Asian Rhinoplasty: details, surgical approaches, and challenges

Lots of different surgical techniques and approaches are applied in Asian rhinoplasty. Both open and closed rhinoplasty approach is possible to achieve desired and balanced nose shape.

In Asian rhinoplasty, a common procedure is to raise the nose. This is because they often have flat-looking, under-projected noses. This means that more parts are added to the nose, making it appear higher, relative to the face. The technique employed for this purpose is referred to as augmentation. To achieve vertical augmentation of the nose, a new structure may need to be created within it. 

Building a structure in your nose is done with the help of cartilage and implants. The traditional method of using your cartilage is the safest option, although you need to consider the donor site morbidity as well. In Asian rhinoplasty, the surgeon will use these approaches to enhance your beauty:

• Alarplasty to reduce the flaring wings of your nostrils
• Cartilage grafting to enhance the shape of your nose
• Reducing a hump for those who have Japanese or Caucasian connections
• Skin defeating to make the changes visible under your skin
• Radix augmentation to balance every part of your nose with each other
• Nasal implants to increase your nose height with alloplastic materials

Now we are going down into details of these procedures.

Alarplasty

To correct the nasal flaring and wide nasal base problem alarplasty is performed. Nasal flaring is the excessive look on each outer side of your nostrils. The wide nasal base is also related to the same problem, but this time the base of the nose is also affected. In some cases, they are both needed to be corrected at the same time.

For Asian rhinoplasty patients, we can say that they have rather wide nasal bases and alarplasty is one of the common procedures. By removing the excess tissue on each nostril’s side, alarplasty can give you a perfectly shaped nose.

The surgeons pay extra attention to this procedure and use a caliper to precisely measure the alar base on each side. By doing that, they prevent any asymmetry and give you a perfectly balanced nasal shape suiting every other facial feature.

Cartilage Grafting

Cartilage grafting means adding spare parts to your nose to give it a good definition and height. With the help of cartilage grafts, surgeons are able to correct flat bridges and reshape ill-defined tips. There are some different resources in patients’ bodies to obtain cartilage. In order, doctors will search for septal cartilage, ear cartilage, and they might prefer harvesting rib cartilage as a last resort.

Dorsal hump reduction

Although it is not a common feature among Asian people, the dorsal hump can be seen in some people who have a connection to Japan and European countries. The reduction of the hump with the combination of osteotome will give the desired nose shape while protecting the person’s cultural identity. After the dorsal hump reduction, the person will get a perfectly aligned dorsal bridge. 

Radix augmentation

Sometimes the dorsal hump reduction is not the solution for Asian patients, but doctors also need to correct another part to create a better aligned nasal bridge, the radix.

Radix is the upper part of your nose. It is a common feature to have low radix for Asian people. To address the radix area grafting techniques or implants are used. In some cases, radix augmentation solves the bumping bridge problem without even reducing it.

Skin defeating

To reveal the beauty of a nicely shaped nose, it is important to tackle the issue of thick skin. To do so means carefully removing any excess layers between the skin and cartilage (1). Asian people typically have slightly thicker skin. Consequently, surgeons carry out delicate techniques between the layers of skin to slim it down. Generally, during skin layer removal procedures, the tip of the nose is dealt with.

Nasal implants

Apart from cartilage used to augment the nose Asian patients benefit from implants as well. Using nasal implants will improve the shape of your nose vertically and give you a better definition of the nasal bridge and tip. 

Most of the implants are made of silicon as it is the safest choice when it comes to infection risks. There are also Gore-Tex implants used in Asian rhinoplasty procedures. Gore-Tex gives a more comfortable experience and a natural look on the nasal contours but it is harder to remove in case of an infection.

There is an easier and similar way to achieve the same uplifting effect as well, called nonsurgical Asian rhinoplasty.

Nonsurgical Asian rhinoplasty

The options you have above are all done under anesthesia. In nonsurgical Asian rhinoplasty, you do not need to undergo surgery as the title suggests and the scale of the operation is way smaller. However, as the scale is smaller the outcomes of this procedure are also less fruitful. Most of the time people choose this option when they want small changes with less complication.

