Nose Surgery in Asian Patients

Nose enlargement surgery

Rhinoplasty (nose surgery) patients can be divided into two main groups: those who want smaller noses and those who want bigger ones. Those who want their noses made smaller are typically Caucasian, African or Middle Eastern; those who want larger noses are comprised mainly Asian patients.

The Asian patient’s nose

There are anatomical differences that are visible as one looks at different peoples’ noses.

My Asian patients in particular have:

• smaller tip cartilage
• weaker cartilage
• a lower nasal bridge
• a wider nasal bones
• a lower nasal height
• wider alae at nasal tip (the round skin outside the nostril)

 They typically want:

• a narrower nose tip
• a higher nasal bridge
• more nasal projection

Surgery on the Asian nose

There are three main options for improving the cosmetics of a small nose:

1. Nasal surgery with cartilage grafts
2. Injections with dermal fillers
3. Silicone dorsal nasal implants

Nasal surgery with ear cartilage grafts

This is my preferred technique for enlarging the nose and giving it more projection.

Cartilage grafts are taken from the back of the ears or, if possible, from the rounded nasal tip itself. Grafts are crushed to allow the tissue ingrowth necessary for stabilization and placed under the nasal bridge skin along the nasal dorsum and even onto the nose tip.

I usually secure the grafts in place with sutures so that they do not move in the first few weeks.

Narrowing the nasal alae with a small incision under the nasal sills allows the sides of the tip to be brought in and the nose tip to be made narrow.

Injections with dermal fillers

Radiesse is my preferred dermal filler for augmentation of the nasal dorsum. A small injection can improve the shape of the nose and the procedure can be repeated as necessary every one to two years, by which time the temporary filler is reabsorbed. The alae still need a surgical solution to increase their width.

Silicone implants

Silicone nasal implants are my least favorite method of nasal dorsal enlargement. The implants are hard and often move over the nasal bones. After a few years, they stretch the nasal skin and become visible and abnormal-looking. In fact, I have taken out more silicone nasal implants than I have put in!

Everyone saw poor Michael Jackson those years when he had a mask covering his nose. I believe his silicone implant was protruding through his skin and he needed multiple reconstructive surgeries to fix it, which he kept a secret.

Surgery on an Asian nose requires the surgeon to have an appreciation of the facial aesthetics of patients and the skill and experience to use techniques that surpass simply inserting a silicone implant where it should not be inserted. After all, we were taught by our parents not to stick things where we shouldn’t.

For more information about nose surgery, see this link: https://abdulsguide.com/tavmd/nose_surgery.html

Morad Tavallali, M.D., FACS