Augmenting the radix. Asian rhinoplasty
ear cartilage does resorb however it doesn't necessarily resorb on evenly. Diced cartilage and a fascia graft is a good option. Both are quite reliable. I do use silicone implants on the dorsum however I only used them in patients who have relatively thick skin. Patients with thicker skin have a more natural appearance with implants over time. If you are a thin skin patient he may want to take a closer look at cartilage grafting. It sounds like you have a very good relationship with your surgeon but you may want to get additional opinions from people who do Asian rhinoplasty frequently.
Chase Lay, MD
Double board-certified facial plastic surgeon
Asian facial plastics specialist
Best technique for radix augmentation
Fillers can be a nice way to see how your radix would look if augmented, but is a temporary solution.
A small DCF (diced cartilage fascia) tailored for your radix will provide a permanent and natural appearing result with smooth contours. Cartilage from your septum (inside your nose) or your ear can be finely diced and wrapped with a small piece of fascia from your scalp to create a DCF graft. Silicone tends to have visible edges at the radix and can appear very unnatural over the years as your skin thins around it.
Building up a low radix
Very good questions. The answer depends to a great extent on the VOLUME that will be needed to augment your radix. I use Artefill for relatively small volume augmentation, and I use rib cartilage for large volume augmentation in patient who wish to have their own body material (cartilage) used. However, other options exist and need to be considered such as layered septal cartilage, layered gortex, silastic rubber implant etc. I also use well-carved, layered or diced ear cartilage. Absorption over many years can be seen with ANY cartilage material.
A graft in the radix can be obtained from several areas. The best choice is always your own cartilage. If you want something less invasive you can opt for Restylane. Silicone is permanent and that means if you do not like the look, you have a permanent problem. With Restylane or Juvederm if you don't like it, it can be removed.
This answer is not intended to give a medical opinion and does not substitute
for medical advice. The information presented in this posting is for patients’
education only. As always, I encourage you to see your personal physician for
further evaluation of your individual case.
Silicone vs Fillers for Low Radix
My first choice for radix augmentation in patients like you is temporalis fascia because it is easy to harvest, will not absorb, and provide a smooth contour without risk of sharp irregular edges, and will be permanent. You do not need silicone or fillers.
Consider Augmentation Rhinoplasty with homograft irradiated rib cartilage.
R W Maloney MD