eMedicine Specialties > Plastic Surgery > Nose

Rhinoplasty, Asian: Follow-up

Author: Charles S Lee, MD, Consulting Surgeon, Department of Plastic Surgery, Olympia Medical Center
Contributor Information and Disclosures

Updated: Aug 27, 2008

Outcome and Prognosis

The widespread use of alloplastic implants for dorsal augmentation is a characteristic feature of Asian rhinoplasty. Because of the relative scarcity of autogenous tissue compared to the amount of augmentation required, few surgeons who perform large numbers of Asian rhinoplasties use autogenous tissue as a primary source of augmentation.

Rib grafts and, more recently, diced cartilage grafts have been advocated for use in dorsal augmentation.2 Their use is not yet widespread.

The Asian nose, perhaps because of thicker skin quality, tolerates silastic augmentation to the dorsum remarkably well. Nevertheless, problems such as skin thinning and extrusion do occur, especially when the alloplastic implant is placed toward the mobile tip. Limiting alloplastic augmentation to the dorsum and using autogenous tissue tip-plasty can maximize the probability of a favorable outcome.

Future and Controversies

Surgeons only recently have applied open rhinoplasty techniques to the Asian nose. The importance of using autogenous tissue for tip-plasty combined with the difficulty of tip-plasty in Asian noses make the merits of open rhinoplasty obvious. Nevertheless, the midcolumellar scar of open rhinoplasty is more noticeable in Asians than in Caucasians, and the author currently prefers an endonasal approach.

The use of autogenous tissue such as rib cartilage compared to a simpler alloplastic augmentation of the dorsum remains a controversial issue. The donor site morbidity of rib grafting frequently meets with patient resistance. Less morbid alternatives, such as diced cartilage wrapped in temporalis fascia, are currently being explored.2

 


More on Rhinoplasty, Asian

Overview: Rhinoplasty, Asian
Treatment: Rhinoplasty, Asian
Follow-up: Rhinoplasty, Asian
Multimedia: Rhinoplasty, Asian
References
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References

  1. Sheen J, Sheen A. Aesthetic Rhinoplasty. Vol 1. 2nd ed. St. Louis, Mo: Mosby; 1987.

  2. Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg. Jun 2004;113(7):2156-71. [Medline].

  3. Flowers RS. Problems in rhinoplasty in Orientals. Problems in plastic and reconstructive surgery. 1991;1:582-608.

  4. Flowers RS. The toboggan graft: A better way of cartilage grafting in the nose. Plastic Surgery Forum, PSEF. 1987.

  5. Kim CW. Complications of rhinoplasty. Problems in plastic and reconstructive surgery. 1991;1:609-613.

  6. Song IC. Changing concepts in cosmetic rhinoplasty in Orientals. Problems in plastic and reconstructive surgery. 1991;1:572-581.

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Further Reading

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Keywords

Asian rhinoplasty, rhinoplasty, oriental rhinoplasty, ethnic rhinoplasty, alloplastic augmentation, alar reduction, dorsal augmentation, nasal augmentation, endonasal rhinoplasty, endonasal approach, open rhinoplasty, asian nose surgery, asian nose job, cartilage shaping, two-layered cartilage, septal cartilage, lower lateral cartilage, ear cartilage, strut graft, conchal cartilage

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Contributor Information and Disclosures

Author

Charles S Lee, MD, Consulting Surgeon, Department of Plastic Surgery, Olympia Medical Center
Charles S Lee, MD is a member of the following medical societies: American College of Surgeons and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Frederick J Menick, MD, Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Arizona College of Medicine; Private Practice in Tucson, Arizona
Frederick J Menick, MD is a member of the following medical societies: American Association of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Plastic and Reconstructive Surgery, American Society of Plastic Surgeons, and Canadian Society of Plastic Surgeons
Disclosure: none None None

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

George Peck, Jr, MD, Consulting Staff, Department of Plastic Surgery, St Barnabas Hospital of New Jersey
George Peck, Jr, MD is a member of the following medical societies: American Society for Aesthetic Plastic Surgery
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Al Aly, MD, FACS, Consulting Surgeon, Iowa City Plastic Surgery
Disclosure: Ethicon  Consulting fee Consulting; QMP Royalty Book royalty; Insorb Stapler Consulting fee Consulting; Insorb Stapler Ownership interest None; Medicis Intellectual property rights None

 
 
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