Asian Rhinoplasty

Written by Dr. Julian De Silva

Asian noses are anatomically different to Caucasian noses and require different surgical techniques to achieve a more refined and natural appearance. Asian noses are often characterised by a relatively low nasal bridge which makes the nose appear relatively small and thicker skin which can result in the tip of the nose being bulbous and lacking definition. The appearance of an Asian nose is a consequence of an underlying difference in the Asian anatomy. As a consequence, standard Caucasian rhinoplasty techniques are less effective in improving the appearance of the Asian nose.

Rhinoplasty is a surgery of finesse and detail, even 1mm change can be seen. Dr De Silva believes that nose reshaping requires special techniques to improving definition and shape and keeping a natural appearance.

Dr De Silva specialises in the face only; he is known for natural looking results and uses the most innovative and contemporary techniques from Beverley Hills and New York. Rhinoplasty is one the most common cosmetic surgery he performs, Asian rhinoplasty is considered to be technically a difficult procedure, which is why some cosmetic and plastic surgeons do not perform the procedure.

Watch Video: Rhinoplasty and Septoplasty Video Testimonial
Rhinoplasty & Septoplasty Video Testimonial

Why have Asian rhinoplasty?

Common reasons for undergoing Asian rhinoplasty are to have more definition of the bridge, tip refinement and narrowing of the nose. Motivations for surgery are specific to each person and other reasons include breathing issues, improve symmetry.

How can the tip of my nose be refined?

In Asian noses, commonly the tip can lack definition and can be relatively wide or even bulbous. The appearance of an Asian nasal tip is partly characterised by the shape of the underlying cartilages, fat beneath the skin and relatively thick skin. To improve the definition of the tip of your nose in Asian Rhinoplasty requires specialist techniques. Often Open rhinoplasty is a preferred technique for increasing tip definition in Asian Rhinoplasty as it offers an improved result as this enables the skin to be thinned and more accurate definition to be achieved in the tip of the nose with sculpting of the underlying cartilages and the use of graft tissue to give more definition. With open rhinoplasty Dr De Silva uses an inverted V technique to make the incision discrete and hidden with time. Dr De Silva utilises open and closed techniques depending on the individual needs of the patient. There are limitations in the degree of definition achievable in the tip of the Asian nose as there is a limit to how much cartilage and skin be shaped safely maintaining sufficient structure and support. The use of a closed technique hides incisions inside the nose and can result in a shorter operating time and recovery. However closed rhinoplasty may not be the optimal treatment for every patient and each Asian Rhinoplasty requires customisation for the individual.

How does Dr De Silva’s techniques differ for Asian Rhinoplasty?

Dr. De Silva focuses on every patient’s individual needs, and rhinoplasty is a procedure that requires customisation for the individual person. Dr De Silva often utilises graft tissue in Asian Rhinoplasty to build a more elegant and refined dorsal bridge, this results in the appearance of the nose becoming narrower and more refined. Thirty percent of all the rhinoplasty Dr De Silva completes is revision rhinoplasty from patients who have undergone surgery elsewhere. Dr De Silva uses specialised Asian Rhinoplasty techniques to improve both the bridge of the nose, definition in the tip of the nose and to enhance recovery time with the use of anti-swelling medication. By the use of these techniques they offer a patient a natural looking result with more definition and refinement and faster healing time. Dr De Silva has focused his skills and techniques on giving patients natural looking results with enhanced recovery with less than twenty percent of Dr De Silva’s patients have bruising after rhinoplasty.
Key to a successful surgery is achieving each individual’s expectations. There is considerable variation in request for Asian rhinoplasty and Dr De Silva advises patients with specific requirements to bring photographs of noses they like. Dr De Silva utilises advanced techniques to ensure a natural long-lasting result.

Do I need graft tissue for Asian Rhinoplasty?

One of the characteristics of Asian noses is a relatively low nasal bridge, which can make your nose appear short. Traditional Caucasian rhinoplasty techniques may be inadequate to improve the definition of the bridge of your nose. Dr De Silva frequently completes revision Asian rhinoplasty for patients who have undergone rhinoplasty elsewhere to improve the definition of the nasal bridge. Choices for graft material include using your own cartilage (septal cartilage) or other material. Dr De Silva’s first choice for graft material is your own cartilage from your nasal septum or cartilage from your ear, sometimes your own cartilage may be insufficient in length the nasal bridge and other material may be required. Silicone is one option, however often this can move with time and need to be revised. Dr De Silva frequently removes silicone material from the nose as a consequence of movement within the nose. Dr De Silva prefers the use of material that will give a permanent long-term correction of your nose that will last indefinitely. Dr De Silva’s focus is on a natural augmentation of the nasal bridge in Asian Rhinoplasty to ensure that the result looks like your nose, just more elegant and refined. The use of graft tissue along the bridge of the Asian nose can result in a more defined and elegant bridge often characterised by Asian models and celebrities.

What does Asian rhinoplasty involve?

Asian rhinoplasty is usually completed as an outpatient procedure under sedation anaesthesia. The procedure takes approximately two and half hours and patients are reviewed after 1-week. Shaping the nose is an intricate procedure as the Asian anatomy is specific to ethnicity including skin type, thickness, shape of bridge, tip width and nostril shape. Dr De Silva modifies his technique depending on a patient’s specific anatomy and expectations from surgery. Dr De Silva uses suture and micro-refinement techniques to maximise the result, uses the most innovative facial plastic surgery techniques to maintain a natural appearance. Dr De Silva has previously written book chapters on Asian rhinoplasty techniques.

Asian male, face - front view

Dr De Silva and patient safety

Patient safety is of key importance for all facial plastic surgery. The intricate anatomy of the nose requires precision and care. Dr De Silva is a keen advocate of patient safety and has championed the need for patient safety on Sky news.

