During an Asian rhinoplasty, many patients request the addition of height to the bridge of the nose. This can improve the look of a flat or wide nose and also augment the profile from a side view. There are a number of ways to add tissues to the nose, one of which is to use a Gore-Tex implant, also known as the material polytetrafluoroethylene (PTFE).
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Two features unique to the Asian nose are a low nasal bridge and wide alar base, both of which contribute to a nose that appears flat and blends in with the rest of the face. These are usually a primary focus in Asian rhinoplasty. Patients want to have a nose with definition to bring their face into sharper focus and give it additional character. Surgeons skilled in Asian rhinoplasty achieve this goal by utilizing several techniques to narrow the nose.
This is the area of the nose with the nostrils, which is commonly wide among Asians. Wider nostrils also have a tendency to flare while breathing. An Asian rhinoplasty surgeon can perform an alar base reduction to narrow the nostrils, making them less prominent and reducing the amount of nostril flare. The surgeon makes incisions along the bottom and inside of each nostril and then removes a small amount of tissue on the inside of the nostril. After removing the excess tissue, the surgeon then moves the remaining tissue over and sutures it in place. This technique brings the nostrils closer together, effectively narrowing the alar base.
The bridge of the nose begins at the spot between the eyes, just below the forehead, then continues down to the soft nasal tip. Asians typically have a low nasal bridge, which is what causes the nose to look flat on the face. An Asian rhinoplasty surgeon can give the nasal bridge more definition in a couple different ways.
One method is to augment the nasal bridge. Basically, this involves using an implant or injectable fillers to build up the nasal bridge, making it higher and more prominent. An implant can be created from the patient’s own tissues, known as the Diced Cartilage Fascia method, or an implant made from synthetic materials can be used. Common choices here include Gore-Tex and silicone. Fillers are a less invasive way of achieving the same result, but the results will not be permanent.
Another way for the surgeon to improve the nasal bridge is to reduce the amount of tissue and cartilage in it. Part of the reason why Asians have a wider nose is because the upper lateral cartilage (the cartilage near the top of the nasal bridge) is broader compared to Caucasians. By removing some of the outermost cartilage and tissue, a surgeon can effectively narrow the bridge.
Asian noses have a round and often bulbous tip. Combining that with the low nasal bridge results in a nose where the primary focus in the on the lower half. Asian rhinoplasty surgeons can refine the tip and give it more projection by reshaping its cartilage. This is the one of the more difficult techniques in Asian rhinoplasty; the surgeon has to be able to elongate the tip and slim it down without giving it a Caucasian appearance, all while continuing to match the proportions and overall features of the patient’s face.
Occasionally, an implant may be needed to give the nasal tip the correct shape and projection. Surgeons typically try to avoid using implants in the tip if possible, because Asians tend to have weaker cartilage in their nose and thicker skin, which can make it difficult for an implant to remain in place. However, when it is needed, surgeons have the same implant material options as the ones listed above for the nasal bridge.
The Final Result
Any one of these techniques or a combination could be used to narrow the nose, giving the face more character and the nose more definition. Every patient’s needs and underlying nasal structures are different, so it’s important to entrust your Asian rhinoplasty surgery to someone who knows what they’re doing. The overall goal of any Asian rhinoplasty is to preserve the ethnicity while creating facial harmony. The changes may be small and subtle, but they can have a lasting impact on the way you feel about your appearance.
Dr. Paul Nassif
If you are interested in finding out more about Asian rhinoplasty, Dr. Paul Nassif is one of the world’s leading experts. Dr. Nassif specializes in all forms of rhinoplasty and has treated thousands of patients around the globe. You can schedule an initial patient consultation with him by calling our office in Beverly Hills, CA at (310) 275-2467. We treat patients from all over and have a great deal of experience working with out-of-town patients. Contact us today for an appointment!
The inside structure of your nose is made up of bone and cartilage. It is common for rhinoplasty surgeons to use a patient’s own cartilage to create grafts or implants. This cartilage is usually harvested from the ear, but it can also come from ribs or other nasal cartilage. In Asian rhinoplasty, a cartilage graft is especially common for repairing deviated septums and reducing or smoothing the nasal bridge.
