What are the operations I have to go through for this kind of nose?

Posted on March 25, 2017 by Donald B. Yoo, M.D.

Q: Hi I am ASIAN. I want to get my nose done, but I don’t know that should I go through, like alarplasty, rhinoplasty, etc. I am okay with my bridge, but adding little height will be excellent. It is just the tip of my nose. Help me please so that I would know the options that I should go through.

A: A nice degree of refinement and projection of the bridge and tip of your nose would be possible using cartilage from inside your nose (septum) as well as from your ears (through an incision behind your ears without altering their appearance).  Fascia could also be used in addition to the cartilage to build up the bridge of your nose to create a more attractive nose.

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Can I still have a pointy nose?

Posted on March 25, 2017 by Donald B. Yoo, M.D.

Q: Hi. I’m 17 years old, turning 18 in 3 months. I’m an Asian female. I’m wondering how to have a pointy nose because I have a small nose and my nose bridge is not high. Can I do something about it? I want the normal way if possible. Hope you can help me. Thanks a lot! 🙂 God bless.

A: The bridge of your nose can be augmented and the tip of your nose refined in a way that is balanced with your facial features and provides a natural, beautiful result using tissue from your own body.  Results depend on the skill and experience of the surgeon, so it’s important to find a rhinoplasty specialist with expertise in Asian rhinoplasty.

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How long will the swelling occur for Asian Rhinoplasty removal?

Posted on March 25, 2017 by Donald B. Yoo, M.D.

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?

Posted on March 25, 2017 by Donald B. Yoo, M.D.

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?

Posted on March 21, 2017 by Donald B. Yoo, M.D.

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?

Posted on March 21, 2017 by Donald B. Yoo, M.D.

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?

Posted on March 21, 2017 by Donald B. Yoo, M.D.

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

Posted on March 21, 2017 by Donald B. Yoo, M.D.

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.

Posted on March 21, 2017 by Donald B. Yoo, M.D.

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?

Posted on March 21, 2017 by Donald B. Yoo, M.D.

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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