The Asian nose is typically characterized by low nasal bridge, rounded & bulbous tip and associated with overhanging alar or sides of the nose.
Nasal augmentation is a procedure that increases the height of the nasal bridge to enhance the facial profile. This is achieved by inserting a silicone implant over the nasal bone through a small cut in the nostril. The enhancement using a solid silicone implant simulates an increase in the bony height of the nasal bone without changing the thickness of the skin and soft tissue. It gives the nose a more natural, solid and defined bridge. Augmentation rhinoplasty is frequently done together with tip rhinoplasty.
A closed method augmentation rhinoplasty takes about 1 hour. The recovery time is about 1 week. The possible and common complications (< 5%) associated with nasal implant surgery include bleeding, hematoma, infection and extrusion of implant. In the long term, care has to be taken to avoid trauma to the nose.
Enhancement of the bridge can be done judiciously with fillers. The filler injected into the soft tissue increases the thickness of the soft tissue over the bridge, thus simulating increased height of the nasal bridge. Appropriate amounts used at the right location can enhance the contour and shape of the nasion and bridge without surgery as an office procedure. However excessive use of fillers will cause the skin and soft tissue over the bridge to look bulky and swollen, thus less natural. The effect generally last about 1-2 years.
The procedure takes about 30 mins with minimal recovery time. Occasionally, if a bruise occurs, it may take about 1 week to resolve.
Tip Rhinoplasty with or without Augmentation
The Asian nose is frequently associated with rounded and fleshy tip. The rounded tip may be reshaped by trimming some soft tissue bulk, reduce and repositioning the alar cartilage. The tip projection may be enhanced with ear conchal cartilage graft. This procedure is generally done using the open rhinplasty approach. The conchal graft is taken from behind the ear leaving a well hidden linear scar at the back of the ear without distorting the shape of the ear. This procedure is usually done together with augmentation rhinoplasty using the open method.
The procedure takes about 2-3 hours under local anaesthesia. The recovery time is about 1 -2 weeks.
The third feature of an Asian nose is the broad overhanging alar or flaring of the alar. When the alar position is lower than the colummella or midline of the nose, it gives the appearance of a short and rounded nose. The alars can be reduced in thickness and height by performing a wedge excision of the overhanging alar tissue at the rim. An incision is also made along the alar groove to rotate the alar inwards. This surgery removes the overhanging effect of the alar, reduces the bulkiness, narrows the alarbase as well as triangulates the lower third of the nose.
This procedure is called alarplasty and takes about 1.5 hours.