Silicone Implant to Get Sharp Tip in Asian Rhinoplasty?

I was wondering if the only real method to achieve a super sharp tip in Asian noses is with the use of a big silicone implant since septal/ear cartilage is insufficient/weak. A respected rhinoplasty surgeon said so, but he doesn't do this. So I figured I'd ask doctors who have more experience with producing sharp tips in Asians. In the photo,note the features,specifically the sharp/projected tip and the supratip break. What kind of cartilage/implant/strut is needed to achieve that profile? The subnasale advancement is separate and would be done prior to having the rhinoplasty. Please chime in with feedback,thanks!


Doctor Answers 23

Tip refinement in Asian rhinoplasty

Part of the reason that silicone implants can create a "super sharp" tip is that they exert a tremendous amount of pressure on the skin, and ultimately thin skin.  A great deal of refinement can be achieved with a septal extension graft and shield graft, but the level of "sharpness" will be limited by the thickness of your skin.  


Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 44 reviews

Silicone Implant to Get Sharp Tip in Asian Rhinoplasty?

I recommend using your own cartilage as best.  Furthermore with the tip you describe and show on the picture, the silicone may be more problematic for you and cause the skin to die over the tip.

For more information, please go to my website at:
WirthPlasticSurgery.com

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 10 reviews

Asian Rhinoplasty - Implan

Surgery with silicone implants is quicker, since they are pre-fabricated and easier to place than autologous grafts (tissue from your own body), and the recovery may be a bit easier. The results may also look good for several years, however they are not a permanent solution. As long as the implant is in place there will be an associated risk of infection, migration, and extrusion (coming through the skin) which is higher than that of autologous grafts.
The reason for the lack of permanence is that synthetic implants never become fully incorporated into your body. Using tissue from your own body will give you the safest, longest lasting results and a beautiful nose.

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

Silastic Implants

Hi,
Silastic implants work very well to augment the nasal bridge and tip if they are custom carved. DO NOT get a preformed "one size fits all implant". Along with the silastic implant you should have a 1) srtut graft 2) shield graft and if needed 3) tip defatting. All these maneuvers will enhance your chances for a defined tip. Be careful with only using a silastic implant, if not placed properly they can necrose through the skin.
Best,
Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 265 reviews

Nasal Implant

Given the option to use your own tissue, this is a safer route. That said, more consistent and reproducible changes to the dorsal contour and projection can be achieved with an implant. There is always a risk of infection and extrusion, so this must be weighed carefully.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 95 reviews

Silicone Implants

The size of the Silicone implant need not necessarily be big to have the sharp tip effect. These factors need to be considered:
1. Thickness of the skin/subcutaneous layers over the nose tip area
      - Thicker skin needs more push while a thinner skin will show the shape of an implant placed below it.
2. How the surgeon carves and places/inserts the implant
      - Making a big or long implant can result to implant extrusion.
      - An implant with adequate length but with the right shape and angle (with the strut) will equally produce a sharper tip. 
Good luck with your choice..

Al Farabi L. Jaafar, MD
Manila Plastic Surgeon

Very refined tip in Asian Rhinoplasty

Thanks for the question,

The reality is that it depends.  As an Asian Facial Plastics specialist I would say that it's still best to avoid full-sized "L-shaped" implants when possible.  in some cases implants of this type are a good choice. Most Asian patients have relatively thick skin with a sometimes soft consistency which makes sharp definition of the tip with cartilage grafting or implants difficult. In general you can augment the nasal dorsal and do very aggressive and sharp cartilage work on the nasal tip to give the Asian nasal tip a very refined look in Asian rhinoplasty. There really are few shortcuts and Asian rhinoplasty.

I'll attach a little information regarding this procedure.

Chase Lay, MD
double board certified facial plastic surgeon

Asian facial plastics specialist

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 72 reviews

Don't recommend silicone at the tip

Thank you for your question. You do bring up some important points when discussing the tip of an Asian nose. The typical Asian nasal tip has thicker skin and weaker underlying cartilages.  So to improve tip definition I typically recommend building out on the tip only with cartilage.  Septal cartilage grafts and rib cartilage grafts can have the "rigidity" required to improve tip definition.  I do not recommend silicone at the tip because of potential extrusion and infection.

Edward S. Kwak, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 20 reviews

Nasal Implants - Asian Rhinoplasty

Thousands of rhinoplasties are performed in the East on Asian patients by inserting a piece of silicone molding to augment the nasal bridge and define, project and elevate the nasal tip. Those typically do very well, but the implant can cause some problems with infection and extrusion.
Another option is using ear or septal cartilage, or even rib cartilage.

Philip J. Miller, MD, FACS
New York Facial Plastic Surgeon
4.6 out of 5 stars 69 reviews

Do not use silicone in the tip of the nose

To get a sharp tip, foreign materials at the tip are not safe. The likelihood of damage to the skin and underlying cartilage is high - probably the rule rather than the exception.

In order to get a sharp tip using cartilage, there is enough tissue in the ear and septum to build the tip by reinforcing the cartilage securely to prevent bending and softening of the tip.

Charles S. Lee, MD
Beverly Hills Plastic Surgeon
4.6 out of 5 stars 75 reviews

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.