Ethnic Rhinoplasty

Some of the more common requests I hear from my Hispanic patients who seek rhinoplasty include a desire to refine the appearance of the nasal tip and narrow the nostrils. The nasal tip refinement in Hispanic patients can be a challenge due to the fact that Hispanics typically have thick nasal skin. This thick nasal skin camouflages the cartilage that forms the shape of the nasal tip. In these situations, I may use several options to achieve refinement of the nasal tip, including suturing techniques and tip grafting techniques. Narrowing the wide nostrils is achieved with nasal base reduction techniques.

Yes, the implant can either be modified or removed and replaced.  If removed and replaced, the question is what should we replace the implant with?  Options include a similar implants as you previously had.  Another option is using your own cartilage, from the rib, with a covering of temporalis fascia, to achieve the desired result.  Of note, the pollybeak deformity you have may be due to scar tissue in the region above the tip of the nose; this region is called the supratip.  Steroid injection in this area may address the pollybeak appearance if the pollybeak is due to scar tissue.

Yes, all of the aforementioned can be addressed in a nose job. The bump along the bridge of the nose can be reduced. We use an innovative instrument designed by Bien Air Surgery to take down that bump in a delicate, yet exact, manner. Meanwhile, the nasal tip rotation can be increased through a variety of techniques. Finally, a slightly crooked nose may be improved upon; however, it is very challenging (if not impossible) to achieve a perfectly straight nose. The reason for this limitation is due to facial asymmetries, as well as the several potential causes of crooked nose, including but not limited to facial asymmetries, bony deformities, septal deviation, cartilage irregularities, enlarged turbinates.

In Asian rhinoplasty cases where augmentation is needed to raise the bridge, I prefer to use your own cartilage. That cartilage is obtained from either the nasal septum, the ear, or the rib.

Alar wedge and base reduction refer to techniques to narrow the nasal base. If you have a wide nasal base, these techniques may address the wide nasal base by narrowing it. The issue is to identify why the nasal base is wide...is it due to excess nostril flare and/or excess nasal sill. Once this is determined, a narrowing technique can be designed to address the specific causes of your nasal base width. The incisions are placed near the crease between the nose and face so that it is well hidden. In Hispanic patients, one potential complication is pigmentation of the scar.

It depends.  Usually, the amount of fat obtained from neck liposuction is not enough for facial augmentation.  However, if there is enough fat harvested from neck liposuction, then it is possible to have that fat injected into specific areas of the face.

I use general anesthesia for nearly all my rhinoplasty procedures.  The reasons I favor general anesthesia include the protection of the airway.  During rhinoplasty, blood may drip down the back of the nose and into the throat.  If the airway is not properly protected, that blood may go into the lungs.  With general anesthesia, the airway is properly protected.  As well, general anesthesia provides a controlled, comfortable environment for the patient.  I use the open technique in rhinoplasty when I need to perform certain procedures on the tip of the nose to achieve refinement.  If the goal of surgery is to reduce a bump along the bridge of the nose and maintain the appearance of the nasal tip, then I prefer the closed approach.  For me, the difference between the ethnic nose and Caucasian nose includes anatomy (skin thickness, bone to cartilage ratio, among other anatomical differences) and the patients' desires.  Typically, patients prefer changes to the appearance of nose that is in harmony with their facial features and their ethnicity.

Thick nasal skin may result in swelling of the nasal tip after surgery. This swelling will resolve over time. The majority of the swelling will resolve within the first 2 months of the surgery. However, subtle resolution of the nasal tip swelling will continue to occur over 6-12 months after surgery. Another issue to consider is nasal tip refinement as a goal for your rhinoplasty. With thicker nasal skin, refinement of the nasal tip can be challenging. At my Orange County plastic surgery practice, I use a variety of surgical techniques to achieve refinement of the nasal tip in thicker skinned patients.

While it is fine to identify the type of nose you desire and use a celebrity or model as a potential example, I then take your desires and integrate those desires with our face to maintain facial harmony and assess what is potentially achievable, given the anatomy of your nose.  While Rihanna's nose may look great on her because of her facial harmony and balance with other facial structures, her nose may not look great on another face.  These are factors we both should consider when discussing your desires for rhinoplasty.

Yes, both procedures can be performed at the same time. This is a common request for patients seeking functional and aesthetic improvement of the nose. Depending upon your insurance policy, you may be able to obtain coverage for the functional components of the surgery; however, health insurance would not cover the cosmetic aspects of the procedure.