- Readily available resource
- Naturally occurring
- Leaves source structure intact
- Cartilage can be pretty rigid, making it difficult to shape
- It can be difficult to remove in the event that revision rhinoplasty is needed
- Secondary surgical site that also requires recovery
Diced Cartilage Fascia
The best way to imagine this type of implant is to think of a piece of sushi. Sushi has small pieces of rice, vegetables, fruit, etc, all wrapped up in seaweed. In diced cartilage fascia, or DCF, the cartilage is cut into very small pieces, then wrapped in muscle fascia. The cartilage is harvested from the ear, nose, or rib. Fascia is connective tissue that surrounds the muscles and can theoretically be harvested from anywhere, but is typically harvested from the muscle that runs from the temple to the ear. This implant is commonly used by Dr. Nassif to create the nasal bridge for Asian rhinoplasty patients.
- Readily available resource
- Uses materials from the patients, reducing the risk of rejection or infection
- Easy to mold into a specific shape
- More discomfort during recovery due to additional recovery sites
- Greater likelihood of swelling around the fascia during recovery
- More likely to be absorbed by the body and lose its definition
Silicone is a synthetic material that is a very common choice for implants in plastic surgery. In Asian rhinoplasty, it can be used to create the nasal tip through augmentation.
- Easy to insert
- Easy to remove in case revision rhinoplasty is needed
- Flexible and can be shaped to specifically match a patient
- Greater risk of infection or rejection
- More likely to migrate from the implant site
- Risk of extrusion (poking out of the skin)
This is one of the more applicable options in rhinoplasty implants. Gore-Tex is a material known as expanded poly-tetrafluroethelene, the same stuff that Teflon is made of. As an implant, it looks like a white, spongey material. Gore-Tex can be used for nasal tip augmentation or nasal bridge structure.
- Easy customizable
- Lower risk of infection or rejection than silicone implants
- Stays in place and infiltrates with the body’s natural tissues
- Proven positive track record
- Possibility of extrusion
- Bacteria growth can occur as the implant integrates with the tissues
- Not easily removed
Each patient has a unique nose that will have its own special requirements during a rhinoplasty procedure. Some patients handle synthetic implants worse than others, while others may prefer to use those over their own cartilage. Most doctors feel that utilizing your own body tissues is the safest choice with the smallest risk of complications. However, it really comes down to the individual doctor’s preference and experience, as well as the needs of the patient.
Dr. Nassif’s Preferences
Whenever possible, Dr. Nassif uses the patient’s cartilage for grafting or implants, either with a simple removal of the cartilage tissue or using the DCF method. During his twenty years of experience as a rhinoplasty surgeon, he has found those to be the best method of creating the nose shape.
In Asian rhinoplasty, synthetic implants are more likely to be used because Asians typically have weaker cartilage and thicker skin that might weigh down any cartilage grafts. If a synthetic implant is required, Dr. Nassif prefers the Gore-Tex implant based on his experience using it in patients.
Schedule a Consultation With Dr. Nassif
If you are interested in finding out more about your implant options for Asian rhinoplasty, contact our office at (310) 275-2467 to schedule an appointment with the doctor. You can also use our patient contact page to reach us. Dr. Nassif conducts consultations in person at his Beverly Hills office or virtually using Skype.
The Asian continent is home to a wide range of races and corresponding nasal shapes. Asian noses differ in their height and width in comparison with other parts of the world. Researchers believe these variances are a natural response to diverse climates. While there may be evolutionary basis to the look of the nose, some people are dissatisfied with certain aspects of this feature.
While rhinoplasty is one of the oldest facial plastic surgeries to date, there are many modern variations of the procedure. With a seemingly unlimited variety of nose procedures, a newer concept is the type of surgery that caters to specific ethnicities. The United States has fostered a more diverse culture than other nations, and plastic surgery does not seek to create homogeny amongst this feature.
Asian rhinoplasty is one of the more common ways a facial plastic surgeon can treat the nose while maintaining the integrity of its genetic structure. Tailoring can border a fine line between aesthetic improvements and total alteration of a feature. Asian rhinoplasty seeks to retain the identifying aspects of the Asian nose, while satisfying the patient’s desires for change.
Misconceptions in Asian Rhinoplasty
Many patients are under the impression that Asian rhinoplasty is performed because patients have a desire to look less ethnic, when this is not often the case. When Asian or other ethnic patients want to take on more Caucasian features, nose surgery is called Westernization rhinoplasty. More often, ethnic patients undergoing rhinoplasty hope to maintain certain genetic features while modifying others. It is common for Asian rhinoplasty patients to voice concerns for the height of the nasal bridge, the projection of the nasal tip, and the shape and placement of the nostrils.
