Asian Rhinoplasty & Other Ethnic Nose Surgeries
With globalization, the rise of cosmetic surgery throughout the world, and our ever diversifying patient base in the U.S., Dr. Kim believes that rhinoplasty surgeons must pay more and more attention to the individual and ethnic differences of patients, both anatomically and aesthetically. Dr. Kim strives to maintain a cultural and ethnic sensitivity in his approach to the nose.
Many Asian patients seek out rhinoplasty under the care of Dr. David Kim, a premier facial plastic surgeon in San Francisco. He has lectures regularly on this subject and is widely recognized as an expert in Asian rhinoplasty. As is the case for all rhinoplasty, Dr. Kim believes the approach to the Asian rhinoplasty patient must be tailored to their unique anatomy and goals.
Patient goals: Removal of infected nasal implant, restoration of normal nasal contours
Asian rhinoplasty: removal of implant, repair of tear of nasal skin from implant extrusion, rib graft for dorsal augmentation and tip projection with septal extension graft support
Specialized approach to Asian Rhinoplasty
There are certain anatomical features seen more commonly in Asian individuals, which Dr. Kim treats with a variety of specialized techniques.
- Bridge One common features of many Asian noses is a low, flat bridge. This may create an unfavorable profile in which the upper half of the nose looks too sunken relative to the tip of the nose. The lack of height on the bridge also leads to poor definition of the upper nose from the front. The flat bridge is not high enough to create the normal shadowing that defines the side walls of the nose.
- Technique Dr. Kim utilizes structural cartilage grafting to augment the bridge and thereby improve the profile and create better definition. If only a small degree of augmentation is needed, he will utilize cartilage taken from the nasal septum. For more significant elevation, he will utilize cartilage obtained from the rib. He does not use artificial implants as they may have problems related to mobility, infection or erosion through the skin.
- Tip Another commonly treated aspect of the Asian nose is the tip. Like the bridge, the tip may also be flat and soft, leading to roundness and poor definition from all angles.
- Technique Because the skin-soft tissue envelope of many Asian noses is thick, techniques to narrow or remove parts of the tip cartilages are not very effective in Asian nose. This is because the thick soft tissue cannot drape tightly over the reduced tip framework is most Asian noses. Instead, Dr. Kim will often use structural cartilage grafting to make the tip more projected (taller) and thereby narrower. Frequently, he will use a combination of techniques to accomplish this: repositioning of the native tip cartilages slightly forward and building on top of the tip with delicate contour grafts.
San Francisco Rhinoplasty Specialist
Disclaimer: it is overly simplistic to classify a non-Caucasian nose as an “ethnic” nose to which “ethnic rhinoplasty” principles apply. Two noses from two different ethnic backgrounds are likely to be as different from each other as they are from a Caucasian nose. In addition, significant variations in facial features are found within any given ethnic group. That being said, three broad nasal morphology types have been used to describe ethnic variations. The leptorrhine (“tall and thin”) nose is associated with Caucasian or Indo-European descent. Because it is the most extensively studied in modern nasal analysis, it also inevitably becomes the reference point for comparison when studying noses of different ethnicities. Only recently have non-Caucasian standards of nasal analysis been developed for specific ethnic groups.
The platyrrhine (“broad and flat”) nose is associated with African descent. It is characterized by thick skin, a low radix, a short dorsum, a bulbous and underprojected tip, and flared nostrils. An analysis of the African-American female nose shows that compared to the Caucasian standard for nasal analysis, the columella-to-lobule ratio is decreased, and the alar width relative to the intercanthal distance is increased.
The mesorrhine (“intermediate”) nose has features intermediate between the leptorrhine nose and the platyrrhine nose. The “typical” Asian or Latino nose is commonly regarded as mesorrhine, with a low radix, variable anterior dorsal projection, rounded and underprojected tip, and rounded nostrils.
Dr. Kim’s Approach
In Dr. Kim’s practice, patients of different backgrounds tend not to want to strive for measurements and metrics consistent with a Caucasian leptorrhine nose. Rather, many patients prefer to soften certain features of their nose while retaining some of their “ethnic identity”. Those features in the nose which tend to make one look “ethnic” varies group to group and person to person. In particular, the height and contour of the bridge, the angle of the tip, and the flare of the nostrils can be very determinant of a characteristic familiar or ethnic look. Dr. Kim approaches these areas very thoughtfully with input from each patient so as to ensure the desired features of the nose are preserved.
Dr. Kim firmly believes that a “cookie cutter” approach to rhinoplasty is now more than ever a culturally insensitive way to approach this operation. Dr. Kim strives to weigh both anatomical and aesthetic variations of patients of different backgrounds in planning for and executing rhinoplasty in order to achieve consistently favorable results.
Schedule a Consultation Today
Dr. David Kim is a renowned facial plastic surgeon who attracts patients from around the world to his state-of-the-art practice in San Francisco. If you are interested in learning more about ethnic rhinoplasty, or other procedures such as chin implant and otoplasty, contact his practice today at 415-773-0800.