Asian rhinoplasty vs. western rhinoplasty - what's the difference?

Although there is great variation in Asian noses (North vs South), the typical Asian nose has the following features:

• Weak tip cartilages
• Small tip cartilages
• Thick skin which lacks contour
• Retracted columella
• Wide flat bridge
• Wide nostrils

Typically Asian rhinoplasty requires a significant degree of grafting to add structure and contour to the nose.  I prefer using rib graft for the bridge although synthetic implants are also used by many surgeons.

Asians characteristically have a low bridge, and dorsal augmentation is frequently performed, either from the patient’s own tissues or with a synthetic Silastic implant.  Western rhinoplasty techniques involve reducing a bump on the bridge of the nose and refining a bulbous tip.

There are HUGE differences between Asian and "Western" Rhinoplasty.

First off, the nasal features are completely different and this requires specific maneuvers or techniques that are used to address each of the differences.

Asian Rhinoplasty: Tend to have short nasal bones (don't lend well to huge bony changes or cuts to be made), depressed dorsum bridge, short nose, wide nasal tip, thick skin, weak cartilage, inadequate septal cartilage for use of grafts, inadequate tip projection (tip does not point out enough), round nostrils, nostrils which show too much on the front view, inadequate columella (area between the nostrils), and a tip which points up too much (over-rotated).

All these features requires the following techniques, in general: Addition of cartilage (or implant) to augment the dorsum; increased support with cartilage added to the columella, nasal tip and above the nostrils; thinning of the thick skin, lowering the nostrils, increasing tip projection, osteotomy (bone cuts) to narrow the bridge.

Western Rhinoplasty: There is much more variation in western noses than Asian. Because of this, it is hard to point to specific features. There is a "melting pot" sort of presentation among western noses.

However, some differences which do not usually exist in Asian noses are: too much of a dorsal (bridge) hump, too much tip projection, long nose, drooping tip, large oval nostrils, thin skin, strong rim, tip, and septal cartilage, airway (breathing) problems.