I have an Asian bulbous nose. Which procedures would be best for rising the bridge and giving the tip more definition? (Photo)

There are many options when choosing Asian rhinoplasty, but the safest, most permanent and predictable way to achieve excellent results is with tissue from your own body (autologous grafts).  The choice of cartilage grafts will depend on the degree of augmentation and refinement you desire.  The photos of noses you like are very refined, tall noses, so rib cartilage may be the best option for you.  I am a strong proponent of building the bridge with a diced cartilage fascia graft, and reinforcing your tip with cartilage grafts to increase the projection and refinement of the tip.  Computer morphing of your nose during an in-person consultation with a rhinoplasty specialist would more definitively determine the best grafts for your nose.  

Several things you should consider. If you are not ready for surgery, you can consider a non-surgical rhinoplasty using fillers (Juvederm) to augment your dorsum and better define your tip. This can be done in the office in less than 15 minutes. Results can last up to a year.For a surgical procedure, I would suggest an open technique for a better access to your tip region. There are several materials to choose from for dorsal augmentation. I prefer rib cartilage or layers of Gore-tex. Asian noses usually lack tip support and definition due to weak cartilages. Your tip needs be better defined and slightly narrowed as well as your alar base. Your tip may need a small tip/lobular graft to de-rotate your nose.  Hope that helps.

Dear Stephanie8853



Here in
California, with a huge Asian-American population, we have many calls for
similar improvement.Raising the bridge
can be done without a formal surgical procedure that might include grafting of
bone or cartilage.You should consider
the permanent non-surgical injection rhinoplasty technique.Non-surgical rhinoplasty works because tiny drops of Silikon
1000 are injected just under the nasal skin. Over time, the body walls off
those drops with new tissue which provides the plumping action to fill in
divots or marks in the nose. The same effect can happen with plain salt water
to provide a preview how the nose will look on completion of treatment. The Saline Demo lasts perhaps two hours, but long enough to take a photo of
what the finished nose will look like.

Best
wishes,



Robert
Kotler, MD, FACS

Open structured rhinoplasty with temporalis fascia graft to increase all the nasal bridge. Your desires are achievable. You need to understand that, all your nose needs to be increased on projection, that means lots of grafts to structure the nose, on my hands this will be near to impossible on a closed rhinoplasty. On primary rhinoplasty your own septal cartilage will be enough for this graft, if is not, ear cartilage will do the job, you will also need a temporal incision that will be hidden by your hair to gain access to the temporal fascia.Find a Board Certified Plastic Surgeon with experience on open rhinoplasty and discuss your expectations.Best of wishes,Dr. Luis Redondo 

You probably need dorsal augmentation and a columella strut to provide more projection. A base excision may be necessary as well.

I would recommend a tip rhinoplasty with a dorsal nasal implant. Either rib cartilage OR medpore.  

I use the term "Asian" rhinoplasty with caution because all Asian noses are not the same. I've never done 2 noses exactly the same regardless of ethnicity. Your I would augment your bridge with your own septal or ear cartilage. I avoid the use of synthetic material such as Silicone because of the increased risk of infection, movement, or extrusion.  Definition of the tip should be accomplished by changing the tip contour; a tip graft will probably be necessary to maintain the refinement because the cartilage is typically very soft. Nasal base narrowing will improve the proportions of your tip.