Q: Would septal cartilage be enough for bridge augmentation and tip projection?
A: Septal cartilage alone is not enough to create dorsal augmentation and tip projection. Tip projection in Asian rhinoplasty often requires several grafts: extended columellar strut, lateral crural struts, and tip grafts. Once those are fashioned from septal cartilage, there is typically very little remaining cartilage.
Q: Can I-shape silicone implants extrude? I am considering Asian rhinoplasty with I-shape implant + cartilage for tip. In fact, is it possible for cartilage to extrude? Furthermore, do issues with L-shape such as contraction and depression also apply to I-shape, considering that it would not exert pressure on the tip like L-shape would?
A: While L-shape implants have a greater risk of extrusion through the skin in the tip of the nose, I-shape implants still carry a higher risk of extrusion through the skin in the bridge of the nose than autologous grafts (your own cartilage). Cartilage has an infinitely lower chance of extrusion than synthetic grafts (practically none under normal conditions), and a much lower risk of infection or migration.
Overall, autologous grafts are a much more permanent and safer option for reshaping the nose during Asian rhinoplasty.
Q: I have an upturned pig like nose. Can Asian rhinoplasty surgery help rotate my nose downwards and make it more pointy? I hate how my nostrils easily show when I take pcitures. I also like the look of the tip of the nose going downwards, and in front view the nose looks like a “V” shape. Is this possible?
A: During Asian rhinoplasty, the tip of the nose can be counter-rotated and thus made to look longer and less “pig” like. The V-shape you like can be re-created by extending the columella (area between the nostrils) downward, and adding volume to your infratip (area below the tip of your nose). Paramount to a successful result is finding a surgeon with the skill and experience to achieve those changes, while sharing your aesthetic vision.
Q: What can I realistically expect my nose to become with rhinoplasty? I would love for it to be sculpted into something much more attractive. Realistically, I would like my nose to look a little longer with a more narrow nasal bridge as well as showing a bit more nostril. I’m tired of flaring my nostrils in pictures to give it shape to make it look more pleasing. Help!
A: Dramatic results can be achieved with Asian rhinoplasty, especially when rib cartilage is used by an experienced rhinoplasty specialist. The bridge and tip of the nose can be made much taller (6-7 mm) in a very predictable fashion. The flare and width of the nostrils may be reduced with alar base modification.
It’s important to keep in mind that although significant results can be achieved using synthetic grafts such as silicone, using autologous grafts (tissue from your own body) will yield the safest and most permanent results.
Q: I was very clear about not wanting my tip touched. I even tried to cancel every aspect of the surgery except for the realigning of my septum, caused by an injury 11 months prior. I tried to say I did not want that done on my final appointment prior to the actual surgery day. My nose was touched. Tip graft was added and I want it removed. I also have very thin skin. When can this be done?
A: In general it is advisable to allow at least 6 months, and preferably 1 year of healing before going back for a revision rhinoplasty. However, in the case of an obvious issue or for removal of specific grafts, it may be advantageous to revisit the nose sooner. A simple onlay tip graft could be safely removed immediately, however if it is not a simple onlay and other changes were made to your tip cartilage than it would be prudent to allow the nose to heal first.
A: I’m not sure if I should go to a surgeon who specializes in Asian rhinoplasty since most Asians have flatter noses and want a bridge. I on the other hand just want to shave down my dorsal bump. Should I go for a doctor that specializes in Asian rhinoplasty? I don’t think my nose is Asian at all…
A: A common mistake patients, and some surgeons, make while addressing an apparent “hump” in Asian patients is lowering the hump to straighten the nose. While this may make your nose appear smaller and straighter on profile view, it will appear wider and flatter from frontal view because it is lower.
The area of the bridge between the eyes, and above the “hump”, needs to be built up slightly while lowering the “hump” slightly to give you a balanced, attractive result. You will have the best results with a rhinoplasty specialist with expertise in Asian rhinoplasty.
Q: It has been almost 2 weeks since I took off my nose splint (3 weeks since the day I got a surgery). The tip of my nose is kind of round, big, short, and upturned. Will the tip drop down, be kind of pointy and grow a little longer as time goes by? The doctor also used my ear cartilage and filler on one side of my nose to make the both sides even.
A: The amount of tip refinement and definition will increase as the swelling resolves. The tip rotation (how upturned it is) will also improve – as the swelling decreases the tip will drop a bit. By about 3-6 months post-op enough swelling will have resolved for you to have a good idea of whether you will be happy or not.
This beautiful African American female patient underwent primary rhinoplasty with Dr. Yoo. The after pictures were taken at 6 months. Her new nose has greater tip projection and refinements.
The swelling is 70% resolved after the first three months, and the remainder goes down over time. The final result will be evident 18-24 months following surgery.
African American Female Rhinoplasty – Frontal View
African American Female Rhinoplasty – Right Three Quarter view
African American Female Rhinoplasty – Left three Quarter View
African American Female Rhinoplasty – Right Profile View
African American Female Rhinoplasty – Left Profile View
Before and After Primary Rhinoplasty with Rhinoplasty specialist, Dr. Donald B. Yoo
This patient underwent primary rhinoplasty 6 weeks ago. The nose is still in the process of healing but it is looking pretty good so far! Dr. Yoo created an attractive profile by straightening the bridge and building tip projection. Happy healing!
Before and After Primary Rhinoplasty (6 weeks post op)
Before and After Primary Rhinoplasty (6 weeks post op)
Before and After Primary Rhinoplasty (6 weeks post op)
Before and After Primary Rhinoplasty (6 weeks post op)
Q: I don’t want a pointy tip. I just want my alar base narrowed and some but not a lot of projection. I have thick skin. What I want is only an alarplasty since I can somewhat play with angles and make my nose look like it has a bridge but the wide alar gives it away. Will the surgeon need to shave some bridge for the placement of an implant? That wouldn’t be ok for me if I reject the implant and needs to be removed leaving an even lower bridge.
A: First, I would caution you on the use of synthetic implants in your nose. While they can provide good results for years – sometimes 20, 30 years – they are never a permanent solution and never become a viable part of your nose. They also carry a higher risk of infection, migration and extrusion than using grafts made from tissue in your own body (autologous grafts).
There is an important relationship between the proportion of the width of the nostrils relative to the width of the tip, and if the nostril width is reduced without addressing the width of the tip – it will appear even more bulbous in comparison.
Given the thickness of your skin, you will need some degree of tip projection to achieve a refined or “pointy” tip. Without projection it will be difficult to see the changes made underneath the skin.
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