An “Asian rhinoplasty” is a variation of traditional rhinoplasty surgery performed on a patient of East Asian descent.
While having a more Caucasian nose was once the goal of many patients of Asian descent, it’s become increasingly common for patients to request a result that preserves their racial identity, according to the authors of “Milestones of Asian Rhinoplasty.”
“It’s a popular misconception that a patient seeking this procedure desires a ‘Caucasian nose,’” says Dr. Jimmy Sung, a board-certified plastic surgeon in New York City. “This fallacy is based on an over-simplistic East-West dichotomy view of aesthetics and failure to recognize the anatomical differences among individual patients."
Dr. Sung underscores that the goal of most Asian patients is no different from that of any other rhinoplasty patient: “to bring their nasal form into balance with their facial features. By achieving the patient’s desire for harmony, the beauty of their individuality and diversity is naturally preserved,” he explains.
While rhinoplasty procedures on Caucasian noses typically involve a reduction of structures, often to soften a dorsal hump or refine the nasal tip, Asian nose jobs are, in essence, nasal augmentation: surgeons usually augment the bridge, lengthen the nose and create more tip definition.
As with other ethnic rhinoplasty procedures, common physical characteristics can influence how this plastic surgery is performed. But, surgeons should be careful not to over-generalize across the board.
According to Dr. Sung, it's inaccurate to categorize all East Asian noses as having low bridges, thick skin, and bulbous nasal tips. Patients from certain regions may possess these qualities, but those from other parts of East Asia may have a nasal hump, thinner skin, and more sculpted nasal tips.
Surgical techniques include cartilage grafts, typically from the rib or back of an ear, reinforcing the bridge and creating more tip definition. "With a Caucasian nose, the septum is usually the common place you harvest cartilage," explains Dr. Sung. "But the East Asian population usually doesn't have a lot of septal tissue, which is why the nose is short to begin with, so there is usually not enough to work with." In the U.S., fresh, frozen rib cartilage (such as those provided by non-profit organizations such as MTF Biologics) can also be used instead of the patient's rib cartilage, sparing an extra incision on the chest. Long-term studies have found fresh frozen donor rib grafts safe, stable, and sound long-term outcomes. Unlike the irradiated rib grafts used elsewhere in the world, which are prone to resorption, fresh, frozen rib cartilage incorporates with the patient's tissue over time for long-lasting results, Dr. Sung explains.
Beyond nasal augmentation, patients with wide nostrils may also have an alarplasty, to narrow the base of the nose. Not every East Asian patient wants or requires an alarplasty, however, and misdiagnosing this as a need can create "a very manufactured-looking nose" with unnecessary scarring, says Dr. Sung.
The thickness of the nasal skin also plays a role in the treatment plan. Many patients of northern Chinese, Korean, and Japanese descent tend to have thinner skin, says Dr. Sung, while patients from other parts of Asia may have a thicker skin envelope that blunts or obscures the nasal tip, requiring surgeons to do more extensive work with cartilage grafts and remove some fatty tissue at the end.
Rhinoplasty is widely considered the most technically demanding form of aesthetic plastic surgery, and the outcome usually takes years to reveal. Furthermore, not all providers have mastered the specialized techniques and have the skill to provide a natural-looking result that balances the facial features while respecting each patient's aesthetic goals and ethnic identity. This makes it especially important to find a surgeon (ideally a board-certified plastic or facial plastic surgeon) who has decades of experience performing Asian nose jobs on patients who look similar to you, with before and after photos showing the type of results you're after.
"Each ethnicity has its cultural ideas of beauty that must be appreciated and enhanced with any procedure that's performed," notes Dr. Jonathan Kulbersh, a board-certified facial plastic surgeon in Charlotte, North Carolina. "If you're interested in ethnic rhinoplasty that respects your cultural identity, take the time to find a professional with experience in this area."
