Asian Rhinoplasty - What's Right for the Asian Nose Job?

Asian rhinoplasty generally involves augmentation of the nose with various type of implants (primarily silicone) and cartilage grafts.  In contrast, most Caucasian rhinoplasty involves reduction of the nose to make it smaller.Asian rhinoplasty has evolved from just putting in a silicone implant, which often leads to an artificial appearance to a technique where a combination of implants and cartilage grafts are harmonized to create a completely natural result.  I feel the greatest advancements in this field are the techniques to reshape the tip of the nose with various cartilage grafting techniques.  In Asian rhinoplasty, increased projection of the tip of the nose is usually necessary.  Often the length of the nose, which is the distance from the root of the nose to the tip is too short.  To adequately address these conditions in most patients, the septum, which is the plate of cartilage that separates the two nasal cavities, is lengthened with a special cartilage graft to support the new tip position.  This septal extension graft is used frequently in my practice and I often see revision rhinoplasty patients that could have avoided a revision surgery if this technique was used in the first place.

Thank you for the great question. There are some typical characteristics of Caucasian and Asian noses, including the shape and structure.  Asian noses are commonly shorter, flatter, and have a wider base than Caucasian noses.  In addition, the cartilage in the tip is frequently thinner, with a thicker skin and fibrofatty tissue contribution to the shape.  These differences lead to a different approach for Asian rhinoplasty. Generally, Asian rhinoplasty involves making a nose a bit bigger -- notably by raising the height of the bridge and/or lengthening the nose.  This is typically performed with cartilage grafts from the septum, ear, or rib.  In addition, the base of the nose (ala or nostrils) is commonly reduced.  Structural grafts are usually required to give the tip more support and shape.

There is a big difference between Caucasian and Asian Rhinoplasty (nose job). This is broken down into 3 differences: 1) Goals 2) Anatomic differences and 3) How surgery is done.1. GOALS. Caucasians usually request reduction of a dorsal bump and refinement of the nasal tip and reducing nasal tip projection (height). Asians often want the a higher nasal bridge, elevated nasal tip and reduction in nostril width to give a more refined appearance to the dorsum and tip. They don't necessarily want a more Caucasian nose and often want to preserve their ethnicity. 2. ANATOMY. Caucasians often have an excess of bone and cartilage creating the features they want to change. Their overlying skin to the nose is thin and less fatty tissue. If cartilage grafting is needed to correct a nasal deformity, their is ample cartilage in their nasal septum and other sources such as ear, rib or synthetic materials are less likely to be needed. Asians on the other hand have too little bone and cartilage along their nasal bridge and tip. They also have thicker overlying skin covering with more fat. Grafting materials are often needed to build up their nasal bridge and tip. Unlike Caucasians, septal cartilage is not plentiful, as most of their septum is made out bone (instead of pliable cartilage). This necessitates other grafting materials or sources such as synthetic materials, ear cartilage and even rib.3. HOW THE SURGERY IS PERFORMED. In Caucasians, dorsal hump (bump) reduction, reshaping the tip cartilage, and decreasing the projection (height) of the nasal tip gives a more refined and balanced look. Cartilage grafting is used to give more definition as needed. Surgery has evolved over the past decade where less cartilage is removed and more is reshaped. This gives long lasting support and results. Because the overlying skin envelope is thin, any changes made to the bony and cartilaginous framework of the nose is visibly noticeable. In Asians, grafting (septum, ear, rib and sometimes synthetic implants) are used to build up the nasal bridge and cartilage is used to add support and definition to the nasal tip. It is always preferable to use grafting material from the body and avoid synthetic materials which can get infected years later. The nostrils are often reduced in size by removing a wedge of skin (alar base reduction). Because the overlying skin is thick, some of the changes to the tip cartilage are not as visible as in Caucasians and it is not possible to have the same type of sculpted nasal tip appearance. In both cases, the goal is for a natural result.