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Monthly Archives: January 2011

Asian Rhinoplasty Beverly Hills

I recently vacationed in Asia and was struck by the wide variation in facial anatomy, especially nasal anatomy. These observations, coupled with my own extensive experience, reinforced my belief that a high, narrow bridge, a well-defined tip, obliquely rather than horizontally oriented nostrils and some degree of “nostril show” (where the columella between the nostrils is lower than the sides of the nostrils) looks better.
To this end, there are many approaches to accomplish this result. Obviously, the approach has to be individualized depending on the variations in anatomy and the patient’s wishes. Though nasal bridge augmentation in the Orient usually involves placing a synthetic implant with acceptable results, I have found them to be unsatisfactory. Besides being moveable over the bridge, many  get infected or extrude. I generally prefer cartilage grafting, with or without a fascia covering. Sometimes it is necessary to fracture the nasal bones inward. Also, cartilage is usually needed to provide an angular defined tip, as well as structural support for the tip in the form of a strut.  The strut is also useful in lowering the columella. And finally, the nostrils may be narrowed via tissue excision, suture cinching, wide undermining or a combination of these.