Other Types of Ethnic Rhinoplasty
Though Asian rhinoplasty is one of the more common facial plastic surgeries designed to alter the look of a culturally-specific nose, doctors have designed procedures for African American rhinoplasty, Middle Eastern rhinoplasty, and Hispanic rhinoplasty. Asian rhinoplasty tends to be a more demanding surgery because it often requires reconstruction of the nose. Dr. Nassif is a specialty surgeon who caters to Asian rhinoplasty patients and has developed innovative methods to treat the areas of the nose that are commonly addressed during the procedure. Though Westernization rhinoplasty is possible, it is but one form of this diverse surgical procedure.
Asian Rhinoplasty Performed in Asia
Some patients believe that Asian surgeons perform the best Asian rhinoplasty surgeries because they share similar nasal anatomy, and may better understand cultural aspects of the procedure. A popular notion is that surgeons operating out of Asia would be the greatest option to create changes on this type of ethnic nose.
In reality, many Asian countries use the outdated practice of inserting nasal implants during Asian rhinoplasty. The inserts may be fashioned out of silicone, Gore-Tex, or another material. Though implants create an initially pleasing look, they do not create long term aesthetically pleasing results. The implant can become dislodged from the bridge of the nose and create an obvious deformity that spans the length of the nose. This can lead to thinning of the skin of the nose, especially in the tip, and other internal tissue disruptions. Secondary issues such as infection are also common in Asian rhinoplasty surgeries performed with a nasal implant.
Not All Plastic Surgeons are Created Equally
While all plastic surgeons are trained as doctors, and have a thorough understanding of human anatomy in its entirety, patients should be careful to choose a doctor with a specialty practice. A doctor would ideally hold an expertise in either body or facial plastic surgery, but not both. Asian rhinoplasty warrants a facial plastic surgery focus. Not only will the doctor have performed a greater number of rhinoplasty surgeries, but he or she will also be much more versed in the unique issues that present themselves during surgery. In addition, facial plastic surgeons may subscribe to medical journals, attend conferences, and have a greater involvement with work of the face than other plastic surgeons.
Asian Rhinoplasty is for People of All Walks of Life
Though some people still hold the misconception that plastic surgery is reserved for wealthy individuals, or those in the entertainment industry, everyone interested in permanently altering the nose is encouraged to set up a consultation. With different credit options and payment plans, patients do not have to delay the enjoyment of long term aesthetic modifications or a self-esteem boost. The doctor may also be able to offer short term results through dermal fillers for less money if the patient plans to save money for the surgical version of Asian rhinoplasty.
Dr. Paul S. Nassif, Asian Rhinoplasty Specialist in Beverly Hills, California
Known for his televised work, Dr. Nassif had developed a strong patient base even before he became a household name. The doctor’s innovative technique – wrapping diced cartilage with fascia (DCF) – offers a unique solution to the low bridge height of most Asian noses. By using patient-donated materials, there is no risk for rejection, and infection is far less likely. While synthetic and animal-donated materials are available options, it is during the consultation that patients can learn more about each options pros and cons.
Contact Dr. Nassif’s Beverly Hills’ office at (310) 275-2467 to set up a visit with the doctor to learn about Asian rhinoplasty, or another facial plastic surgery or cosmetic procedure that interests you.
View actual patient Before-and-After Photos to see numerous successful results of Asian rhinoplasty surgery.
While nasal implants can be used during Asian rhinoplasty surgery, it is only through trial and error that doctors discovered patient-donated tissues work best. They provide realistic, long term results and are less likely the cause for revision rhinoplasty. Synthetic materials such as Gore-Tex or silicone sculpt a pleasing shape for the exterior nose, but often cause issues. While Gore-Tex, also known as the material polytetrafluoroethylene (PTFE), creates a realistic and often aesthetically pleasing nose shape, there are a number of issues associated with the material. It coexists with the tissues of the nose in such a way that can trap and promote the growth of bacteria.
Silicone is still commonly used in Asian rhinoplasty procedures performed in Asian countries. The technique usually requires an open rhinoplasty and a more invasive approach to placing the implant overt the bridge of the nose. While Gore-Tex implants can lead to the intertwining of tissue growth between the synthetic material of the transplanted insert and natural tissues of the nose, silicone implants pose the opposite issue: they do not become fully fixed into place.
