Increased Swelling 4 Months After Rhinoplasty – Just Swelling or Excess Cartilage?

Posted on July 31, 2016 by Donald B. Yoo, M.D.

Q: I’ve undergone Asian rhinoplasty and septoplasty about 4months ago to fix a deviated septum and to narrow/sharpen my bulbous tip, using my own nasal cartilage. 1-2 weeks ago, I had a cold and there were mucus & congestion. I blow my nose rather heavily sometimes and pick my nose several times throughout. Now I noticed increased swelling at the lateral sides on the nasal tip area, making my tip look rather bulbous now. Swelling? Cartilage fell off to the side? How can I know the difference?

A: For an entire year after your surgery, your nose is continuing to heal and take on its final appearance.  During that period of healing, it’s not unusual to see your nose fluctuate in size and the amount of swelling.  You manipulated your nose quite vigorously, so that is the most likely explanation for the sudden increase in swelling.  It’s unlikely that at 4 months out cartilage would have been displaced, but also a possibility.  Give the swelling some time to settle down before you start worrying about cartilage shifting, and try to be more gentle blowing and picking your nose.

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L-shaped Silicone in My Nose, But Want to Get Rid of the Hard Tip?

Posted on July 19, 2016 by Donald B. Yoo, M.D.

Q: I am Asian and I had L-shaped silicone in my nose now and I actually likes the shape of my nose now except for the hard tip that make people notice I had work done. But then I heard some people say that L-shaped silicone will continue thinning the tip and sooner or later always needs revision surgery. I want to ask, is it true? Will it happen to everyone? So does it mean that I better do my revision surgery as soon as possible?

A: L-shaped silicone implants are a quick and easy way to get a more projected (taller), more refined nose.  The problem that you are starting to encounter is a common one for many patients that have rhinoplasty with an L-shaped implant.  Unfortunately there is a risk of extrusion and infection of the implant.  When the skin overlying the implant thins to the point of extrusion, it must be removed asap.  In your situation, there’s no need to panic since that has not happened, but the best option is to replace the silicone implant with your own tissue.  You will be able to achieve the shape you want, without people noticing you had work done.

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Is It Possible for Space Between Eyes to Be Shaved Down And Have Nose Fixed To Look More Asian? I’m Half Asian.

Posted on July 19, 2016 by Donald B. Yoo, M.D.

Q: I’m mixed Asian, but I don’t look like it. But I really want my Caucasian nose to look Asian. I hate it! I edited it one time and saw what it would be like with an Asian nose, and it looked so much better! Also, my eyes are a problem. Is it possible to slightly lift or tighten the ends of my eye to make them a little bit slanted? Whenever I am with my sisters and mom I look like a stranger! I know I have dark circles but no problem.

A: I have many mixed-race friends, and being Asian myself, I can certainly relate to your feelings regarding your cultural identity.  I can see that you relate more to your Asian side at the moment, but things may change as you get older.  In my humble opinion, I do not think plastic surgery is the best option for you right now.  It’s amazing how our view of the world and ourselves change as we age; so don’t be in a rush to jump into surgery quite yet.

 

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What Would Be the Best Rhinoplasty Procedure for Me?

Posted on July 19, 2016 by Donald B. Yoo, M.D.

Q: I’m in my 20s, and I’ve always disliked my nose for being too wide. I’m considering an alar base reduction, but what else? I’m not sure if I want to change anything about the bridge… the change might be too risky and radical. My main complaint is that the size and width of my nose basically ruins my face, especially when I smile. Ideally I want some subtle changes to my nose that’ll put it in harmony with the rest of my face. Nothing too crazy.

A: An alar base modification would help improve the balance of your nose, as would some tip refinement.  A subtle dorsal augmentation would help make your nose appear more “narrow”, while still maintaining a look that is 100-percent you.

Looking at computer-morphed images with your surgeon during consultation will give you a good idea of what is possible, and also give you a great chance to convey to your surgeon what you envision.

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Columella Too Low Upper Lips Too High Teeth Showing?

Posted on July 16, 2016 by Donald B. Yoo, M.D.

Q: My philtrum and upper lip looks too short for my face. My septum might be too short too that my columella is hanging too high. To achieve my desired shape of my upper lip, I would have to pull my columella down, which effectively pushes my upper lip downward. Is there any solution to this? I want the shape of my upper lip to be like the shape of it when I’m pulling my columella down. Also, my nose is too wide and bulby. Can that too be corrected all at once?

