafts are utilized to counter rotate the nose and lengthen the nose. Oftentimes, the patient will require fascia, which is soft tissue covering, to allow beautiful and aesthetically pleasing tip in addition to counter rotation of the nose.

What should I know before an Asian Rhinoplasty consultation?

In the past, all patients regardless of their ethnic origin were treated with the same rhinoplasty techniques resulting in poor results with un-natural aesthetics. The patient's ethnicity must play a critical role in the rhinoplasty approach as well the ultimate aesthetic objectives. During your consultation, make sure to go over your overall goals with your treating physician in detail in order to better serve your specific wishes.

Every consultation is different and it is up to you to be prepared. The patient's height needs to be taken into consideration when the nose is being analyzed as someone who is very short can tolerate a slightly more overturned nose than someone who is extremely tall. A tall individual with a very overturned nose will experience extremely poor aesthetics, as anyone who is at their level will see into the nostrils very easily. These are extremely important aspects of the nasal analysis as not only does the nose need to be analyzed in relation to the face, but furthermore needs to be analyzed with patient's ethnicity, body, height and shape as well.

How long might recovery time last?

Asian Rhinoplasty is typically performed as an outpatient procedure. Because bones are rarely broken during Asian Rhinoplasty, recovery time is often as short as one to two weeks. However, as with all rhinoplasty procedures, you must have someone care for you for at least 72 hours after your surgery is done. A small splint is typically placed on the nose to bestow stabilization for one week. You will also have to have some stitches in place for a short period of time while the incisions heal.

About the Author: Dr. Babak Azizzadeh is the Director of the Institute for Rhinoplasty & Nasal Reconstruction and The Center for Facial & Nasal Plastic Surgery in Beverly Hills, California. Dr. Azizzadeh is one of the leading facial plastic surgeons in the country with an expertise in primary and revision rhinoplasty. He is the author of the upcoming textbook Master Techniques in Rhinoplasty & Nasal Reconstruction and Beverly Hills Beauty Secrets.

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