Rhinoplasty

A Comprehensive Guide to Rhinoplasty: Primary, Revision, and Asian Rhinoplasty

Rhinoplasty, commonly referred to as a "nose job," is one of the most technically challenging procedures in plastic surgery. It includes Primary Rhinoplasty (first-time nose surgery) and Revision Rhinoplasty (corrective surgery after a previous rhinoplasty). Both require precision, expertise, and a deep understanding of nasal anatomy.

Who Are Candidates for Rhinoplasty?

The best candidates for rhinoplasty are healthy individuals with realistic expectations. Common reasons for seeking rhinoplasty include:

• Crooked nose

• Wide or boxy nasal tip

• Droopy nasal tip

• Dorsal nasal hump

For revision rhinoplasty, the procedure is even more complex due to potential challenges like:

• Insufficient cartilage support.

• Existing perforation of the nasal septum.

It’s important to note that both primary and revision rhinoplasty may require a follow-up "touch-up" procedure to refine results.

How Is Rhinoplasty Performed?

Rhinoplasty is performed under general anesthesia in an operating room, with the surgery typically lasting 2-4 hours. Breathing issues, such as a deviated septum, can also be addressed during the procedure.

Surgical Approaches:

1. Endonasal (Closed) Approach: Incisions are made entirely inside the nose, leaving no visible scars.

2. External (Open) Approach: A small incision is made across the columella (the tissue between the nostrils). This approach allows for greater visibility and precision and generally heals very well.

The choice of approach depends on the patient’s anatomy and aesthetic goals, which are discussed during the consultation.

What Is Recovery Like After Rhinoplasty?

Recovery from rhinoplasty is a gradual process. Here’s what to expect:

• Splint and Packing: A small plastic splint is worn on the bridge of the nose for at least one week. Packing may also be placed inside the nose.

• Stitches: External stitches (if any) are removed after one week.

• Bruising and Swelling: Black eyes may occur if nasal bones are broken, lasting about 10 days. Swelling and nasal stuffiness are common for the first few weeks.

• Precautions: For two months, avoid:

• Pressure on the nose (e.g., glasses or sunglasses).

• Blowing, picking, or squeezing the nose.

• Downtime: Most patients return to work or school within 1-2 weeks.

​​​​​​​Healing Timeline:

• 1 Month: 50-75% of the final result is visible.

• 6 Months: 90% of the final result is achieved.

• 1-2 Years: Full results are realized.

Asian Rhinoplasty: Unique Challenges and Techniques

Asian Rhinoplasty is a specialized category due to the unique structural and aesthetic characteristics of Asian noses. Common concerns include:

• Lack of bridge height.

• Short nose.

• Bulbous or undefined nasal tip.

• Wide, hanging alar (nostrils).

Structural Differences in Asian Noses:

• Wider nasal bones.

• Softer, smaller nasal cartilages.

• Thicker, tighter skin.

These factors require careful evaluation during the consultation to ensure the desired results are achieved.

Silicone Implants vs. Structural Rhinoplasty

The majority of Asian rhinoplasties worldwide are performed using silicone implants. However, these implants have a high complication rate (10-40%), with issues such as:

• Foreign body reaction.

• Implant infection or exposure.

• Capsular contracture (scar tissue forming around the implant).

To avoid these complications, structural rhinoplasty using cartilage grafts (from the ears, ribs, or allografts) is recommended. This approach provides a more natural and durable result.

Alar Reduction: Refining Nostril Size

Alar reduction is a common ancillary procedure performed alongside rhinoplasty to reduce nostril size and improve facial harmony. It can also be done as a standalone procedure if nostril size is the primary concern.

Techniques:

1. Basal Sill Reduction: A small incision inside the base of the nose.

2. Weir’s Excision: A small incision along the sides of the nostrils.

These incisions are well-camouflaged within the natural creases of the nose and typically become unnoticeable within six weeks.

​​​​​​​Combining Procedures for Optimal Results

Rhinoplasty, whether primary, revision, or Asian, is a highly personalized procedure. Combining techniques like alar reduction or addressing breathing issues ensures both aesthetic and functional improvements. With proper planning and expert execution, rhinoplasty can deliver life-changing results.

​​​​​​​If you’re ready to explore your options, consult with Dr. Han Hoang, a board-certified, UCLA-trained craniofacial surgeon, to create a customized plan tailored to your unique needs.

📞 Call us at 714-584-3507
 📧 Email us at hanhoangmd@gmail.com