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Middle Eastern Rhinoplasty

Middle Eastern Rhinoplasty

Written by Dr Julian De Silva

Middle Eastern noses are anatomically different from Caucasian noses and require different surgical techniques are required to achieve a more refined and natural appearance.

Middle Eastern noses are often characterised by a relatively high nasal bridge which makes the nose appear relatively large and thicker skin which can result in the tip of the nose being bulbous and lacking definition.

The appearance of a Middle Eastern nose is a consequence of an underlying difference in the nasal anatomy. As a consequence, standard caucasian nose job techniques are less effective in improving the appearance of the Middle Eastern nose.

Middle Eastern rhinoplasty is a surgery of finesse and detail, even a 1mm change can be seen. Dr De Silva believes that nose reshaping requires special techniques to improve definition and shape and keep 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 Beverly Hills and New York.

Rhinoplasty is one of the most common cosmetic surgeries he performs, and Middle Eastern rhinoplasty is considered to be technically a difficult procedure, which is why some cosmetic and plastic surgeons do not perform the procedure.

Middle Eastern female patient

Why Have Middle Eastern Rhinoplasty?

Common reasons for undergoing Middle Eastern rhinoplasty are to have more tip refinement, straightening of the nasal bridge, improved breathing and narrowing of the nose.

Motivations for surgery are specific to each person and other reasons include breathing issues, improved symmetry.

How Do Dr De Silva’s Techniques Differ for Middle Eastern Patients?

Dr De Silva focuses on every patient’s individual needs, and nose surgery is a procedure that requires customisation for the individual person.

Dr De Silva often utilises specialist techniques in surgery to build a more elegant and refined dorsal bridge, this results in the appearance of the nose becoming narrower and more refined. Thirty per cent of all the nose jobs Dr De Silva completes is revision surgery from patients who have undergone surgery elsewhere.

Dr De Silva uses specialised Rhinoplasty techniques to improve both the bridge of the nose, the 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 per cent of Dr De Silva’s patients having bruising after surgery. The key to a successful surgery is achieving each individual’s expectations.

There is considerable variation in a request for Middle Eastern nose surgery 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.

Middle Eastern, smiling photomodel

What Can Be Achieved with the Tip of My Nose in Middle Eastern Rhinoplasty?

In Middle Eastern noses, commonly the tip can lack definition and can be relatively wide or even bulbous. The appearance of the nasal tip is partly characterised by the shape of the underlying cartilages, fat beneath the skin and relatively thick skin.

Improving the definition of the tip of your nose requires specialist techniques. Often open rhinoplasty is a preferred technique for increasing tip definition 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 the sculpting of the underlying cartilages and the use of graft tissue to give more definition.

With open surgery, 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 ethnic 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 procedure requires customisation for the individual.

What Does Middle Eastern Nose Surgery Involve?

Surgery 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 nasal anatomy is specific to ethnicity including skin type, thickness, the shape of the 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 ethnic rhinoplasty techniques.

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.

What Is the Recovery Time After Surgery?

The recovery after surgery traditionally resulted in increased swelling and a longer recovery time. 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 (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 the profession, need for HD cameras and filming.

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 nose surgery 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.

Asian woman face, before and after treatment, front view

*Results May Vary

What Type of Anaesthesia is Used?

Sedative anaesthesia, also known as “twilight anaesthesia,” is a 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 to 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 nose surgery.

For more information on sedation anaesthesia please click here.

What Are the Risks?

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 nose surgery are around 8%, although the risks can be resolved, secondary surgery is more challenging than the original procedure 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, symmetry scheme with lines on face, Middle Eastern Rhinoplasty

Will I Have a Visible Scar After Surgery?

Dr De Silva uses his own customised technique to achieve Asian rhinoplasty, the advantage over is the methods include a rapid recovery with less swelling at 1-week after surgery.

Of paramount importance in hiding the scar from surgery 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 may be slightly red and elevated immediately after surgery compared with normal healing the scar remodels to become flat and difficult to see.

Can It Be Combined with Other Procedures

Dr De Silva frequently combines nose reshaping surgery 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 Surgery

Middle Eastern nose surgery is regarded as a challenging aspect of nose reshaping as the degree of detail is fine and aspects such as skin thickness limit definition.

Over 30% of all Dr De Silva’s patients have undergone 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.

Revision Ethnic Rhinoplasty - female model

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