Kenalog injections to refine nose tip in thick skinned patient? (rhinoplasty 3 years ago)

Posted on January 18, 2017 by Donald B. Yoo, M.D.

Q: I went to a diff plastic surgeon looking to refine my nose tip. He said most of the cartilage from my tip was taken out already; it is mostly thick skin left b/c I’m thick skinned (Asian w/ oily skin, larger pores). He recommended Kenalog injections to thin the tip out. But after researching, it seems that these injections are used to decrease scar tissue/swelling within a year after rhinoplasty. So I’m wondering if Kenalog injections could be used to thin out the thick skin in the nose tip?

A: The best way to create nasal tip refinement during Asian rhinoplasty is to create greater structural support for the tip of your nose, rather than to simply attempt to thin out the skin.  Kenalog injections may help to a certain degree, but only if you have appropriate tip cartilage support and strength.

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Suggestion for nose and chin and eyes stretching

Posted on January 18, 2017 by Donald B. Yoo, M.D.

Q: My nose is wide and small I have been suggested by the Dr to do septal rhinoplasty for the bridge and tip will automatically be sharp after the bridge and he also says that rhinoplasty will stretch my eyes fold plus chin implant what should I do sir ?

A: Augmenting your dorsum will not automatically create refinement of the tip of your nose.  In addition, rhinoplasty will not “stretch your eyes fold”.  It’s important to do your due diligence in researching and finding a rhinoplasty specialist with experience performing Asian rhinoplasty to achieve the results you are looking for.

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Which Rhinoplasty procedures will give me what I’m looking for? I am Asian

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: I love Rhianna nose job. It’s is very natural and fitting. My nose is “slight and bulbous” when I smile, the whole nose is flat. I love my delicate bridge because my mother has one but I want a more defined nose. Is a Colluma strut, alar reduction, and tip refinement taking me on the right track for what I want?

A: In order to achieve excellent, attractive results, it is more important as a patient to find the right surgeon, rather than worry about columellar struts, septal extension grafts, etc.  An Asian rhinoplasty specialist will be able to comprehensively address the issues you have with your nose, both cosmetic and functional.

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Is tip-plasty possible for a bulbous Asian tip?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: I had a septo-rhinoplasty operation. 18 months post-operation the nose is still crooked and the tip still looks very bulbous. I was wondering if it is possible to get more definition in the tip? After my one year post-op I left the doctors office feeling not very confident with my options. He mentioned there wasn’t much else he could do but try again with another procedure. Should I try another rhinoplasty procedure with this doctor? Are there any other options?

A: It’s important as a patient to feel confident about your surgeon’s abilities as well as your surgeon’s aesthetic.  Not only do you want someone that has the surgical expertise to deliver the results you seek, but also shares your aesthetic sense.

The bottom line is, you don’t want to go through all the time, effort, and expense of a revision surgery until you are 100% confident that your surgeon can deliver the results you are looking for.

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Would I be too young for a rhinoplasty?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: I am a 14-year-old girl who’s had this idea of rhinoplasty since around age 11. I have a very typical Asian nose. Is 14 too young for a rhinoplasty? It has been around 3 years since my first menstrual period and my height, shoe size, and weight have been rigid since the beginning of high school. I would preferably like to change my nose over this summer if possible. Thanks!

A: From a purely anatomical standpoint, patients may safely undergo rhinoplasty when they are fully grown and have achieved their adult size.  For most girls, this is between the age of 14-16, and with parental consent the appropriateness of surgery may be discussed.

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I would like an ethnic rhinoplasty for a more defined nose. What would you recommend?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: Hello, my name is Don, I am 23 years old and I live in Holland. For my nose I’d really like to have a more narrow and defined nose. One doctor in Manila, Philippines, advised me this: “to augment the bridge with an implant, infracture the nasal bones and do alarplasty or trimming of the sides”. It sounds really good to me. Though I’d really like to have a second opinion. What do you think?

A: For dorsal augmentation during Asian rhinoplasty, there are many different options including using your own tissue or using synthetic implants.  Autologous grafts have the advantage of providing permanent results in a safe, predictable manner.  Synthetic grafts can produce acceptable results temporarily, but will not yield a permanent result.

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Asian Non Surgical Nose Job?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: Hi, my nose too “flat” for an injection filler to work. I am afraid to have an actual surgery but want to try something like Perlane to build a bridge of my nose… Please advise, Thank you.

A: Nonsurgical rhinoplasty will certainly “work” to the extent that it is able to, when performed by an Asian rhinoplasty specialist experienced in nonsurgical rhinoplasty.  For the dorsum (bridge) nonsurgical rhinoplasty is quite effective at creating augmentation and a significant change.

Surgical Asian rhinoplasty will be able to create a much more dramatic change, however when performed by an experienced Asian rhinoplasty specialist nonsurgical rhinoplasty can be a nice way to “try out” dorsal augmentation.

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Why some doctors don’t recommend Irradiated Rib Cartilage in Rhinoplasty and Asian Rhinoplasty?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: There are many pros with irradiated rib cartilage such as: no donor site morbidity, ease of use, shorter operation time & healing time. Why most of the doctors I consulted with don’t recommend using it for Asian Rhinoplasty? Since Asians are prone to keloid, don’t know how I feel about Autologous Rib Grafts. Please recommend doctors who are experts in Asian Rhinoplasty with Irradiated Cartilage in LA area. I would love to research more before making a big decision like this. Thank you! 🙂

A: The main downside with irradiated rib cartilage is the fact that it is dead tissue and not living, viable cartilage as from your own rib.  This means that it will not become a living part of your nose, but rather will be placed by fibrotic tissue that will eventually resorb.

For permanent results, your own cartilage (autologous grafts) is superior to any homologous grafts.

I perform rib cartilage harvest through a 2 cm incision, which will heal as a thin line which will become unnoticeable in the vast majority of patients.

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As an Asian, I was wondering how I could go about making it taller/lengthen?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: As an Asian, I was wondering how I could go about making it taller/lengthen?

A: Whether or not to change the appearance of your nose is a very personal decision.  If you do decide to augment or refine your nose, this can be performed during Asian rhinoplasty using autologous grafts (your own tissue).  Cartilage from either your septum and ears, or rib, may be used to augment your nose.

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One doctor wants to use Gore Tex for my nose, but I need a second opinion about it. How risky is it to use Gore Tex?

Posted on January 13, 2017 by Donald B. Yoo, M.D.

Q: He wants to use my own cartilage (taken from my ear) to refine the tip of the nose, but to enhance and augment my bridge, he wants to use Gore Tex. When asked if he could use my own cartilage from the bridge as well, he replied that it would not give the same effect. Note that this is about an ethnic nose job. How risky really is the use of Gore Tex? He says that the risk of complications is 3% only. Why can’t cartilage be used for the bridge of my nose according to him do you think? Thank you

A: Using tissue from your own body will create the most permanent results in the safest manner.  The biggest risk with Gore-tex long-term is the risk of extrusion through the skin.  Since Gore-tex is a synthetic material it will never become incorporated as a living part of the nose as your own cartilage will.

A rhinoplasty specialist experienced in autologous grafts will be able to precisely and safely augment your nose using only tissue from your own body.

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