How long will the swelling occur for Asian Rhinoplasty removal?

Q: How long will the swelling occur for Asian rhinoplasty removal (without any replacement) and what if I also want to inject a small amount of filler for subtle changes (how long will the swelling occur)?

A: A number of factors will come into play with regards to the duration of swelling after removal of implants including how long ago the implant was placed, what kind of implant, and how much tissue trauma occurs when the implant is removed.  Much of the swelling will have resolved by 4-6 weeks, and by 3-6 months will virtually be gone.

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How do Gore-Tex, Medpor and Silastic compare when properly used in Indian/Asian short nosed patients?

Q: It’s my understanding that placement of the implant in natural cartilage is the real onus of any implant to help a patient augment a low bridge/support a tip through the dorsum. Which is better? Which can best refine a nose & provide columellar support without adding excess projection?

A: In terms of amount of tissue ingrowth, Medpor > Gore-Tex > Silastic.  All of these synthetic implants have a higher rate of complications than using tissue from your own body.  Only autologous grafts provide a permanent result.

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What are the best methods to stabilize a shield graft in an Asian patient?

Q: I had a rhinoplasty with a septal shield graft and notice the tip is dropping. I need a revision for additional scar tissue removal, but I was wondering if a graft could be reused and altered so it is stabilized against dropping so much in thick skin.

A: Depending on the condition and quality of the original graft, previously placed grafts may be used during a revision procedure.  With regard to stabilizing your tip rotation – this is a product more of stabilizing your tip cartilages with a septal extension graft or even a columellar strut more than it is the shield graft.

In order to resist the forces of thick skin, additional grafts may be needed to support the tip of your nose.

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How to make nose bridge wider and nose look fuller?

Q: I’m an Asian male and I kind of already know how to make my nose bridge wider based on my research, which is the spreader graft. My nose is similar to the African American woman’s whereby bridge is thin and dented at the side of the nose (with arrow pointing). My question is, how do you “fill” the dent so my nose bridge wont appear so skinny? My ideal nose is triangular shape and mine is looks like an inverted T.

A: Using grafts to support the external nasal valve – such as lateral crural strut grafts or alar batten grafts, may be used to widen this “pinched” area and to provide a more gradual transition from the bridge to the tip.

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Would Alarplasty be adequate to reduce wide bulbous Chinese nose and chronic history of acne/seborrheic skin?

16yndoyiya

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What’s the best cartilage source to define & rotate a nose?

Q: I need dorsal augmentation but still want a softly rounded, feminine tip. I don’t feel septal cartilage looks natural. Why might or might not ear cartilage be a better choice for some augmentation/definition of an SE Asian tip?

A: The choice of graft will depend on the type of grafts needed as well as the amount and volume of augmentation and refinement desired.  A soft, rounded feminine tip can be created from septal, ear, or rib cartilage when performed by the right surgeon.

Ear cartilage has the advantage of being soft and offering smooth contours.  It can also create nice refinement in the tip of the nose in combination with grafts to project the nose (columellar strut/septal extension graft).

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How often can the ear be used for cartilage? Asian patient, no septal cartilage to use.

Q: I’ve already had the back of my ear used for one failed rhinoplasty. I need to get it right this time. I need dorsal augmentation, tip support, definition & slight rotation/projection. I feel building up my bridge w/anything more rigid will make me look masculine (I am female & want a short but straight nose). Where can the ear be mined for tip-suitable cartilage?

A: With cartilage from your septum and one ear already exhausted, it is unlikely the other ear will provide enough cartilage to provide dorsal augmentation, tip support, and counter-rotation + projection.  Rib cartilage provides a large volume of strong, straight cartilage for structural grafts (extended spreader grafts, septal extension graft) for tip projection/counter-rotation.

For dorsal augmentation, I feel the diced cartilage fascia (DCF) technique is the best option as it provides the most natural looking and attractive contours in a permanent fashion.

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If I don’t want a drastic change when removing the implant, will reducing the implant height work?

Q: If I don’t want a drastic change when removing the implant of (2-3 mm silicone), do you think reducing the implant height in several attempts (once every year) will work? I’m always paranoid of people looking at my nose and I made determination to remove it someday

A: I would not recommend trying to reduce the height of the silicone implant, and certainly not yearly, as this will introduce more scar tissue to your nose and further impair the viability of the skin.

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Visibly lumpy bridge after Asian rhinoplasty – Can ear cartilage grafts (Asian rhinoplasty) be removed?

Q: Had an Asian rhinoplasty 9 months ago, and had ear cartilage grafts put in the bridge (radix area). After swelling went away, the graft is very visible and you can clearly see and feel the edges. From a distance, it looks like a bump. No fascia was used to wrap the graft, an intact (not crushed/diced) piece approx 4-5 mm long. Do I have to wait up to a year since my surgery to get a revision, or is this something that can be fixed now in a simple procedure? Could the graft resorb on its own?

A: Removing an onlay graft on your bridge can safely be performed at any point after surgery (and especially at 9 months post-op this will not create any increased risk).  The ear cartilage graft is unlikely to resorb on its own.  The question is whether or not you will be satisfied with the appearance of your bridge and radix without anything to augment that area.

One of the great strengths of the diced cartilage fascia (DCF) technique for radix and dorsal augmentation is that when performed well it creates the smoothest, most natural contour.  At 9 months post-op, you could safely undergo a revision to remove the visible cartilage graft and replace it with a DCF graft.

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3 weeks post op Asian nose job. Will it be pointy and grow a longer as time goes by?

Q: It’s been almost 2 weeks since they took off my nose splint (3 weeks since the day I got a surgery). I feel like the tip of my nose is kind of round, big and short. Will it be kind of pointy and grow a little longer as time goes by? p.s: they used my ear cartilage

A: Swelling of the tip of the nose 3 weeks after rhinoplasty is expected and completely normal.  While your profile should begin to look good at 3-4 weeks after surgery, the majority of the tip edema (swelling) will not resolve for 3-6 months.  At that point you will be able to tell whether or not the initial surgery provided enough tip support and refinement to achieve the results you were hoping for.

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