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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Is revision Asian rhinoplasty safe, and how long will the swelling last?

Posted on January 12, 2017 by Donald B. Yoo, M.D.

Q: Hi, I had my first rhinoplasty 5 years ago, but the silicon moves and it’s crooked. Also the cartilage they took from my ear and put on the tip of my nose shifted to the side of my nose. If I wanted to get it redone, how dangerous would it be? Would it be less difficult because the silicon never adhered to my nose? Also how long would the healing time usually take? I also have bumps on my nose, if they were to shave that down would that effect healing time as well?

A: Both Asian rhinoplasty and revision rhinoplasty are challenging, and it is of paramount importance to seek out a rhinoplasty specialist experienced in Asian rhinoplasty to achieve the best results possible in a safe, predictable manner.

In general, silicone implants are more easily removed than other synthetic implants such as medpore and Gore-tex.  The challenge often lies in the quality of the skin envelope and how much of the status of the nasal anatomy.  While revision Asian rhinoplasty can certainly be challenging, for some of us, it’s what we do every week.

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I’ve had frequent radiesse injections for about 4 years. Am I still a candidate for rhinoplasty?

Posted on January 12, 2017 by Donald B. Yoo, M.D.

Q: I am a 22 years old Asian. With the typical flat nose bridge and wide alar base. Have been doing radiesse injections frequently for the last 4 years. However I have been considering doing a rhinoplasty in the near future, will there be any problems? Eg: destroyed tissue etc. I would also like to know what should be done to my nose to make it more attractive.

A: One of the main disadvantages of Radiesse vs. the hyaluronic acid fillers for nonsurgical rhinoplasty is that it is not reversible.  Especially if you are considering a surgical rhinoplasty, you should stop receiving treatments with Radiesse.

The reason Radiesse may become an issue when planning surgical rhinoplasty is that it becomes difficult to accurately assess your nasal anatomy without knowing exactly how much filler is present.  Waiting at least 1 year after your most recent Radiesse treatment would be prudent to allow precise changes during your surgery.

Beyond that, as long as you seek out a Rhinoplasty Specialist very experienced in Asian rhinoplasty, then you shouldn’t encounter any other major issues.

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Possible Nose Job for an Asian with a flat nose?

Posted on January 12, 2017 by Donald B. Yoo, M.D.

Q: I have a flat nose and it’s pretty hard for me to find glasses that fit my face and nose bridge. Not only that, but once allergy season comes around, it gets really hard for me to breathe through my nose. I was wondering if getting a nose job could help me and if I can get my insurance to cover it. If not, how much should I expect for it to cost? And what kind of nose job would work for me?

A: While functional aspects of the surgery may be covered partially by insurance, typically for surgery will not address allergic nasal obstruction.

With regards to your cosmetic concerns of having a low, flat nose, the safest and most beautiful results are possible using tissue and grafts from your own body.  Achieving the best results in Asian rhinoplasty requires meticulous surgical technique in synergy with a keen aesthetic eye.

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What type of nose is this and what operation would I need?

Posted on January 12, 2017 by Donald B. Yoo, M.D.

Q: Hi, I’m a 19-year-old Asian male and I’ve been thinking about getting rhinoplasty so it looks more “normal”. When I mean normal I mean more upright and with a more defined nose bridge and the bottom to be more angular. Is there a terminology to it (my nose) or what type of rhinoplasty operation I would need so I can go do some more research on my own before visiting an actual clinic.

A: The safest and most permanent way of achieving permanent results in Asian rhinoplasty is to use autologous grafts (or tissue from your own body).  The best option to create refinement and definition in the tip and bridge of your nose is rib cartilage.  The thickness of your skin will necessitate the use of strong, straight cartilage – the best source of which is your own rib cartilage.

Focus on finding Rhinoplasty Specialists, experienced in Asian rhinoplasty and consult with 2-3.  This will give you a better idea of the best approach for achieving the nose you seek.

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After removal of the implant and graft, will I be able to push my nose up and side-to-side? Will my nose collapse?

Posted on January 12, 2017 by Donald B. Yoo, M.D.

Q: Hello. I had a silicon implant and cartilage graft rhinoplasty about 1.5 years ago. I am unable to touch my nose as carelessly as I could before b/c the tip is hard and won’t move in certain ways. After removal of the implant and graft, will I be able to push my nose up and side-to-side and be all right if I accidentally drop something on my face (like my phone…) just like pre-op? Or will my nose collapse like Michael?! Will it feel and look the same as my old nose?

A: Depending on how your nasal anatomy was altered during your surgery will determine how it reacts once the silicone implant is removed.  It certainly will be softer, and you will be able to move it side to side.

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What is the Asian Rhinoplasty recovery time?

Posted on January 8, 2017 by Donald B. Yoo, M.D.

Q: How long does the bruising last? I will be travelling from Canada to Beverly Hills to get my Asian rhinoplasty done. I will be staying there for 10 days, and will fly home 7 days post op. Will the bruising still be evident? None of my family members know I will be getting a nose job done and want to keep it that way. Thanks.

A: Most patients are pleasantly surprised by the post-operative recovery after Asian rhinoplasty.  While bruising is present after osteotomies, for many Asian rhinoplasty patients fracturing the bones is unnecessary to achieve ideal results.  Most of my patients will be ready to return to work or school for 10-14 days without any obvious signs of surgery.

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What causes this indentation on the supra tip post rhinoplasty and what options are available to fix it?

Posted on January 7, 2017 by Donald B. Yoo, M.D.

Q: I had an Asian rhinoplasty done almost 3 months ago, and recently noticed a slight indentation above the tip (supra tip?). An I-shaped silicon implant was used to raise the bridge and cartilage from my ear was used on the tip of the nose. What causes this indentation and what options are available to fix it? Could it be temporary due to residual swelling on the tip? I can’t tell if there’s swelling still or not. The indentation is most visible under top lighting that causes shadows.

A: While a large part of the swelling will have resolved 3 months after Asian rhinoplasty, you still do have a significant amount of healing left to do.  If it really, really bothers you then an easy way to temporarily correct the depression while your nose continues to heal is to use a hyaluronic acid filler (Restylane silk, Belotero) to soften the depression.

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