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Asian Rhinoplasty

The nose takes center stage on your face, and is often the first facial feature other people notice. Rhinoplasty and Asian rhinoplasty have continued to grow in popularity, as technical refinements have allowed ever improving cosmetic and functional results.

What is Asian Rhinoplasty?

Rhinoplasty is one of the oldest plastic surgery procedures, and Asian nose job surgery has made immense advances in recent times as surgeons have continued to make technical innovations such as using autologous grafts (tissue from your own body such as rib cartilage, temporalis fascia and diced cartilage fascia DCF) to create aesthetically superior Asian rhinoplasty results in a permanent manner.

Some rhinoplasty surgeons try to generalize Asian rhinoplasty to mean reshaping noses that are bulbous, short, wide and flat. However, in many ways this perspective is too simplistic and limited. As an Asian rhinoplasty specialist, Dr. Donald Yoo prefers to take a more personalized approach to Asian rhinoplasty, customizing each procedure for the individual patient.

Asian Rhinoplasty Procedure

How is Asian Rhinoplasty different?

Asian rhinoplasty is unique, and requires not only special expertise but also a keen eye for Asian beauty. A beautiful nose is not just tall and projected, but should look natural and balanced when viewed from every angle. Some of the distinct characteristics of Asian noses are plain to see from the outside, while others extend far beyond the skin surface. The anatomy of the nasal framework and nasal bones often differ from other ethnicities, as well as the skin itself. Asians tend to have nasal skin that is thicker and more sebaceous, creating less definition in the tip of the nose.

Before and After Photo of Asian Rhinoplasty Procedure

The lower lateral cartilage, or tip cartilage, tends to be softer and less rigid than other ethnicities, and often is shorter in overall length. Tip shape, size and projection is determined by the intrinsic characteristics of the tip cartilage, and these characteristics many times result in a tip that may be bulbous, wide and under-projected. The nostrils may also appear to “flare” due to the convexity of these cartilages.

Dorsal height, or the height of the “bridge” of the nose is determined by the size, shape and orientation of the nasal bones, as well as the cartilage in the middle vault of the nose.
In some Asians, the nasal bones have an oblique (more horizontal than vertical) orientation, and simply fracturing the nasal bones will not allow them to be narrowed sufficiently. In these cases, the dorsum must be augmented to allow better definition of the bridge, and create a more attractive profile and a more refined frontal view.

What type of Asian Rhinoplasty implant should I get?

Silicone / Gore-tex vs. Autologous grafts

Before and After Photo of Asian Rhinoplasty Procedure One of the advancements in Asian rhinoplasty is the choice of material used to construct a beautiful nose. In the past, artificial implants made of Silicone or Gore-tex were the most popular choice due to their ease of use, and the quick learning-curve for surgeons to become comfortable with them. Surgeries using Silicone or Gore-tex implants can be performed quickly, since there is no need to harvest or tailor grafts to the individual patient. However, synthetic implants do come with several distinct disadvantages compared to grafts made from your own tissue (autologous grafts). These include:

1) Infection
2) Migration (movement)
3) Extrusion (coming through the skin)

Silicone Implant

This patient had a previous silicone implant in her nose by another doctor. Dr. Yoo removed the synthetic implant and performed a revision rhinoplasty with Rib Cartilage and DCF

With a synthetic implant, such as Silicone or Gore-tex, the nose may look great initially – sometimes even 15-20 years. However, in the vast majority of patients the implant will need to be removed or revised at some point. Some have attempted to improve the safety of this old-fashioned technique by employing a synthetic implant in the bridge while using septal or ear cartilage grafts in the tip of the nose. A foreign body still remains in the nose, and the result continues to have a higher rate of complications than autologous grafts. With autologous grafts, the result lasts a lifetime.

