Repeat Asian Rhinoplasty For More Prominent Tip?

I've had 2 rhinoplasty in the past, but still not completely satisfied with the tip of my nose. The surgeon have used my ear's cartilage, but I am definitely open to using silicone & such in obtaining the "sharper & pointier" nose tip, for a more dramatic effect. Please advise me for any experienced surgeons in the Southern California area? Or if anyone has any input on my inquiry? Thank you!

Doctor Answers (8)

Need to find out why first two surgeries failed meeting your expectation.

+1

First, your surgeon and you need to find out why your two previous rhinoplasty procedures using ear cartilages have failed to meet your expectation to avoid having another unsatisfactory outcome.

How the procedure was performed is probably more important than the fact that ear cartilage was used. Perhaps you have thick nose skin and/or significant amount of subcutaneous fat thus limiting the outcome potential. 

I don't recommend using silicone in the tip because of the risk of extrusion and infection.


New York Plastic Surgeon
4.5 out of 5 stars 29 reviews

Revision Asian rhinoplasty

+1

First, I wouldn't recommend that you use a silicone implant, especially for the tip of your nose.  It sounds as though your first 2 rhinoplasties were through a closed (endonasal) approach.  An open approach will give you the potential for greater tip refinement (sharper & pointier).  The baby incision used to open the nose heals beautifully, even in Asian noses.  You will likely need to increase the projection of your nose to achieve the full "dramatic effect" you are looking for, and this could be performed with tissue from your own body through an open rhinoplasty approach.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Revision Asian rhinoplasty

+1

Stay away from silicone or any foreign material in the tip of your nose...I have seen several Asian patients who have had tip strut implants placed in the far east to provide more tip support and have had implant extrusion (exposure) and needed removal of the implant from very minor trauma...your own cartilage (septal would be ideal) is the best option.

Leonard T. Yu, MD
Maui Plastic Surgeon
4.5 out of 5 stars 15 reviews

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+1

I'm sorry to hear about your experience.  Enhancing the nasal tip is a very common request from my Asian patients.  I would not advise you to use silicone or other implants to achieve this.  While it is difficult to make any recommendations without having seen you and what is needed to be done, if you do need additional cartilage, using your own cartilage is always best.  Please consult with a board certified specialist who can assist you in achieving the results you seek.

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As we speak, I just finished a Revision-Revision Open Rhinoplasty for similar reasons!  In fact, you have many options available to help you achieve your stated goals.  You need a full rhinoplasty consultation that discusses the "pros & cons" of your existing options.

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+1

Yes, it would be useful to see your pictures to give you the best advise.  It sounds like you will benefit from tip revision surgery if you want to improve your tip definition.  Asian noses tend to have a thicker skin, especially at the tip, therefore auricular cartilage may not be rigid enough to give you a definition that you desire.  I prefer to use either a septal or rib cartilage for this purpose.  Silicone implants are not a favorable option, especially in the US, as they carry a risk of extrusion/ infection/ foreign body reaction, which is especially higher if these implants are placed on the nasal tip under tension.

Alexander Ovchinsky, MD
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You can improve the prominence and definition of your tip, but I would strongly recommend that silicone not be used because of frequent and severe complications when this is used in the tip. Cartilage is still the best material to use in the tip; success will depend on the technique that is used.

Richard W. Fleming, MD
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Hi,

To achieve more definition in your tip you may need a tip revision. However, I wouldnt suggest putting silicone or any artificial implant in your tip. This runs a high risk of extrusion and infection. You just may need a more refined tip cartilage by reshaping what you already have or using small pieces of cartilage placed and shaped in the right way. A picture would help asses to the problem. Feel free to send one.

Best,

Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.