ABSTRACT
When compared with Caucasian noses, the typical Asian nose appears to be relatively
small and flat and has poor tip definition. Therefore, the main concept of rhinoplasty
for Asians is augmentation rather than reduction. In selecting the dorsal implant
material, skin thickness should be considered. Although autologous cartilage has the
lowest risk of infection among graft materials, autologous cartilage including costal
cartilage is associated with a significant risk of revision surgery due to aesthetic
failure. Alloplastic implants, including silicone and Gore-Tex, are easy to use and
can reduce operation time. But they carry significant risks of complications including
infection, deviation, extrusion, and delayed inflammation, which must be seriously
considered by rhinoplasty surgeons. Cartilage grafting procedures, including shield
graft, onlay graft, modified vertical dome division, and septal extension graft, are
mainstays in proper projection and better refinement of the Asian tip, which is intrinsically
round and underdeveloped in its appearance. In placing a shield graft, it is important
to place an additional supporting graft at the cephalic border and additional tip
grafts at the caudal aspect, so that the final tip graft complex has an antero-caudal
projection on the profile view.
KEYWORDS
Rhinoplasty - Asian nose - projection - augmentation
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Yong Ju JangM.D. Ph.D.
Department of Otolaryngology, Asan Medical Center
University of Ulsan College of Medicine, Seoul, South Korea
eMail: jangyj@amc.seoul.kr