Besides synthetic implants, some surgeons have also used homologous implants (donated tissue from a cadaver). Cadaveric cartilage has a lower risk of complications than synthetic grafts, but generally have less predictable long term results than autologous grafts from your own body. Unlike autologous tissue, which is still viable and has living cells which become incorporated into your nose, homologous implants have been irradiated and do not have any living cells. This causes these implants to be more prone to resorption and loss of volume than autologous grafts which provide lifelong results.

Dr. Yoo exclusively uses autologous grafts as they provide the most permanent, natural, and beautiful results in the safest manner. Using the most cutting-edge techniques, he is able to harvest these grafts with hidden, minimal scars.

What are the available options for Autologous Grafts?

Dr. Yoo chooses the best material for your nose, and each type has a specific purpose and application.
The autologous graft materials Dr. Yoo may use include:

1) nasal septal cartilage
2) ear cartilage (auricular conchal cartilage)
3) rib cartilage (costal cartilage)
4) fascia (deep temporalis fascia)

During your consultation, Dr. Yoo will perform a comprehensive external and intranasal examination of your nose. He will then sit down with you and create personalized computer imaging of your nose based on your aesthetic goals and determine which combination of surgical techniques and grafts will be necessary to achieve your ideal profile line and the most attractive nose for your face.

Not all surgeons are equally comfortable harvesting each of these grafts, and this is another reason pre-made Silicone and Gore-tex implants are so popular. Nasal septal cartilage is the cartilage between the nostrils, and a small portion can easily be removed without visible incisions to provide material for grafts. Ear cartilage is harvested through an incision hidden in the crease behind the ear, and does not change the size, shape or appearance of the ear.

Rib Cartilage Graft Specialist

Specialized training and expertise is especially necessary to safely and efficiently harvest rib cartilage, and Dr. Yoo is amongst a small group of surgeons who routinely perform this procedure. Dr. Yoo harvests rib cartilage (~4 cm) from the 5th or 6th rib through a minimal incision (~1.0 cm) hidden in the infra-mammary crease (under the right breast/chest). Once healed, the appearance, contour and feel of the chest is just as it was before surgery, with the addition of a small scar.

Dr. Yoo will determine the most suitable autologous tissue for grafting based on your unique anatomy, and your aesthetic as well as functional goals. The septum provides relatively straight, strong, cartilage and is a good source of creating grafts to project, support and refine the tip of the nose. When dorsal augmentation is desired (building the bridge of the nose), and often during revision rhinoplasty, additional cartilage is usually required. Ear cartilage is soft, and provides a great source of tip refining grafts and for mild to moderate dorsal augmentation. When more dramatic tip refinement, tip projection or dorsal augmentation is desired, rib cartilage is the preferred choice as it provides the greatest strength and the most volume of cartilage for maximal change.

Fascia is harvested through a small incision hidden in the hair above the ear, without shaving or cutting any hair. The incision is closed with surgical clips for 1 week, and once these clips are removed a week after surgery most patients forget anything was done in this area as it is hidden in the hairline.

A great benefit of autologous grafts is that within a few weeks after surgery, the grafts become fully incorporated into the nose – with its own blood supply and lymphatic drainage. It is as if you were born with it, because it is your very own tissue.

Benefit of an Alar Base Modification / Nostril Reduction

Alar base modification, also known as nostril reduction surgery, is a technique used in rhinoplasty to alter the width, and/or the flare of the nostrils. When excess flare is present, a Weir incision is designed which removes a wedge of the nostril tissue. When excess width is present, a sill incision is designed to reduce the width of the nostrils.

As a general guideline, the width of the base of the nose should approximate the distance between the inside corners of the eyes. Alar base modification may be considered when this relationship is distorted and the base of the nose is wider than the distance between the inside corners of the eyes. When performed correctly, alar base modification can improve the balance and harmony of the facial features while preserving a natural appearance.

Before and After Photo of Asian Nose Job

How much does Asian Rhinoplasty Cost?

