Ethnic Rhinoplasty

Ethnic rhinoplasty is a challenge due to various factors inherent in the ethnic patient and ethnic nose. First and foremost, an understanding of the desired aesthetic goal is paramount. Once this understanding is achieved in the context of the individual's ethnic background, facial features, and desires, the next step is the analysis. Ethnic patients may have variable strengths of cartilage of the nose, variable lengths of the nasal bones, and variable thickness of the nasal skin; all these variables have implications in the rhinoplasty procedure. In the revision case, these factors play a role.

Thick nasal skin makes refinement of the nasal tip challenging because the thick skin hides the underlying nasal tip cartilages. Therefore, we use a variety of techniques to achieve nasal tip refinement in the ethnic rhinoplasty patient. The first maneuver is to re-shape your nasal tip cartilages to refine the appearance. This includes trimming some excess cartilage and using stitches to re-shape the cartilage. If more refinement is still needed, we can use cartilage from your nasal septum to achieve further refinement to the nasal tip. Finally, another aspect of thick nasal skin to consider in the ethnic rhinoplasty is the healing process. It takes approximately 12 months to truly appreciate the refined appearance of the nasal tip as the thick nasal skin tends to hold onto swelling for a longer period of time than thinner nasal skin.

Keloid scar after rhinoplasty is very rare.

A necklift is an excellent option to address laxity of skin in the neck.  The necklift is a surgical procedure performed through incisions behind the ear and occasionally underneath the chin.  Through these incisions, we can perform neck liposuction as needed to address excess fat in the neck.  We can further tighten the neck muscle to achieve refinement in the neckline.  Then, the excess skin can be trimmed.

 For more information about healing after a rhinoplasty, click here.

The "hook" appearance may be due to a combination of bump along the bridge of the nose and weakness of support to the nasal tip.  The bump along the bridge of the nose is typically bony and cartilage in nature.  Shaving down these structures will help to address the "hook" appearance.  As well, improvement in the position of the nasal tip (if needed) will further address the "hook" appearance.

Each ethnic rhinoplasty is performed so that the final result "fits the face."  In other words, I take into consideration your face and consider the nose job to change the overall appearance of the nose so that it is in harmony with your facial features.  As a result, each facial plastic surgery is individualized rather than performed in a "cookie cutter" fashion.  Finally, your ethnicity and race are considered during the consultation when discussing the goals for surgery.

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.