Complications in Asian Rhinoplasty
Rhinoplasty is one of the most popular cosmetic surgery procedures performed today. Each year, hundreds of thousands of individuals undergo successful rhinoplasty procedures and find not only an improved appearance but increased self-confidence as well. Unfortunately, as one of the most complicated plastic surgery procedures to perform, rhinoplasty does have a fairly high revision rate compared to other procedures, with some estimates placing the average revision rate at around 10-15%. Revision rates are generally higher with less experienced surgeons and lower with more skilled surgeons, and this is particularly true when it comes to ethnic rhinoplasty.
Many Asian rhinoplasty candidates wish to increase the height, length, and/or projection of their nose, which is not an easy feat. Augmentation rhinoplasty, during which the size of the nasal structure is increased, is more prevalent among Asian patients than Caucasians, who more frequently undergo dorsal hump reduction or lower later cartilage reduction. The anatomy of the Asian nose typically consists of a low nasal bridge, wide dorsum and round, undefined tip. The base of the nose is generally thick and wide and the columella, nasolabial junction, and maxilla are frequently retracted. Due to these features, in addition to the presence of heavy but weak skin, complications can arise if the procedure is not performed by a specialist in Asian rhinoplasty. In Asian patients, complications may be associated with the use of implants or grafts designed to augment the nose.
Silicone Implants in Asian Rhinoplasty
Nasal dorsum and tip augmentation with silicone implants is a common practice in Asia. There are several reasons for the popularity of implants, including better aesthetic results in Asian noses, lower cost, and reduced complications. There is also no need to retrieve grafts from a donor site during the straightforward procedure.
Silicone Implant Complications
Silicone implants are not a suitable solution for all Asian patients. Complications associated with silicone implant augmentation may include scarring of the nasal skin, infection, and the possibility of implant removal. Extrusion has also occurred in some cases, with the implant eroding through the nasal tip or columella as a result of capsular contracture. The rate of complication tends to increase as the implant size increases.
Diced Cartilage in Fascia (DCF)
A second common procedure in Asian rhinoplasty involves dicing cartilage very finely and wrapping it in fascia to add height to the bridge of the nose. Fascia is a layer of fibrous tissue that surrounds muscles, which may be harvested from the patient’s temporal region. The cartilage can be derived from the patient’s rib, ear, or nose. The cartilage wrapped in fascia is then inserted into a pocket in the dorsum. With DCF, infection and risk of rejection are diminished because the material is from the patient’s own body. The risk of thinning nasal tissue and movement of the implant is also reduced when compared to silicone implants. The overall results are more natural looking.
Following DCF, stitches and dressings placed over the nose at the end of the surgery can be removed around 5 to 7 days. Most swelling will subside after 1 month, but the nose will take up to 1 year to fully heal.
Complications with DCF
Though the preferred method over silicone implants, DCF is not without its own complications. Nasal asymmetry and nasal tip blunting can occur. Over time the size of the graft may also shrink as the skin contracts over the new nasal shape. Because the cartilage is diced, sometimes the surface of the nose may not feel perfectly smooth to the touch, though visually this is not typically a problem.
Which is right for me?
A consultation with Dr. Nassif will help to determine if you are a candidate for Asian rhinoplasty, and which techniques are right for you based on your goals. Dr. Nassif is an Asian rhinoplasty specialist with years of experience using carefully developed techniques to deliver an aesthetically pleasing appearance to the nose that will match the rest of the facial features. Call his Beverly Hills office today at (310) 275-2467 to schedule a consultation.