A thorough understanding of the anatomy and the principles of rhinoplasty are essential to achieve the most satisfactory and elegant result. The nose structure includes skin, bone, cartilage, and a mucosal lining on the inside. It is a very complex structure. This is also true when is comes to Asian rhinoplasty.
In our practice, we review this in detail with all consulting patients. For the patient to understand and have as clear a vision as possible of the outcome they must have a demonstrable understanding of these principles. In our practice, we utilize the closed approach with incisions primarily on the inside of the nose. This is a little more challenging and beneficial than the open technique. In my opinion, the internal incision approach is preferable for many reasons we discuss in previous blogs.
Therefore, the Asian nose has several specific characteristics that must be taken into consideration to achieve the best result. The Asian nose falls into the category of ethnic Rhinoplasty. A thorough discussion of the goals of the Asian rhinoplasty patient is essential.
Asian Rhinoplasty
In the right hands, a very elegant nose can be an achievement for the Asian rhinoplasty patient. The fundamental challenge is several folds. The skin of the Asian patient is usually much thicker than that of the Caucasian patient. This thick skin is a challenge. And, there’s no predictable reliable way to make it thinner. The thicker the skin the more unpredictable the healing process. This means that resolution of the swelling from the surgery may take longer. Base reduction is almost always necessary.
Base reduction requires small external incisions in the groove or shadow where the nostril meets the cheek. In my practice cartilage grafting is essential. Banked cartilage grafts are readily available and in my opinion preferable. We also utilize ear cartilage grafting in some cases. This cartilage gives me an abundance of material to structure the most ideal nose with the challenge of a paucity of anatomic structures. Which is the situation with the Asian nose. Knowledge, experience, skill, training, and talent are the mainstays of the surgeon performing Asian rhinoplasty.
And in the right hands, a very elegant pleasing result is the expectation. When all the factors are in place a good rhinoplasty result can make all the difference in the world to a person’s self-confidence and self-image which improves the quality of life. We have one of the most extensive before and after galleries for rhinoplasty, primary, revision, and ethnic including Asian.
THOMAS TREVISANI, MD
BOARD-CERTIFICATION PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