Asian Rhinoplasty Cost will vary based upon the complexity of the surgery which will also influence the expected duration of the surgery. A patient’s pre-existing anatomy, history of previous rhinoplasty surgeries, nasal airway/functional issues, and desired aesthetic goals may all contribute to the potential complexity of a particular surgery.

The total cost for Asian Rhinoplasty and Revision Asian Rhinoplasty typically includes:

1) Anesthesia
2) Facility
3) Surgeon Fee
4) Pre-Operative Costs
5) Post-Operative Costs

During your consultation, Dr. Donald B. Yoo will work with you to create a surgical plan to achieve your desired aesthetic and functional goals. Based on this plan, our patient care coordinator will provide you with a quote that includes the Surgeon Fee + Facility Fee + Anesthesia Fee. All post-operative visits with Dr. Yoo are also included at no additional charge.

Anesthesia

Dr. Yoo works only with the top board-certified (MD) anesthesiologists in Beverly Hills to provide you with the best general anesthesia during your Asian rhinoplasty surgery. The anesthesiologist will ensure you remain completely comfortable and asleep during the entire surgery, and wake up from surgery without nausea or pain. Most patients will wake up from Asian nose job surgery feeling like it was a short nap.

Facility

Your Asian Rhinoplasty surgery will be performed in a fully accredited outpatient surgery center in the heart of Beverly Hills. Dr. Yoo works with his own team of registered nurses (RN) and certified surgical technologists (CST) dedicated to ensuring a safe and comfortable surgery experience for you. After Asian rhinoplasty you will recover in the recovery room (typically 1-2 hours), and then may return home or to a local hotel.

Surgeon Fee

Dr. Donald B. Yoo is an internationally renowned expert in Asian Rhinoplasty and Asian nose job surgery. As a leader in natural surgical techniques utilizing tissue from a patient’s own body, he has published and lectured internationally on his specialized techniques and unique approach for achieving aesthetically balanced and naturally beautiful outcomes during Asian Rhinoplasty. He has innovated the most advanced Asian rhinoplasty, including: rib cartilage harvesting techniques through the smallest and most minimal incision (0.8 – 1.0 cm) available today to minimize discomfort and accelerate rapid recovery; tip refining techniques to create a beautiful, defined appearance while improving airway function; dorsal augmentation with unique updates to the diced cartilage fascia (DCF) technique to maximize precision, longevity and dorsal aesthetic results.

Autologous graft techniques (tissue from your own body) with many individualized, custom grafts during Asian rhinoplasty does create greater complexity and technical challenge for the surgeon, with resultant longer surgery times than using a single en bloc rib cartilage, cartilage from a cadaver, or synthetic materials.

When it comes to choosing an Asian rhinoplasty surgeon, once she/he meets the qualifications of proper training and experience, the most important determinant is your comfort level that the surgeon is 1) technically capable of achieving your goals, 2) aesthetically on the same page with your ideals.

Pre-Operative Costs

To make certain you are a safe candidate for surgery, we do require routine medical tests (blood work and an electrocardiogram) and medical clearance prior to surgery. These may be obtained from the primary care provider of your choosing, and our office will coordinate with your provider’s office to request the appropriate tests. Dr. Yoo will prescribe a number of medications to optimize your surgical recovery, and these should be filled prior to surgery. The costs of the medical tests and prescriptions are the patient’s responsibility, and in some cases may be covered by insurance.

Post-Operative Costs

Our office will provide a post-operative bag including all of the essentials to get you started on the road to recovery. The bag includes:

  • gauze sponges
  • sterile Q-tips
  • eyemask for cold and hot compresses
  • nasal tape
  • peroxide
  • antibiotic ointment (Bacitracin)
  • Aquaphor
  • scar gel (Skinuva)
  • saline rinses (Sinurinse)
  • medicine cups

The post-operative bag will be provided to you free of charge prior to surgery. After Asian nose job surgery, you will need to follow up closely with Dr. Donald B. Yoo to ensure optimal healing, and this includes follow-up visits 1 day, 1 week, 2 weeks, 4 weeks, 2 months, 6 months, 1 year and 2 years after surgery. All post-operative visits with Dr. Yoo are also free of charge.

