I am an Asian female with a asymmetrical/tilted nose. I am thinking about rhinoplasty surgery to highen the bridge of my nose. What kind of implant should I use? How would the surgeon "untilt" my asymmetric nose?
Rhinoplasty for Asian with Asymmetric Nose
Doctor Answers 15
Dear Double L,
The bridge may be raised using your own cartilage or using an implant (silicone, polypropylene, Goretex, etc.). There are advantages and disadvantages with each option. The nose can be made more symmetric by reshaping your cartilage. I would consult with a Board Certified Plastic Surgeon who is highly experienced with Asian rhinoplasty.
Larry Fan, MD
Many options for augmenting the Asian nose
The Asian nose, like many African-American noses, often requires augmentation of the bridge, or "nasal dorsum." Many different implants are available, including synthetic and non-synthetic materials. Although Gore-Tex and silicone implants can provide excellent elevation of the bridge height, sometimes they can become displaced or even extrude. Other options include using your own cartilage from your septum, ear or rib. Also irradiated rib cartilage is available commercially and some have found this to be quite useful in dorsum augmentation. Your best bet is to talk to surgeons who have experience with this type of rhinoplasty, and ask their advice and experience with different materials for augmentation.
The asymmetry of your nose will probably require the "open" approach to reposition the cartilage. Even the best rhinoplasty surgeons are challenged when faced with the crooked nose. I suspect your surgeon will tell you they can try to improve the asymmetry, but it may not end up "perfectly" symmetric.
Rhinoplasty for Asian asymmetric nose
I've been very happy using a straight silastic (not L-shaped) nasal dorsal implant to raise the nasal bridge for over 20 years. The asymmetry below will be removed by rasping the nasal bonrs and trimming the cartilage during your Rhinoplasty.
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Asian rhinoplasty with asymmetry
Silicone implants usually work well in rhinoplasty and can be tailored to the individual. "Tilting" of the nose is probaby from cartilage asymmetry, correction of which would be part of the rhinoplasty procedure.
Rhinoplasty for asians
it is not unusual for rhinoplasty in patients with asian ancestry to request heightening of the nasal dorsum. There are multiple options of material to use. My preference is to use the patients own (autologous) cartilage either from your own septum or if more cartilage is needed, the ear. this avoids concerns for future infections and foreign body reactions from silicone implants. "Untilting" you nose involves manipulation of your nasal cartilage, which is part of a rhinoplasty.
There are several good choices for nasal implant material. I use a custom made silicone implant. This implant is custom carved for every patient. I do not use the preformed implants; "one size fits all". I have many examples of this implant on my ethnic rhinoplasty site below. Gortex is another good implant material. It all depends on what the surgeon is comfortable using. As far as the asymmetry is concerned, it all depends on which part of your nose is curved - cartilage vs bone or both.
Asian rhinoplasty with a deviated dorsum
Dear double L, you bring up two distinct concerns for your nose. The first is the "tilt" in your nose. I would assume you are referring a crooked bridge. The second issue is adding height to your bridge. Choosing the type of implant required to build up the bridge is not as critical as ensuring you build up on a solid foundation. What I mean by that, is that the bridge of your nose needs to be straightened first. To do this, the surgeon may require manipulating your nasal bones or altering the cartilage in the middle of the nose. After straightening the bridge, a dorsal implant can be used to increase the height of your bridge.
Rhinoplasty for asymmetric Asian nose
The implants that are used for Asian rhinoplasty are made of silastic and manufactured by Implantech. We prefer the Flowers nasal dorsal implant of appropriate size, which is determined at the consultation with patient’s desires in mind.
Implant for Asian rhinoplasty?
I am not a fan of synthetic implants, except in very specific situations. I feel that using the patient's own cartilage for augmentation is a much safer option. I see many patients for revision rhinoplasty in my office, and I can tell you that I have to remove quite a few implants. Many times these implants have led to a chronic infection. My preference in Asian rhinoplasty is costal (rib) cartilage. With proper technique, the risk of complications, such as warping, is lessened. In Asian patients who don't require as much augmentation, septal or ear cartilage can also be used. My advice is to seek a surgeon who is truly experienced in rhinoplasty. In my opinion, Asian patients who require augmentation should find a surgeon who specializes in rhinoplasty; this is much more important than selecting a surgeon simply because they are certified by a particular board. Do your homework, and you will make the correct decision. Good luck.
I recommend a combination of cortex and AlloDerm dermal matrix graft. This provides the most natural feel and is least likely to be rejected by the body.
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