Asian Rhinoplasty

Pricing for Asian Rhinoplasty will depend on a few key factors, including primarily the experience-level and esteem of the Asian rhinoplasty surgeon, the complexity of your specific case (as it relates to your baseline nasal anatomy as well as previous surgical history), and the geographic location of the surgeon’s practice.

Asian Nose Job is a general term for rhinoplasty or nose reshaping surgery for patients of Asian descent, including but not limited to: Korean, Chinese, Japanese, Vietnamese, Filipino/Filipina, Indonesian, Hmong, Laotian, Cambodian, Maylasian, etc. During Asian nose job surgery the commonalities of dorsal augmentation (increasing height of the bridge of the nose) and increasing nasal tip projection and refinement, while adding overall definition to the nose often exist. While many different techniques exist to address these shared attributes, using tissue from your own body (rib cartilage with diced cartilage and fascia, or ear cartilage with septal cartilage) will create the best aesthetic and functional result.

As with any surgery, nose job and rhinoplasty surgery does come with its share of risks. Chief amongst these risk is the risk of not loving your surgical result, which in the case of rhinoplasty is an astonishingly high 17-20% in the United States on average. This makes it critically important to do your due diligence as a patient, by seeking out experienced and qualified surgeons who have many previous patients with your characteristics, and before and after photos and videos demonstrating proficiency in performing the exact surgery you seek in those similar patients.

Typically a nose job or rhinoplasty surgery is not painful, and the most uncomfortable part of recovery is the inability to breathe fully through the nose. Most surgeons will use some type of compression inside the nose during recovery to reduce swelling inside the nose which will cause some reduction in nasal airflow. By the end of the week, breathing should return to normal.

In the case of rib cartilage harvest during rhinoplasty, when performed through a minimal incision with precise dissection around the rib, discomfort will feel like a sore ab muscle (rectus abdominus) for the first 3-5 days. Exercise may resume at 2 weeks after surgery.

Though many factors come into play when determining appropriate candidacy for a nose job, the paramount factor is the patient’s expectations. The goal for surgery should always be improvement not perfection. With the right surgeon, and with clear communication, this will almost always be achieved. Patients who are looking to a nose job or rhinoplasty to alter the course of their lives or bring happiness to their life through surgery, are often not good candidates.

Depending on the way the shape and structure of the nose is altered during surgery, the smile may also change. This can often be anticipated by your surgeon prior to surgery, and the surgical plan adjusted to reflect your personal preferences.

Typically a nose job will not change the core qualities of your voice. However, if there is a significant cause of nasal obstruction, and that obstruction is addressed during your nose job surgery, then the increased air flow may have a mild effect on your tone.

When the nasal bones are too wide, deviated or asymmetric in orientation, they may be fractured or “broken” to reposition them. Though this may contribute to bruising after surgery, it typically is not a source of pain during recovery.

Most nose jobs, even a bad or “botched” rhinoplasty, can often be improved. The degree of improvement will depend on the pre-existing anatomy, the presence of scar tissue, the health of the vascular supply and the skill level of the revision rhinoplasty surgeon.

For patients desiring a mild to moderate degree of augmentation and change, cartilage from the nose (septum) or cartilage from the ear (conchal) may be sufficient to create the desired appearance. Often in Asian patients, septal cartilage and cartilage from the ear may be weak and flimsy. Consequently, for patients with thicker skin, softer nasal cartilage, and for patients seeking a more significant degree of change, often greater structure and support is necessary – in the form of rib cartilage.

Rib cartilage is permanent, as it is from your own body, and depending on the surgeon’s finesse, may create a structurally strong yet aesthetically delicate and refined nose.

The term Asian Rhinoplasty is a broad, descriptive term that describes a common set of anatomical traits and a group of surgical techniques used to address them. While in the strictest sense, it does apply to Asians undergoing rhinoplasty, in a more general sense it is possible for patients from any ethnicity to have the characteristics shared by individuals seeking Asian nose job surgery – namely, greater augmentation of the nasal dorsum, projection of the nasal tip, and increased definition and refinement of the nose.

While a small portion of the costal cartilage may regrow if the edges of the perichondrium covering it are re-approximated, it will be different in shape and appearance than the cartilage that was removed. Nonetheless, after rib cartilage harvest the only difference you will be able to notice or feel between the left and right is the presence of a small, thin scar.

The diced cartilage fascia technique does require special expertise and a great deal of experienced to create consistent, predictable results. The most commonly encountered issue is contour irregularities and asymmetries – as with any technique for dorsal augmentation. In skilled hands, the diced cartilage fascia technique provides permanent, natural and attractive results, but in inexperienced hands can be unpredictable and inconsistent.

A small portion of the cartilaginous portion of the rib is taken (for my patients, usually ~4 cm from the right 6th rib). You will not have any untoward effects in terms of health or function, as it only a small portion of the 12 ribs on each side of the body, and the rib cage will continue to function to protect the vital organs and provide structure to the chest in exactly the same manner. Rib cartilage harvest is well tolerated even in my patients who are professional boxers and mixed-martial artists. The biggest downside to have rib cartilage harvested is a thin ~1 cm scar, which will be present in the crease under your right breast or pectoral.

Alar base modification is an effective way to reduce the flare and/or width of the nostrils. Excess width can be reduced with sill incisions, excess flare with Weir incisions, and excess flare + width addressed with a combined Weir+sill incision. The most appropriate type of Alar base modification for your Asian nose job surgery will be determined during your consultation with Dr. Donald B. Yoo and will be based on the confluence of your existing anatomy with your aesthetic goals.

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, though at some point the implant will have to be removed.

When an silicone or Goretex implant has been placed in the nose, it may be removed and replaced with your own cartilage simultaneously during revision Asian rhinoplasty as long as there is no active infection, and the skin is completely intact.

For an entire 1-2 years after your surgery, your nose is continuing to heal and take on its final appearance. For most patients, the resolution of swelling follows a sinusoidal curve rather than a linear pattern, meaning some days and weeks the swelling will be even more than the ones directly preceding them.

During the first year of healing, it’s not unusual to see your nose fluctuate in size and the in the amount of swelling, but the gradual trend will be towards reduction of edema. Following up closely with Dr. Yoo is important, as in some cases (especially with sebaceous skin and in patients with thicker skin) swelling may remain prolonged, and may benefit from injections of Kenalog and 5-Fluourouracil to expedite its resolution.

The main downside with irradiated rib cartilage is the fact that it is dead tissue and not living, viable cartilage as from your own rib. This means that it will not become a living part of your nose, but rather will be placed by fibrotic tissue that will eventually resorb. For permanent results, your own cartilage (autologous grafts) is superior to any homologous grafts.

Diced cartilage fascia provides permanent results without the risk of warping or resorption of en bloc rib cartilage, and with a much lower rate of migration, infection, or extrusion than synthetic grafts.

For my out of town/out of country patients my preference is a 2 week stay in Beverly Hills/Los Angeles, with a 1 week stay being the minimum stay. The highest risk of infection is between 1-2 weeks after surgery while the nose is early in its healing stages. Sutures and a cast will be on your nose for a week, at which time my patients may fly home if they wish, but the incision lines will still have dissolvable sutures and remain a little raw until ~2 weeks after surgery.

At 2 weeks after surgery the incision lines will be nearly healed, and makeup can be applied to the nose. This is the point that most patients feel comfortable going back to their daily routine, and feel comfortable going back to work. With autologous grafts (rib grafts) the risk of infection is much lower than synthetic grafts, and after the nose is healed there is no increased risk of infection over your natural nose.