Revision Rhinoplasty in March. Still Have Hump, But it is Soft?

Q: Hi there – I had Rhinoplasty last November and a small revision at the same surgeon in March this year since my nose was crooked after the operation due to a bigger hump on the one side. I now still have a hump on the same side but if feels soft – if I press on it, it will go down only to stand back up after a few seconds. Can this be cartilage? I can almost feel the rim…. Must this be corrected surgically or will it go down with time? Thank you.

A: If it’s soft, it could be cartilage or it could be skin or the underlying subcutaneous tissue.  If it’s cartilage, it will not resolve with time.  If it’s just scar tissue or swelling in and under the skin, it could go down.  Touch base with your surgeon as she/he will be best suited to answer.

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How Difficult is It to Fix a Pinched Bridge?

Q: Hello, I got my first revision about 3 months ago to fix pinching, but the sides of the bridge is still pinched. The tip looks great but the bridge still looks pinched. Not as bad as before, but it is still pinched. How can this be fixed? Thanks.

A: A number of approaches can be used to improve the appearance of this “pinching” along your bridge (dorsum).  The best option as mentioned is probably with revision rhinoplasty with placement of spreader grafts – which will address the underlying collapse of your middle vault which is creating the pinched appearance.  Another approach, which is reasonable if nasal obstruction is not a major complaint, is to camouflage the depressed “pinched” areas.  This could be temporarily with a dermal filler, or more permanently with a cartilage graft – either an onlay graft or diced cartilage.

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I have an Asian bulbous nose. Which procedures would be best for rising the bridge and giving the tip more definition?

Q: I have an Asian bulbous nose that I would like slim down with rhinoplasty. I would also like the bridge raised and the tip defined. Any recommendations on what procedure to go with and what would be necessary to achieve my desired outcome (and if it is even possible with my current nose)?

A: There are many options when choosing Asian rhinoplasty, but the safest, most permanent and predictable way to achieve excellent results is with tissue from your own body (autologous grafts).  The choice of cartilage grafts will depend on the degree of augmentation and refinement you desire.  If you like very refined, tall noses, rib cartilage may be the best option for you.  I am a strong proponent of building the bridge with a diced cartilage fascia graft, and reinforcing your tip with cartilage grafts to increase the projection and refinement of the tip.
Computer morphing of your nose during an in-person consultation with a rhinoplasty specialist would more definitively determine the best grafts for your nose.

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Asian rhinoplasty using rib cartilage. How long would it take to heal?

Q: I’m Filipina with a flat bulbous nose. I was wondering if harvesting rib cartilage, how long will it fully heal? My PS says he needs to use rib cartilage for a significant change. I also want to get a breast augmentation done 3 months after Asian rhinoplasty, but I am worried because my PS will have to operate on my chest to harvest my rib cartilage for my nose that it will take a while to heal.

A: For the most significant change in Asian rhinoplasty, rib cartilage is the best choice for a number of reasons.  The rib and chest will be somewhat sore for the first 4-5 days after surgery, and sutures are removed a week after surgery.  By the second week, most of this soreness has resolved and patients may resume light exercise after 2 weeks.  At this point the incision line is typically well-healed.  By 4 weeks full exercise may resume.  A 2 cm linear scar hidden in the crease below your breast is all that remains by this point.

The incision for rib cartilage harvest is typically smaller and more medially placed than the incision for breast augmentation, and should not affect it.  Nearly a third of my female patients have had breast augmentation, and the rib harvest is performed entirely below the breast, and does not interfere with the implant or breast at all.

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Plastic surgeons who are experts in doing Asian Rhinoplasty, Cheek Augmentation, Chin Implants & Eyelifts!

Q: I want to get Asian Rhinoplasty, Cheek & Chin Implants, Eyelid surgery that would help correct downturned droopy eyes. To save money I’d like to do all this in just one procedure. I found this plastic surgeon who is an Asian rhinoplasty specialist but he doesn’t do cheek implants. I found another surgeon who does cheek implants but is not an expert in Asian rhinoplasty. How do I find a plastic surgeon that is an expert in all these fields? I don’t want to get out of surgery looking like a monster.

