Asian Rhinoplasty: Q&A
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Silicone Implant to Get Sharp Tip in Asian Rhinoplasty?
I was wondering if the only real method to achieve a super sharp tip in Asian noses is with the use of a big silicone implant since septal/ear cartilage is insufficient/weak. A respected rhinoplasty surgeon said so, but he doesn't do this. So I figured I'd ask doctors who have more experience with producing sharp tips in Asians. In the photo,note the features,specifically the sharp/projected tip and the supratip break. What kind of cartilage/implant/strut is needed to achieve that profile? The subnasale advancement is separate and would be done prior to having the rhinoplasty. Please chime in with feedback,thanks!
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15 Doctor Answers |
Asked by
paul80
in NY
+2
I would use rib cartilage, not a silicone implant
While I have never personally placed a silicone nasal implant in a nose, I have seen several patients that were having problems with them. There is a real risk of infection and a gradual thinning of the skin overlying the implant to the point of it actually becoming exposed.
Having seen these examples it is clear to me the risks are not worth the benefits of using a silicone implant. For an Asian patient seeking a more defined and projected tip I would use a rib cartilage graft. The major...
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Don't recommend silicone at the tip
Thank you for your question. You do bring up some important points when discussing the tip of an Asian nose. The typical Asian nasal tip has thicker skin and weaker underlying cartilages. So to improve tip definition I typically recommend building out on the tip only with cartilage. Septal cartilage grafts and rib cartilage grafts can have the "rigidity" required to improve tip definition. I do not recommend silicone at the tip because of potential extrusion and...
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Nasal Implants - Asian Rhinoplasty
Thousands of rhinoplasties are performed in the East on Asian patients by inserting a piece of silicone molding to augment the nasal bridge and define, project and elevate the nasal tip. Those typically do very well, but the implant can cause some problems with infection and extrusion.
Another option is using ear or septal cartilage, or even rib cartilage.
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Do not use silicone in the tip of the nose
To get a sharp tip, foreign materials at the tip are not safe. The likelihood of damage to the skin and underlying cartilage is high - probably the rule rather than the exception.
In order to get a sharp tip using cartilage, there is enough tissue in the ear and septum to build the tip by reinforcing the cartilage securely to prevent bending and softening of the tip.
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Silastic Implants
Hi,
Silastic implants work very well to augment the nasal bridge and tip if the are custom carved. DO NOT get a preformed "one size fits all implant". Along with the silastic implant you should have a 1) srtut graft 2) shield graft and if needed 3) tip defatting. All these maneuvers will enhance your chances for a defined tip. Be careful with only using a silastic implant, if not placed properly they can necrose through the skin.
Best,
Dr.S.
+1
Nasal implants for Asian rhinoplasty
We do not prefer a sharp tip for Asian noses since anything that will create a sharp tip is likely to put excess pressure on the skin causing necrosis and break down the overlying skin. The most common nasal implant we use for Asian rhinoplasty is the Flowers nasal dorsal implant, not the L-strut. There have been numerous complications from L-struts over the years and we have taken many of these out. We prefer a very natural and balanced Asian rhinoplasty that does not look like it has...
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Silicone Implants in Asian Rhinoplasty
Although silicone nasal implants are are frequently used in Asia, they are less common here in the USA because of the risk of movement after placement and the associated risk of extrusion. Cartilage grafts can be designed to provide strength and improve contour and definition.
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Surgical judgement necessary for Asian augment rhinoplasty
Silicone implants for Asian augmentation Rhinoplasty are extremely common world wide. In North America however we tend to be more cautions with the use of Silicone in the nose because of the possibility of infection and extrusion.
I think excellent refinement of the nasal tip can be achieved with the use of a autogenous grafts (patient's own cartilage). I personally use gortex for the nasal bridge and autogenous cartilage for the tip.
Regardless of whether a full silicone implant is used...
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For Asian rhinoplasty, cartilage grafts are the best way to shape the tip
Silicone is commonly used in Asia to raise the nasal profile, sometimes with nasal tips included, called an L-Strut. The problem with silicone is that it can become infected and even erode through the skin or into the nose decades after it is place, especially if the tip is made of silicone as well.
I prefer shaping and strengthening the tip with your own cartilage, usually septal cartilage and then using Gortex for the bridge. Silicone is acceptable fro the bridge as well.
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Asian rhinoplasty (nose job) and implants or cartilage grafts.
I have removed silicone nasal implants placed in Asian rhinoplasty on two occasions. In most instances, the amount of tip support or augmentation you request would be achieved with either ear or rib cartilage.
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Nasal tip surgery in patients of Asian descent
Tip definition is dependent upon a lot of things including graft material, soft tissue coverage and underlying bony and cartilaginous framework. Sometimes all that is needed is suturing the tips with or without a tip graft in thinner skin.
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Ways to enhance tip definition in Asian rhinoplasty
Tip projection, narrowing, and definition in Asian rhinoplasty often require significant sculpting in the nasal tip area. Here are some of the ways to achieve the goals more safely and effectively:
cartilage sculpting of the existing nasal tip cartilages
cartilage grafting, from the septum, ear, or at times from rib cartilage
silicone implant with layered AlloDerm, fascia to minimize chance of extrusion
Los Angeles Facial Plastic Surgeon
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Suture techniques and cartilage grafts allow nasal shaping
Usually the desired nasal shape can be accomplished with suture techniques and cartilage grafts. The cartilages of the nasal tip can be narrowed, increasing tip definition and projection, and also setting the proper angle of the tip. Cartilage grafts can further increase tip definition, projection,and support, and also build up the bridge if necessary.
The septum is the best source for cartilage grafts, and if this is not sufficient, then ear cartilage or rib cartilage can be used. Your...
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Nasal tip surgery in Asian rhinoplasty
Nasal tip surgery in Asian patients typically requires maximum narrowing of the existing cartilages followed by grafting. This is especially true if a sharp narrow tip is the desired aesthetic result. I do not favor solid silicone implants there due to the risk of extrusion and scarring and infection and migration. If insufficient septal cartilage is present, an excellent alternative is rib cartilage either from you or another irradiated source from a cadaver. I hope this information helps.
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Silicone implants in the nasal tip
Dear Paul,
It is true that augmentation rhinoplasty with silicone implants is one of the most common rhinoplasty operations in the world, but not in the United States. In the nose, silicone has a tendency to get infected and then would need to be removed. The chance of running into this problem is MUCH higher if it is used on the tip rather than for strict dorsal augmentation. For most Asian patients seeking dorsal augmentation rhinoplasty, the volume of graft material required is...
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