Silicone vs. diced cartilage in fascia for Asian rhinoplasty (radix augmentation + dorsum contouring)? (Photo)

One of the advantages of diced cartilage fascia (DCF) is that unlike solid pieces of cartilage, it does not warp over time.  When designed and fashioned properly, DCF grafts provide consistently natural and beautiful results.  Using cartilage from your septum and both ears, a moderate degree of augmentation can be achieved (3-4 mm) which will still provide a fairly dramatic change.  The bony growth could be addressed during surgery to improve the contour.  Your allergic rhinitis is not likely to change significantly from the surgery, but your breathing may improve.  It's important to seek an Asian rhinoplasty specialist to achieve a nose that is not just tall, but is also attractive and balanced with your Asian facial features.  

Hello, thank you for the questions.  Diced cartilage in my opinion often resorbs to much.  Ear cartilage tends to warp too much for my liking as a method of augmenting the dorsum.  Asians tend to have very low nasal dorsum.  I have had good results with using a silicone dorsal implant.  When sized and placed correctly, they provide a very natural appearing augmentation.  Good luck and be safe.John T. Nguyen, MD, FACS, FICSDouble Board Certified Plastic Surgeon

thank you for the photograph but when we enlarge it it appears quite small.  Also a profile shot would be helpful.  In any case, diced cartilage has a high rate of resorption so if I was going to recommend any cartilage it would be auricular cartilage that is solid or rib cartilage.  If you're looking for reliable but more subtle results a auricular cartilage should do.regarding the bony spur we really can't say whether or not that will affect surgery based on her photograph but it is something that can likely be addressed during your surgery.silicone or Silastic implants can be great but they need to be appropriately chosen for the right nose.  Thin skin and irregularities of your dorsum would make you a poor candidate.  I'll attach some information you may find helpful.Chase Lay, MDAsian facial plastic surgery specialistDouble board-certified facial plastic surgeon

The answer to your questions depends on what your goal is. If you are talking about a subtle raise in dorsal height then there should be enough cartilage available in your septum and ear. If you want to also increase tip support or counter rotate the tip as well as raise the dorsum, then I favor costal cartilage as it's readily available, strong and straight. I do use the diced cartilage technique but often find that it's not necessary in Asian noses because the nasal skin is usually on the thicker side. In such cases the cartilage can be shaped and used as solid grafts with low risk of any edges becoming visible and the results are obtained more readily and predictably than when diced cartilage is used.

For 35 years I've recommended the use of the Asian patient's own cartilage to augment the radix and dorsum rather than deal with possible complications such as infection, movement, and extrusion of silicone implants. I now use diced cartilage in fascia.