How common is augmentation in Asian rhinoplasty and how is this achieved?
Answer:
Augmentation of the nasal dorsum is almost routinely performed in Asian noses. Asian patients generally complain that they do not have much of a bridge and request this. Dorsal augmentation can be accomplished with a variety of materials. Cartilage can be taken from the nasal septum or the ear or donor cartilage may be used if these areas are not sufficient. In addition, gortex is an excellent means of dorsal augmentation. It has a very natural feel, adapts readily to the contour of the nose and does not move. I’ve used this frequently with great success. Having just come back from Vietnam, where I performed five rhinoplasties during a pro bono Face to Face program, in each case, I had to augment the dorsum. The common means of dorsal augmentation in Asian countries is a pre-formed Silastic implant. This has a higher incidence of problems than gortex or cartilage.
In addition, when building up the dorsum, we frequently have to project the nasal tip in order to balance the increased height of the rest of the nose. This is always done with cartilage grafts, generally taken from the septum.