Doctors use a dermal filler to augment the nose, which is either temporary or permanent. People generally prefer temporary fillers that last around 6 months to a year. Permanent ones are not preferred since the long-term effects might be problematic. It takes less than an hour to finish this operation and there is no long healing period. You only need to be careful with your nose within 2 days after the operation and it is done.

Challenges of Asian Rhinoplasty

While skilled plastic surgeons or ENT doctors are operating in ethnic-style rhinoplasty, they come across lots of challenges. Most of the time they need to refer to the low nasal dorsum of Asian people. To make the nasal bridge well-built and defined, they use various techniques while dealing with lots of challenges.

Due to the thick skin issue of Asian patients, extra surgical steps to protect the nose might be necessary. Besides, it could also affect the recovery by lengthening the recovery procedure of swelling and increasing the risk for necrosis. Here, we listed the challenges that surgeons and patients need to deal with.

• Low nasal dorsum
• Scarring
• Swelling
• Risk of necrosis
• Skin thickness
• Recovery

Now, we will discuss all of them and guide you to the challenges of Asian rhinoplasty.

Low nasal dorsum

During the operation, one of the challenging aspects of the Asian nose job is lifting the nose. Most Asian people have a low dorsum, or in other words, a shorter nose. The grafting techniques and implantation aim to give you a better-defined and more projected nose if you have low nasal dorsum.

The challenging part is combining all these efforts with the definition of your tip. When the structure of your nasal tip and bridge is not well-built, then the structure might collapse and you might need revision rhinoplasty surgery. To prevent that, surgery needs to be done with precaution and delicacy. They take measurements of your nose beforehand to find the most suitable augmentation on your low radix.

Scarring

Harvesting cartilage from your body might leave a visible scar, called donor site morbidity (2). Especially costal cartilage harvesting might do that. It is not a serious and common problem, though patients are asked if they are okay with this procedure. Sometimes surgeons offer to use implants to avoid donor site morbidity.

Swelling

Swelling is common after any rhinoplasty operation. With Asian people, it is the same with only one difference, skin thickness.

In some surgeries, as we mentioned before, your surgeon makes changes to the skin and this could result in a longer swelling period. To prevent that, your surgeon might suggest you some tips like massaging over your nose for a while.

Another thing to affect your swelling period is placing an implant. To give you a better definition and projection over your nose your rhinoplasty surgeon might place an implant. Rarely do these implants get displaced, if not properly stitched, or you might damage it, leading to prolonged swelling.

Risk of necrosis

Skin thickness and different usage of different surgical techniques might arise the risks for necrosis. So, what is it? Necrosis is a tissue death problem. It occurs when the blood support is cut. Necrosis is one of the risk factors of rhinoplasty and is rarely seen. Generally, it occurs as a result of wrongly placed implants or overly done rhinoplasty operations.

Skin thickness

Another challenging part of rhinoplasty is addressing skin thickness in Asian patients. It is a game-changing factor for rhinoplasty that to see the best results, the doctor always needs to keep in mind the skin layers. The skin thickness slowly increases beginning from the upper nose bridge to the edge of your nasal tip where it gets the thickest. There are many layers in the skin and generally, Asian patients have thick fatty nasal skin layers.

Since your surgeon knows about the thick skin issue, they will make subtle changes to get the best results. What we mean by subtle changes is to make enough supportive structure beneath the skin so that the results can be seen on the outside. 

Recovery

The recovery procedure for Asian rhinoplasty is not too challenging, but there are some points to consider. After the first 2 weeks of your operation, you can go back to your normal life. 3-4 weeks after surgery, it is okay to perform moderate exercising activities. The full recovery from an Asian rhinoplasty surgery might take a year or two. Generally, it is the swelling that lasts this long and is barely noticeable after the first couple of months.

During your recovery period, your doctor will advise you to be gentle on your nasal structure during the first months, especially on the bridge.