The silicone implant is especially susceptible to movement, which can lead to a host of subsequent issues. The bridge and tip of the nose may appear distorted, and cosmetic intervention becomes obvious. The protruding implant can cause damage to the tissues in the tip of the nose, creating the formation of excess scar tissue. The fibrous tissue can be seen in the exterior of the nose and can be difficult to treat.
The material of the silicone implant is transparent, and causes the overlying skin to stretch to accommodate its size. This combination can cause the visibility of the implant in certain lights. Gore-Tex implants are opaque in color, so this issue is specific to silicone materials used in the nose.
The Ideal Option for Nasal Implants During Asian Rhinoplasty
Synthetic implants are not an ideal solution to increasing nasal bridge height and refining the nasal tip during Asian rhinoplasty. They may be rejected by the body, become dangerously fixed into place, or slip out of their intended position. Dr. Nassif, an Asian rhinoplasty specialist well known for his DCF (dice cartilage wrapped in fascia) method, can harvest the patient’s own materials for the purpose of this cosmetic surgery.
About the Doctor
Paul S. Nassif , M.D., F.A.C.S. of Spalding Drive Plastic Surgery in Beverly Hills, California is a specialist in a number of facial surgeries, with a special dedication to Asian rhinoplasty. Patients from all over the world schedule surgery with the doctor due to his advanced knowledge of Asian facial anatomy and his effective, innovative surgical techniques, such as DCF. If a patient has visited a plastic surgeon for a prior Asian rhinoplasty where they had a Gore-Tex or silicone implant placed, they can see Dr. Nassif to have the procedure reversed. The doctor will then implement his tried-and-true methods to ensure a safe surgery and long-lasting results.
Dr. Nassif’s Contact Information
Phone: (310) 275-2467
Email: Patient Contact Form
Location: 120 S. Spalding Dr. #315 Beverly Hills, CA 90212
Typically, Asian rhinoplasty refers to surgical modifications of the nose to achieve goals common to this ethnicity. Most patients who come to see Asian Rhinoplasty Specialist Dr. Paul Nassif wish to increase the height and projection of the nose, modify the tip of the nose to create more prominence and angles, and decrease the size and width of the nostrils, among other changes.
The Postoperative Course in Asian Rhinoplasty
Rhinoplasty is a common, yet complicated surgery. Even a skilled facial plastic surgeon such as Dr. Nassif cannot always predict the ways in which the nose will heal. During an Asian rhinoplasty, the nose is often altered in similar ways as other ethnic patients. In comparison with a typical Caucasian rhinoplasty, the Asian nose is often increased in prominence during surgery rather than reduced in size. This is often achieved by adding some material to the Asian patient’s nose, while Caucasians and other patients commonly require tissues to be removed so the nose can be refined in size and shape.
Rhinoplasty has long been one of the most popular cosmetic surgery procedures. In fact, according to the American Academy of Facial Plastic and Reconstructive Surgery, rhinoplasty was the most requested procedure in 2012, with their member surgeons performing a total of 40,298 rhinoplasty procedures that year. Also according to the report, AAFPRS member surgeons saw an increase in their practice among patients of Asian American, Hispanic and African American descent, with Asian American patients being most likely to receive rhinoplasty or blepharoplasty.
How common are problems with implants used during nose jobs and how often does shifting of the implant or extrusion occur?
I am not a big fan of using implants. Many years ago, if I had to use an implant to augment the nasal dorsum, I would use Gore-Tex as the infection and extrusion rate with Gore-Tex is extremely very low. I would estimate there is about a 1% chance of having an infection or an extrusion.
If a patient needed nasal dorsal augmentation and did not want their own tissue used, I would use Gore-Tex. I would inform them about the risks associated with the surgical procedure as well as with the implant.
There are also different types of implants such as silicone and Medpor with which I have seen extrusion, especially of the nasal tip and side of the nose. I have never used a silicone implant or Medpor implant based on these reasons. As a revision rhinoplasty specialist, I see many patients with these problems or just even a deviated or mobile implant.
I will remove the implant and replace it with the patient’s own natural tissue. The primary material used to augment the nasal dorsum is diced cartilaginous tissue. I just had a patient whom I operated on approximately three weeks ago. The patient was an Asian female with an L-shaped silicone implant which augmented the nasal dorsum and also extended all the way down into the tip. The dissection over the mid part of the tip was extremely tedious because there was an extreme amount of tension on the skin at the region where the implant was placed. I felt that the implant was about to extrude and that is why the dissection in the area was very, very difficult to perform.
Hope this helps and thank you very much for the question.