Watch Video: SkyNews interviews Dr. Julian De Silva about Patient Safety in Cosmetic Surgery
Sky News interviews Dr. Julian De Silva about Patient Safety in Cosmetic Surgery

Do I need to have nostril reduction with Asian rhinoplasty?

The need to narrow nostrils with Asian rhinoplasty requires complete customisation for the individual. The position of the eyes in your face can give a good indication for facial proportions and need for nostril reduction. Wide nostrils are reduced with alar narrowing techniques. Nostril narrowing is one of the more challenging aspects of Asian Rhinoplasty, as complete symmetry cannot be achieved in the nostrils as they are a complex 3-dimensional dome, a natural shape. Dr De Silva hides the incision of nostril reduction by making incision in the natural curvature under the nose. Dr De Silva is frequently asked to correct the scars from patients who have undergone rhinoplasty elsewhere which are best avoided by making hidden incisions in the first place. Nostril reduction also termed alar reduction results in a narrower nose that looks more elegant and improve facial balance.

What will my friends and family think?

The nose is a key element of facial appearance and many patients are concerned whether friends or family will be able to tell. Good rhinoplasty is discrete and natural, patient’s report to Dr De Silva every week that most of their friends and family could not tell they had undergone surgery unless they are shown before and after photos.

What type of anaesthesia is used?

Sedative anaesthesia, also known as “twilight anaesthesia,” which is combination of local and sedative medications. At the centre we have developed our own specialised form of twilight anaesthesia, based on practices in the USA. This sophisticated sedation uses tiny amounts of four to five sedation medications that cumulatively give a relaxing and safe experience avoid the risks and side effects of general anaesthesia. A much shorter recovery period than general anaesthesia, with most patients able to leave 30 to 60 minutes following the procedure. These are the most advanced sedation techniques available, and the optimal option for patients considering ethnic rhinoplasty.

For more information on sedation anaesthesia please click here.

Asian male, face - obique view

What is recovery time after Asian Rhinoplasty?

Dr De Silva uses refined techniques during the surgery and anti-swelling agents after surgery to speed up recovery. With Dr De Silva’s techniques the majority of patients (80-90%) have no bruising after surgery which speeds up recovery time. Patients need to take a minimum of 1-week off professional and social responsibilities, sometimes two weeks is preferred depending on profession, need for HD cameras and filming.

Asian woman face, before and after treatment, front view

*Results May Vary

When can I return to social activities and work after Asian rhinoplasty?

Most patients take one to two weeks off work and social activities. Approximately 80-90% of the swelling has resolved at this time. Residual bruising can be covered with cosmetics and mascara after ten days. As a result of normal swelling the nose may look to high immediately after the surgery, as the swelling reduced the skin crease height comes down. There are surgical techniques that Dr De Silva takes to minimise swelling and bruising, and there are steps that patients can take to improve the recovery period including avoiding medications and foods that encourage swelling and the use of cold compresses after surgery. The recovery from Asian rhinoplasty is dependent on the method used for surgery. The recovery after Asian Rhinoplasty traditionally resulted in increased swelling secondary to thicker skin. Dr De Silva treats his patients with anti-inflammatory (anti-swelling) medication one week after surgery to enhance recovery.

Asian woman face, before and after Asian rhinoplasty treatment, front view, patient 2

*Results May Vary

What are the risks of rhinoplasty?

All patients have a degree of swelling and bruising, that resolves over a period of weeks, 80-90% of the swelling resolves over the first two weeks although the final result is not apparent until at least twelve months. Risks that are relatively uncommon include asymmetries, tip definition, delayed healing, numbness, infection and scarring. The majority of these risks are avoidable with technical expertise and skill. Revision rates for rhinoplasty are around 8%, although the risks can be resolved, revision rhinoplasty is more challenging than primary rhinoplasty as a consequence of previous surgery and scarring. Patients who smoke have delayed healing as a consequence of smoking, Dr De Silva advises patients who smoke, to stop smoking before surgery as there is a risk of delayed healing and safety must come first. Dr De Silva utilises advanced regenerative medicine technology and oxygen therapy to enhance recovery when required.

Woman's face, Asian eyelid surgery photo, oblique view

Will I have a visible scar after surgery?

Dr De Silva uses his own customised technique to achieve Asian rhinoplasty, the advantage over are the methods include a rapid recovery with less swelling at 1-week after surgery. Of paramount importance in hiding the scar from Asian rhinoplasty under the nose where it is discrete. The probability of having an issue with the scars is approximately 1%. Utilising specific techniques including multiple levels of stitches the scar is discrete and difficult to see. Any scar in the skin maybe slightly red and elevated immediately after surgery then with normal healing the scar remodels to become flat and difficult to see.

Can Asian rhinoplasty be combined with other procedures?

Dr De Silva frequently combines Asian rhinoplasty with other facial procedures:

  • Blepharoplasty
  • Facelift (deep plane, natural facelift) & Neck lift surgery
  • Lower eyelid surgery for puffiness (eye bags)
  • Chin augmentation and facial balance
  • Regenerative medicine
  • Volume enhancement with fat transfer.

Revision Asian Rhinoplasty

Asian rhinoplasty is regarding a challenging aspect of rhinoplasty as the degree of detail is fine and aspects including asymmetry are often present. Over 30% of all Dr De Silva’s patients have undergoing previous surgery and are termed revision procedures. Although more challenging than primary surgery often with Dr De Silva’s advanced techniques the overall appearance of the nose can be improved.

Asian woman face, before and after Asian rhinoplasty treatment, front view, patient 3

*Results May Vary

Asian woman face, before and after Asian rhinoplasty treatment, front view, patient 4

*Results May Vary

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