I am planning to get my nose job in October during my semester break which is 3 weeks. I have the typical filipina button nose. It is bolbous at the tip &I barely have a bridge. I'd like for it to look natural but not so natural that it looks like I barely did anything to it. Does that make sense? I have tried to research as much as I could about the different types of implants. I'm iffy about Silicone because I have heard they can shift overtime. What would you recommend?
What Type of Material Would You Recommend? (photo)
Doctor Answers 5
What Type of Material Would You Recommend
A silicone implant or cartilage grafting would be two reasonable options. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA
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Augmentation rhinoplasty for the Asian nose
Silicone (Silastic) implants worked very well an Asian nose. We prefer the Flowers nasal dorsal implant and we do not use L. strut implants.
Correct implants for Asian noses
I practice here in Honolulu, Hawaii and I do a lot of Asian noses. Silicone implants have gotten a bad reputation in the past but if used properly can give a very nice and predictable result. The dorsal part of the nose, i.e. the bridge can be augmented safely and predictably with a silicone implant. The use of rib cartilage, diced cartilage rolled in fascia can be used but the result over time may change as some reabsorption of the cartilage may occur. I routinely use a Rizzo nasal implant to augment the dorsum, but the tip has to be reconstructed using ear cartilage. To keep the dorsal implant from moving or shifting its important to put small holes with a 2 mm punch so tissue ingrowth may occur and prevent the implant from shifting due to scarring. The tip should be built using carefully carved ear cartilage. An intercural strut is necessary to build strength so the tip does not collapse. Tip projection is important and created with multiple height tip grafts to match the height of the dorsum. Finally a shield graft is needed to give the tip the adequate projection and angle. This technique is very difficult to master but when done can give an Asian nose a beautiful profile. The L-shaped implant made of silicone should be avoided as extrusion can occur if the tip height is too high. Dr. Chu
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Last month I removed an infected silicone implant from the nasal bridge that had been placed in the nose in Manila 10 years ago. I think the infection was caused by an injection near the implant within the last year. So I am basically biased against silicone.
You have the typical features of a flattened wide bridge, round tip, wide alar base and retruded short columella with horizontally oriented nostrils. In planning for surgery you should decide before hand which of these you want to change and which you want to keep as is. On side view you can see the typical greater deficit in the bone bridge than the cartilage part of the bridge so you also need to choose between double grafting the bone portion vs. removing some cartilage and single grafting the bone and cartilage portions.
I personally prefer medpor because I do not believe I can get enough cartilage from the ears. Some doctors prefer using rib cartilage and never use synthetic material. In the end the decision has to be yours after reviewing the pros and cons of each choice.
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