A: A cartilage graft called a septal extension graft can help to push down your columella like you are demonstrating with your fingers.  When designed correctly it can help to balance the look of your upper lip.  Reducing the width and bulbosity of your nose can easily be addressed during rhinoplasty.  You can expect the best, most natural results with a surgeon who specializes in Asian rhinoplasty.

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Asian Rhinoplasty & Chin Augmentation for Facial Harmony?

Posted on July 15, 2016 by Donald B. Yoo, M.D.

Q: My ‘strong’ nose bothers me. When I smile, it overpowers my other features. Work on my chin can improve my profile. I don’t know if my jaw has to do with anything. My nose has a tall bridge. Would this still be considered Asian rhinoplasty? Will I still need implants for either nose or chin? A more refined nose and improved chin will give me a softer, feminine look.

A: The techniques that would be required depend on what aesthetic you are trying to achieve, but given the height of your dorsum (bridge), you will not need a large amount of extra cartilage.  You will not need a nasal implant, but you may need some cartilage grafts to refine the tip of your nose (from your septum and/or ear).  Alar base modification will soften the width of your nose and nostrils when you smile.  I think you will achieve an excellent result without a chin augmentation.

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How Much Cartilage is Needed for a Taller Nose?

Posted on July 15, 2016 by Donald B. Yoo, M.D.

Q: I am of Asian and European descent, however I have a short Asian nose. I don’t want to use implants or my ribs, would my ear cartilage be enough to make difference?

A: First of all, wise decision to say no to synthetic implants.
The amount of cartilage required for your rhinoplasty will depend solely on the degree of change you hope to achieve.  Will cartilage harvested from your septum and ear be sufficient to give you a significant change?  Most definitely.  Will it give you the maximal change?  No.  If you are completely against rib cartilage being harvested, and this is your first rhinoplasty, then a combination of your septal cartilage and one or both ears will give you a significant result.
Rib cartilage is great for patients who have undergone prior surgeries (where cartilage has already been used) and for patients seeking the absolute maximum difference.  There is simply much for cartilage available to graft when rib is harvested, allowing for greater augmentation and a nose that is taller.

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I think my silicone implant is displaced?

Posted on June 24, 2016 by Donald B. Yoo, M.D.

Q: I am a Korean woman who got a nose job 3 years ago to make my bridge higher. My surgeon used a silicone implant. Not sure what “displacement” means, but my implant has shifted upwards. 1) Do I need reconstructive surgery if I still like the way my nose looks? If I don’t, is this dangerous for my health? 2) I think the part of my nose bridge towards my forehead flattened when I applied heavy downwards pressure to the top. I bumped my nose & wanted to make sure it was still in place. Is this possible?

A: Silicone implants can become “displaced” or “migrate”, meaning they can move.  The possible danger to your health would be from the risk of extrusion (of the implant thinning your skin to the point of ulcerating through) and the risk of infection.  Signs that this is occurring include redness and tenderness along the nose where the implant is.  Unless either of these is happening, your health is not at imminent risk.

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Should Asian Nose-concerns (Ie:fractures, Broken Nose, Sinusitis) Be Approached & Diagnosed Like Other Ethnicities?

Posted on June 24, 2016 by Donald B. Yoo, M.D.

Q: I am an Asian female, and I was recently head-butted directly onto the bridge of my nose. My nose physically feels different (indented) and my breathing feels different ever since the injury. It has been 2 weeks now. Bruising and swelling have gone down. I did research & many Asian-rhinoplasty specialists state there’s an anatomical difference between Asian noses and other ethnicities. Will a regular Otolaryngologist [without much experience with Asian noses] be able to diagnose/evaluate me effectively?

A: Anatomically there certainly are differences, but a well-trained otolaryngologist will be able to account for these.  When it comes to a closed reduction of a fracture, sinus surgery, or septoplasty, you can expect excellent treatment from an otolaryngologist.

The need for an Asian rhinoplasty specialist comes into play more during rhinoplasty – or reshaping of the nose.  This is because the aesthetics of the Asian nose certainly are different from other ethnicities, and it’s important to seek out a surgeon familiar with the subtleties and nuances of your nose – and knows which techniques will achieve the best results during surgery.

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Can Ear Cartilage Grow Back After Being Harvested?

Posted on June 21, 2016 by Donald B. Yoo, M.D.

Q: Would it be possible for cartilage to grow back? How does an ear look after the harvest?

A: When properly performed, ear cartilage harvest results in little to no change in appearance to the ear.  The incision can be hidden in a crease behind the ear, and cartilage only from the center – which does not alter size, shape or appearance – is harvested.

This video is a little graphic, but shows the procedure in detail.

 

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