Financing is available through CareCredit here

Frequently Asked Questions about Asian Rhinoplasty
Q&A with Dr. Donald B. Yoo, M.D., F.A.C.S

How much is an Asian Rhinoplasty / Asian Nose Job?

Pricing for Asian Rhinoplasty and Asian nose job will depend on a few key factors, including primarily the experience-level and esteem of the Asian rhinoplasty surgeon, the complexity of your specific case (as it relates to your baseline nasal anatomy as well as previous surgical history), and the geographic location of the surgeon’s practice.

What is an Asian Nose Job?

Asian Nose Job is a general term for rhinoplasty or nose reshaping surgery for patients of Asian descent, including but not limited to: Korean, Chinese, Japanese, Vietnamese, Filipino/Filipina, Indonesian, Hmong, Laotian, Cambodian, Maylasian, etc. During Asian nose job surgery the commonalities of dorsal augmentation (increasing height of the bridge of the nose) and increasing nasal tip projection and refinement, while adding overall definition to the nose often exist. While many different techniques exist to address these shared attributes, using tissue from your own body (rib cartilage with diced cartilage and fascia, or ear cartilage with septal cartilage) will create the best aesthetic and functional result.

Are nose jobs safe?

As with any surgery, nose job and rhinoplasty surgery does come with its share of risks. Chief amongst these risk is the risk of not loving your surgical result, which in the case of rhinoplasty is an astonishingly high 17-20% in the United States on average. This makes it critically important to do your due diligence as a patient, by seeking out experienced and qualified surgeons who have many previous patients with your characteristics, and before and after photos and videos demonstrating proficiency in performing the exact surgery you seek in those similar patients.

Do nose jobs last forever?

When only tissue from your own body is used (septal cartilage, ear cartilage, rib cartilage, fascia) during rhinoplasty or nose job surgery, the result is permanent. This is not to say that the nose will be frozen in time and remain constant in appearance. The nose will continue to undergo age-related changes (a common change is that the tip of the nose will drop slightly each year due to the effect of gravity, whether an individual has surgery or not). Depending on the surgical techniques used, the nose may retain greater strength than the previous unoperated nose, and may be more resistant to age-related changes.

How painful is a nose job?

Typically a nose job or rhinoplasty surgery is not painful, and the most uncomfortable part of recovery is the inability to breathe fully through the nose. Most surgeons will use some type of compression inside the nose during recovery to reduce swelling inside the nose which will cause some reduction in nasal airflow. By the end of the week, breathing should return to normal.

In the case of rib cartilage harvest during rhinoplasty, when performed through a minimal incision with precise dissection around the rib, discomfort will feel like a sore ab muscle (rectus abdominus) for the first 3-5 days. Exercise may resume at 2 weeks after surgery.

Who is a good candidate for a nose job?

Though many factors come into play when determining appropriate candidacy for a nose job, the paramount factor is the patient’s expectations. The goal for surgery should always be improvement not perfection. With the right surgeon, and with clear communication, this will almost always be achieved. Patients who are looking to a nose job or rhinoplasty to alter the course of their lives or bring happiness to their life through surgery, are often not good candidates.

Does a nose job change your smile?

Depending on the way the shape and structure of the nose is altered during surgery, the smile may also change. This can often be anticipated by your surgeon prior to surgery, and the surgical plan adjusted to reflect your personal preferences.

Can a nose job change your voice?

Typically a nose job will not change the core qualities of your voice. However, if there is a significant cause of nasal obstruction, and that obstruction is addressed during your nose job surgery, then the increased air flow may have a mild effect on your tone.

Do they break your nose during rhinoplasty?