A: Personally, I feel the goal of cosmetic plastic surgery should be to enhance and highlight your natural beauty.  That being said, as others have mentioned you already have an attractive face, and you don’t need dramatic changes to enhance this.  A rhinoplasty would help to improve the balance and harmony of your face, but cheek implants and drastic eyelid surgery may make you less attractive instead of more.

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I’m Filipino – Can I achieve a nose with Asian Rhinoplasty?

Q: I’m Filipino. My nose is flat and wide, and is bulbous. Can I do Asian rhinoplasty using only ear cartilage and septal cartilage? I want the bridge taller and a bit thinner, and I want the tip more refined. Are my expectations realistic enough?

A: Using grafts fashioned from cartilage from both your ears and septum, and fascia harvested from your scalp, it is possible to achieve a result similar to the photos you have provided.  The diced cartilage wrapped in fascia (DCF) can be used to augment the bridge of your nose to make it taller and thinner, while a combination of grafts can be used to project and refine the tip of your nose.

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Is it a good idea to get an Asian Osteotomy?

Q: Is it even a good idea for one? What exactly does it do and what look will it give? I feel that my nose root in very deep/sunken into my face and want to push this area out. Will a osteotomy help with projecting my whole nose outwards?

A: The majority of patients undergoing augmentation Asian rhinoplasty will not benefit from osteotomies.  Especially patients with a deep radix (root of the nose), building this area and making it taller will improve the appearance of the bridge and correct the dorsal aesthetic lines without the need for osteotomies.  Autologous grafts (such as diced cartilage fascia – DCF) fashioned from ear or rib cartilage, will project and refine the nose.

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Asian Rhinoplasty after Breast Augmentation?

Q: Hi, I’m planning on getting an Asian rhinoplasty in November. I just got my breast augmentation done last week. I’m aware that my PS will probably be harvesting my rib cartilage to create a taller bridge for my nose. But how will he get it without poking my implant? Can he use any other cartilage aside from the rib? I want a taller nose, but I don’t want him puncturing my implant while he harvests my rib cartilage. Also, I don’t want any silicone implant up my nose. Thank you.

A: For a rhinoplasty specialist experienced in rib cartilage harvest, this is a very common scenario.  Approximately a third of my female patients have had breast augmentation.  Rib cartilage harvest leaves a thin ~2 cm scar hidden in the right breast, but does not alter the breast or breast implant in any way.

Rib cartilage harvest does have risks, and that is why it is so important to seek out a surgeon proficient in this procedure to ensure the safest results.

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Nose is crooked 6months post revision rhinoplasty. How soon can I have a revision?

Q: 6 months is nearing the final outcome, I hated my nose everyday more and more because it is getting more crooked. My nose is crooked leaning to the left side. How soon can I redo my nose? The implant is bulky, my whole nose is big, no shape how can I achieve a natural bridge? Who does the most natural looking Asian rhinoplasty in nyc?

A: The safest time frame to consider a revision procedure is ~1 year after your primary procedure.  Achieving refinement and definition during Asian rhinoplasty is challenging, and it’s important to do your due diligence in researching and finding an experienced Asian rhinoplasty specialist.

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Asian with Western Nose

Q: I am an Asian female with a low radix, high dorsum with a bump, and somewhat droopy tip when I smile. I would like to get rid of the bump and improve tip projection to reduce the droopiness. The surgeons that I’ve met with all agree that I have a more western nose. While that is true, my genetic makeup is still Asian placing me at a higher risk for complications most associated with Asian rhinoplasty. Is this a valid concern? Should I be looking for a surgeon that specializes in Asian rhinoplasty? My biggest fear is a botched nose job. I would just die. Any insight, opinions, suggestions would be most appreciated! Thanks!

A: One of the things that I find so exciting about plastic surgery is that to achieve a successful outcome, technical expertise has to be coupled with artistry.  The same holds true for Asian rhinoplasty.  While many surgeons may be proficient in rhinoplasty, it is important to find a rhinoplasty specialist experienced with Asian noses and enhancing Asian beauty to achieve the best result possible for you.

Personally I think a combination of raising the height of your bridge between your eyes (radix augmentation) and slightly lowering your dorsal convexity, while projecting and refining the tip of your nose, will create the best balance for you.

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