Rhinoplasty to make the nose more American

Westernization of the Asian nose

Nose surgery or rhinoplasty is becoming an increasingly popular request by Asian patients. The typical Asian nose appears wide and flat. Today many Asians are interested in changing their appearance in a way that makes them look more American. Two most common cosmetic surgical procedures requested to accomplish this are blepharoplasty, specifically upper eyelid surgery, and rhinoplasty surgery.

Most rhinoplasty patients, particularly American and European rhinoplasty patients are bothered by the “bump” on their nose. In these cases, the rhinoplasty surgeon will reduce the size and shape of the nose by removing and narrowing the nasal bones and cartilage which make up the bridge and dorsum of the nose. Asians patients on the other hand, typically lack projection of the tip of the nose and height of the bridge. Asians rhinoplasties are often additive, meaning something is added to the tip of the nose or along the bridge or dorsum of the nose to give more projection and height.

Tip projection can be increased by placing either cartilage in front of or on top of the existing tip cartilage. The second maneuver which is commonly used to increase tip projection is to place a strut of cartilages between the tip cartilages. This strut acts like a tent pole to which the tip cartilages can be sutured. Cartilage can also be added along the dorsum or bridge of the nose to increase the height and projection. The nasal septum is an ideal donor site for the cartilage graft in both of these situations. The repositioned cartilage depends on in growth of new blood vessels for survival and fortunately the nose is a very vascular organ.

Occasionally an Asian patient may not have adequate septal cartilage. In these cases the facial plastic surgeon or plastic surgeon may choose to use the patients rib cartilage. However, one drawback with rib cartilage is that is can warp or change shape over time. In addition an incision is required over the rib in the anterior portion of the chest. Other sources for augmentation might be irradiated cadaver cartilage or artificial synthetic implants.

Nasal implants consist of a solid silicone rubber material which is extremely biocompatible meaning, our body is not likely to react or reject the implant. However, any implant placed into the body such as a breast implant, or knee replacement can potentially become infected. Therefore precautions are taken by placing patients on antibiotics before, during, and after, the placement of nasal implants. The implants used in rhinoplasty surgery come in various shapes and sizes. Once the proper nasal implant is place under the skin of the nose they appear and feel quite natural. Our body forms a capsule of good scar tissue around the implant to secure its placement. Fortunately today facial plastic surgeons and plastic surgeons have many options to safely westernize the Asian nose for patients who want to appear more American.