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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I have a typical Asian big nose as well as a pretty flat bridge. What can be done to enhance my nose?

Q: I think I might need a silicon implant for a slightly higher ( just a tat higher) bridge as well as a tipplastry? I hope for a slightly sharper tip n narrower nose. Would a nasal bone shaving be necessary? Pls advise.

A: I do agree that your nose will have a more attractive profile and greater refinement from frontal view with some bridge augmentation.  I would strongly recommend using tissue from your own body as this will create the safest, permanent and I feel, the most attractive result.  Silicone is less than ideal for its temporary nature, high risk of complications, and un-natural contours it can create over time.  

By building up and projecting and refining the tip and bridge of your nose, you will be able to achieve the look you seek without shaving the nasal bones.  

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Diced cartilage life term – is there a significant difference if fascia is used or not? Is the fascia important?

Q: Is there a significant difference of the cartilage Life Term (resorption) between using diced cartilage wrapped in fascia and diced cartilage combined with Fibringlue without fascia? Is the fascia Important?

A: Fascia is more important to maintain the height, width and shape of the graft more than it is the viability.  The potential issue with free fine-diced cartilage (FDC) versus diced cartilage fascia (DCF) is mobility and visibility.  It is just as likely to remain viable, but it can shift or it can begin to show through the skin.

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Is it possible to have surgery to get a more “Asian looking” nose?

Q: I am looking to make my nose wider and flatter. I am Eurasian but I have completely Caucasian nose – very high nose bridge and I hate it. I am looking to widen the lower part of my nose and have flat nose bridge like stereotypical Asian nose… Would this be possible?

A: While it is possible reshape the nose in a number of ways during rhinoplasty, my goal as a facial plastic surgeon is to make each and every one of my patients more attractive.  If I feel a procedure will make my patient less attractive, I will strongly advise against it.

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I want a nose job and I am wondering about the price of one?

Q: I have an Asian nose that is flat and round and it flares out when I yawn and it is disgusting for people to look at. I also have acne on it so I was wondering if that would be affected too. I am also 16 years old.

A: The cost of a nose job will vary based on your geography and the experience/proficiency of the surgeon.  While it’s not necessarily true in rhinoplasty you get what you pay for, typically the top surgeons in a given geographic will command the higher surgeon fees.  As a patient it’s important to do your due diligence in researching rhinoplasty specialists to determine which prices are reasonable, and which really are “too good” to be true.

On a side note, I also grew up in Plano and loved it.

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L-Shaped implant causing too much pressure on nose tip. Should I wait or try to do revision ASAP?

Q: Almost 5 months ago I had Asian rhinoplasty done with L silicon implant and ear cartilage at the tip. There has been lots of pressure at the tip ever since the operation. Aside from the pressure, the nose tip points dramatically to the right since the day of the operation. The bridge is straight. I’m sure I will seek another, more experienced surgeon for revision, but when should I do revision? I’ve read that it is recommended to wait 6 months, but I’m worried about the pressure on the tip.

A:  Signs of impending implant extrusion include increasing redness and tenderness.  Extrusion is a gradual process, as the skin is slowly thinned by the implant to the point of ulcerating.  In this case, when the skin is being thinned by a synthetic implant, the risks of waiting too long may be greater than operating sooner than the “recommended” time.  Using tissue from your own body (autologous grafts) will greatly reduce the risk of this possible complication.

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1 year post op Rhinoplasty, is this a Zit or Silicone implant infection?

Q: I had a nose job using a I-shaped silicone implant a year ago. Keep in mind, I am very acne-prone and have similar bumps all over the rest of my face. About 1-2 months ago, this bump started forming on my nose (not directly on top of the implant, but rather the side of my nose).Is this a silicone implant infection, or just another zit? It’s been over a month, so I’m getting worried. Also, this appeared about three days after I bumped my nose when the showerhead fell on me.

A: Implants will typically begin to show signs of ulceration and extrusion closer to the midline of the nose, because this is where they are exerting the greatest amount of pressure on the skin.

It would be advisable to see your surgeon in person to better evaluate your nose as to prevent progression of this “pimple” into a larger complication.

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5 months post op Asian Revision Rhinoplasty, could it be possible that the columella bone got trimmed?

Q: I have Asian nose. It’s been 5 months post-op but the collumella feels so soft, it can be pushed to right/left easily. Isn’t it supposed to be cartilage kind of feel /a little bit hard when touched? My nose does looked upturned then previous. Could it be possible that the collumella bone got trimmed? What could this mean? Thank you.

A: The columella is made of cartilage, and note bone, and is naturally a soft area of the nose.  When extensive cartilage grafts are placed in this area, the area may become more rigid and take time to soften.

The fact that your columella is soft is not likely to have an effect on your final result, but bring up your concerns with your surgeon as he/she is in the best position to reassure you with the details of your surgery.  Tip rotation will decrease and will look less upturned as you continue to heal.

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