My body's extremely sensitive to medications and even reacts to adhesives such as bandaids. During a rhinoplasty consult the surgeon told me that I do not have enough cartilage on my ears to make my nose look "pretty." He suggested to improve my Asian nose, he would narrow the base, elevate the bridge and add a tip. He tried to convince me that silicone is safe and well tolerated by most but knowing my weird body, I am skeptical...What is the best and safest method to improve my typical flat Asian nose?
Not Enough Cartilage on my Ears for Asian Rhinoplasty?
Doctor Answers 11
Dorsal augmentation during Asian rhinoplasty
In my experience, if you do not have enough cartilage in your ears, then rib cartilage is the best and safest method to build up a "flat" nose. I dice the cartilage into small pieces and wrap it in fascia to provide a customizable and individually tailored "implant" to refine your nose. Rib cartilage harvest will leave a small incision hidden in the crease below your right breast.
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Allergic reaction to solid silicone should be extremely rare.
I understand your concern about possibility of your body having an allergic reaction to silicone implants since your body is "extremely sensitive to medications". Fortunately, risk of having an allergic reaction to solid silicone is and should be extremely minimal since soild silicone is an inert material and should not trigger allergic reactions. Silicone definitely has its share of drawbacks, like any other material options, but when it's done well on good patient candidates , it can be a good option.
I would suggest you to look thoroughly at all surgical options and their benefits and risks before making the final decision. When there are too many questions, take your time until you find the answers.
Silicone or Ear Cartilage, why and when.
Please understand that what I have to say is my opinion, other surgeons may differ and may differ strongly. I do not like silicone implants. Over the years I have seen many patients who had them placed and ultimately had infections, often many years later. The implant can start to come out with even the slightest trauma. The treatment is removal of the implant and antibiotics. I prefer cartilage implants. This is your own tissue, and it becomes integrated into the tissues of the nose. Why go right to the ears? The best source for nasal reconstruction is your nasal septum. If there is not enough usable cartilage in the septum, then I go to one or both ears. Rib cartilage is also possible and still better than silicone, I think. I have supplied a line for you to look at. Get more than one opinion.
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Cartilage for Asian Rhinoplasty
Over the past 35 years I've never seen an Asian patient who did not have enough ear cartilage to augment their nose as long as it was not reconstructive surgery. I strongly recommend that you do not use silicone implants to avoid the increased risks of infection, movement, and extrusion.
Your own cartilage is best and safest for asian rhinoplasty
Since your emphasis is on safety, there is no doubt that your own tissue is the safest material. I use ear cartilage almost exclusively for the entire nasal augmentation. Occasionally a portion of the second ear is needed (10% or less). I prefer the ear rather than rib due to the ease of obtaining the material and also the suppleness of ear cartilage (unless the rib cartilage is diced). I have yet to meet a patient without prior surgery who needed more than ear cartilage.
Asian nose and augmentation
I prefer using rib cartilage or irradiated cartilage to augment the nose. They both work well and each has positive and negatives to deal with.
Not Enough Cartilage on my Ears for Asian Rhinoplasty?
I frequently perform "Asian Rhinoplasty" and use both straight silastic dorsal implants as well as septal cartilage. IMHO, it is well documented that ear cartilage folded (since it is curved in the ear) as well as rib or irradiated cartialge
does absorb unevenly over the years and as such, I do not use or recvommend these materials for dorsal augmentation. These are some of the differences between Rhinoplasty Surgeons and you should have severral consultations with experienced Rhinoplasty Surgeons in order to decide which one is best suited for your particular case.
Depending on the amount of cartilage you can usually obtain enough from the nasal septum and the ear combined. If not you can use rib cartilage. All these have low rejection and infection rate. Donald R. Nunn MD Atlanta Plastic Surgeon
It's always safest to use your own cartilage. If you have never had nasal surgery before you likely will have enough cartilage in your nose and ears. The diced cartilage in fascia technique works well in Asian patients but there are other ways to use your cartilage as well. If necessary you can use your rib cartilage. That may sound extreme but you want to get this right the first time and never have to do it again so a little extra recovery now will pay off in the future.
Safest method of dorsal augmentation during Asian rhinoplasty
A silicone implant will carry with it a higher risk of infection, extrusion (eroding through the skin), and migration (moving from its ideal position) than an autologous graft (made from your own body). Dorsal augmentation (building your bridge) with diced cartilage wrapped in fascia provides predictable, reliable, consistently excellent results and becomes incorporated fully into your nose, unlike silicone.