When the nasal bones are too wide, deviated or asymmetric in orientation, they may be fractured or “broken” to reposition them. Though this may contribute to bruising after surgery, it typically is not a source of pain during recovery.

Can a bad nose job be fixed?

Most nose jobs, even a bad or “botched” rhinoplasty, can often be improved. The degree of improvement will depend on the pre-existing anatomy, the presence of scar tissue, the health of the vascular supply and the skill level of the revision rhinoplasty surgeon.

Why do you use rib cartilage during Asian Rhinoplasty?

For patients desiring a mild to moderate degree of augmentation and change, cartilage from the nose (septum) or cartilage from the ear (conchal) may be sufficient to create the desired appearance. Often in Asian patients, septal cartilage and cartilage from the ear may be weak and flimsy. Consequently, for patients with thicker skin, softer nasal cartilage, and for patients seeking a more significant degree of change, often greater structure and support is necessary – in the form of rib cartilage.

Rib cartilage is permanent, as it is from your own body, and depending on the surgeon’s finesse, may create a structurally strong yet aesthetically delicate and refined nose.

Do I have to be Asian to undergo Asian Rhinoplasty?

The term Asian Rhinoplasty is a broad, descriptive term that describes a common set of anatomical traits and a group of surgical techniques used to address them. While in the strictest sense, it does apply to Asians undergoing rhinoplasty, in a more general sense it is possible for patients from any ethnicity to have the characteristics shared by individuals seeking Asian nose job surgery – namely, greater augmentation of the nasal dorsum, projection of the nasal tip, and increased definition and refinement of the nose.

Can Rib Cartilage Grow Back After Being Harvested?

While a small portion of the costal cartilage may regrow if the edges of the perichondrium covering it are re-approximated, it will be different in shape and appearance than the cartilage that was removed. Nonetheless, after rib cartilage harvest the only difference you will be able to notice or feel between the left and right is the presence of a small, thin scar.

What are the risks of using DCF (Diced Cartilage Fascia)?

The diced cartilage fascia technique does require special expertise and a great deal of experienced to create consistent, predictable results. The most commonly encountered issue is contour irregularities and asymmetries – as with any technique for dorsal augmentation. In skilled hands, the diced cartilage fascia technique provides permanent, natural and attractive results, but in inexperienced hands can be unpredictable and inconsistent.

Will my rib cartilage become weaker after rib harvest during Asian rhinoplasty?

A small portion of the cartilaginous portion of the rib is taken (for my patients, usually ~4 cm from the right 6th rib). You will not have any untoward effects in terms of health or function, as it only a small portion of the 12 ribs on each side of the body, and the rib cage will continue to function to protect the vital organs and provide structure to the chest in exactly the same manner. Rib cartilage harvest is well tolerated even in my patients who are professional boxers and mixed-martial artists. The biggest downside to have rib cartilage harvested is a thin ~1 cm scar, which will be present in the crease under your right breast or pectoral.

What kind of nose surgery do I need to make my nostrils (or sides of my nose) smaller?

Alar base modification is an effective way to reduce the flare and/or width of the nostrils. Excess width can be reduced with sill incisions, excess flare with Weir incisions, and excess flare + width addressed with a combined Weir+sill incision. The most appropriate type of Alar base modification for your Asian nose job surgery will be determined during your consultation with Dr. Donald B. Yoo and will be based on the confluence of your existing anatomy with your aesthetic goals.

What should I do if my pre-existing silicone implant is displaced from a previous surgery?

Silicone implants can become “displaced” or “migrate”, meaning they can move. The possible danger to your health would be from the risk of extrusion (of the implant thinning your skin to the point of ulcerating through) and the risk of infection. Signs that this is occurring include redness and tenderness along the nose where the implant is. Unless either of these is happening, your health is not at imminent risk, though at some point the implant will have to be removed.

When an silicone or Goretex implant has been placed in the nose, it may be removed and replaced with your own cartilage simultaneously during revision Asian rhinoplasty as long as there is no active infection, and the skin is completely intact.

Increased Swelling 4 Months After Asian Rhinoplasty – Should I be worried?

For an entire 1-2 years after your surgery, your nose is continuing to heal and take on its final appearance. For most patients, the resolution of swelling follows a sinusoidal curve rather than a linear pattern, meaning some days and weeks the swelling will be even more than the ones directly preceding them.

During the first year of healing, it’s not unusual to see your nose fluctuate in size and the in the amount of swelling, but the gradual trend will be towards reduction of edema. Following up closely with Dr. Yoo is important, as in some cases (especially with sebaceous skin and in patients with thicker skin) swelling may remain prolonged, and may benefit from injections of Kenalog and 5-Fluourouracil to expedite its resolution.

Why is irradiated rib cartilage in Asian Rhinoplasty sometimes not recommended?

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.

Diced cartilage fascia provides permanent results without the risk of warping or resorption of en bloc rib cartilage, and with a much lower rate of migration, infection, or extrusion than synthetic grafts.

How long should an out of town patient stay in the area after Asian nose job surgery?

For my out of town/out of country patients my preference is a 2 week stay in Beverly Hills/Los Angeles, with a 1 week stay being the minimum stay. The highest risk of infection is between 1-2 weeks after surgery while the nose is early in its healing stages. Sutures and a cast will be on your nose for a week, at which time my patients may fly home if they wish, but the incision lines will still have dissolvable sutures and remain a little raw until ~2 weeks after surgery.

At 2 weeks after surgery the incision lines will be nearly healed, and makeup can be applied to the nose. This is the point that most patients feel comfortable going back to their daily routine, and feel comfortable going back to work. With autologous grafts (rib grafts) the risk of infection is much lower than synthetic grafts, and after the nose is healed there is no increased risk of infection over your natural nose.

Dr. Yoo looks forward to helping achieve a more beautiful you.

Call now for your consultation: 310-772-0766

Asian Rhinoplasty Before & After Gallery

Asian Rhinoplasty Videos

Asian Rhinoplasty in 1 Minute Fascia with narration Fascia Harvest
Asian Rhinoplasty with rib cartilage and fascia
Revision Asian Rhinoplasty Making DCF - Suturing Fascia Making DCF - Suturing only
Making an incision on the nose Making grafts with Rib cartilage Rib Cartilage Harvest - rib Rib Cartilage Harvest Rib Cartilage Harvest Rib Cartilage Harvest - rib harvest Rib Cartilage Harvest - rib coming out Suturing grafts inside the nose Taking out hump from the nose

To speak to a specialist directly: 310-772-0766

Asian Rhinoplasty Blog Articles

November 5, 2021

Nasal septum perforation is a condition where there is a full thickness defect (or hole) of the nasal septum. The nasal septum divides the inside of the nose from the left and right cavities. Septum perforations can be caused by … Continue reading

December 16, 2020

December 16, 2020

Each surgeon will have his/her preference in terms of general anesthesia.  For me personally, I find general anesthesia to be the most comfortable and safe form of anesthesia for my patients during rhinoplasty.  The nose is a part of the … Continue reading

January 21, 2019

When performed judiciously, alar base modification should have no effect on breathing.  Typically the sensation of nasal obstruction or flow is most easily affected at an area referred to as the “nasal valve”, which should not be affected by alar … Continue reading

January 21, 2019

A number of different surgical techniques are available to increase the projection and the refinement (pointiness) of your tip.  Conservative excision of cartilage in the tip of your nose, and suture techniques can be used to increase the refinement in … Continue reading

January 12, 2019

For an entire year after your surgery, your nose is continuing to heal and take on its final appearance.  During that period of healing, it’s not unusual to see your nose fluctuate in size and the amount of swelling.  You … Continue reading

Dr. Yoo looks forward to helping achieve a more beautiful you.

Call now for your consultation: 310-772-0766