Lengthening of the Asian Nose.

The Asian nose has its unique morphology and forms a significant proportion of noses treated by the rhinoplasty surgeon not only in Asia but also in other countries where the Asian diaspora resides. The anatomical features and dimensions of the Asian nose differ from noses of persons of African, Caucasian, Indian, and Middle Eastern origins, poses its own challenges, and warrants a unique set of techniques for its aesthetic improvement. In this article, we present an overview of the approach to the lengthening of the Asian nose, drawing from our own experience with managing the Asian nose and referencing the published literature on the subject.

Correction of Short Nose.

To correct an Asian short nose with low dorsum, short columella, and poorly defined nose tip, augmentation rhinoplasty has been popularized. A simple augmentation no longer is considered an efficient rhinoplasty approach for Asians aesthetically; most surgeons simultaneously perform nasal elongation and augmentation during rhinoplasty. To extend the nose length successfully, important factors are cartilages, mucosal and skin conditions, and presence and degree of fibrotic changes.

Surgical Techniques for the Correction of Postrhinoplasty Depressed Scars on the Nasal Tip.

Importance: Augmentation rhinoplasty is common in the Asian population and the lack of suitable autologous material for augmentation has led to the use of alloplastic materials. Many of these patients develop complications, including a depressed dimple-like scar of the nasal tip. Causes of such dimpling include the use of large implants, infection, extrusion, and surgeon incompetence.

The Seesaw Technique for Correction of Vertical Alar Discrepancy.

Alar vertical discrepancy including alar base has been viewed as one of the most challenging reconstructive problems in rhinoplasty. The authors have created a simple technique that consistently gives aesthetically acceptable results. The authors have designed the seesaw technique to correct alar discrepancy (type 1 to 3).

Pressure necrosis of septal cartilage associated with bilateral extended spreader grafts in rhinoplasty.

Objective: To investigate septal cartilage compressive changes as a result of bilateral extended spreader grafts (ESGs), which are commonly used in rhinoplasty. The buckling, rupturing, or necrosis of the recipient site leads to nasal tip structural deformity. These pathologic changes associated with bilateral ESGs warrant the clinician's attention and in-depth basic and clinical research.

Surgical anatomy of cartilaginous structures of the Asian nose: clinical implications in rhinoplasty.

Objectives/hypothesis: The morphologic features of upper and lower lateral cartilage and septal cartilage of the cadaveric nose were analyzed to provide practical anatomical knowledge for Asian rhinoplasty.

Study Design: Cadaveric dissection.

Methods: A total of 21 Korean adult cadavers were dissected.

Subnasale flap for correction of columella base deviation in secondary unilateral cleft lip nasal deformity.

Objective: To present the effects of subnasale (SN) flap on the correction of deviated columella base in patients with secondary unilateral cleft lip nasal (UCLN) deformity.

Patients And Methods: The patients were 6 adult Koreans with cleft cases (mean age, 29.1 y; range, 20-43 y; 1 man and 5 women; secondary UCLN deformity with columella base deviation).

Correction of pollybeak and dimpling deformities of the nasal tip in the contracted, short nose by the use of a supratip transposition flap.

Objective: To discuss our experiences with the use of a supratip transposition flap to simultaneously correct pollybeak deformity and nasal tip dimpling.

Design: From April 1, 2007, through August 31, 2008, 10 Asian women with a contracted, short nose that exhibited nasal tip dimpling were retrospectively included in this study. By use of an open approach, the osteocartilaginous framework was elongated first.

Correction of severe alar retraction with use of a cutaneous alar rotation flap.

Background: Severe alar retraction is one of the most challenging problems to correct in nasal surgery. Management for severe alar retraction traditionally requires multiple stages and uses several surgical techniques. This article introduces a single-stage technique to correct severe alar retraction deformities using a cutaneous alar rotation flap in conjunction with alar batten grafts.

Histologic study of Gore-Tex removed after rhinoplasty.

Objectives/hypothesis: Gore-Tex is known to be a relatively safe material. However, it leads to complications. Although widely used, the reasons complications occur are poorly understood.

Gross and pathologic analysis of long-term silicone implants inserted into the human body for augmentation rhinoplasty: 221 revision cases.

Background: In augmentation rhinoplasty, delayed morphologic changes are often observed with silicone implants, despite them being known as a safe implant material. The purpose of this study was to identify the cause and time course of delayed shape changes of silicone implants, through the long-term evaluation of inserted implants and their surrounding nasal soft tissues after their removal at revision rhinoplasty operations.

Methods: Two hundred twenty-one silicone implants removed during revision rhinoplasty were studied.

Subnasale flap for correction of columellar deformity.

Background: Columellar defects or deformities are challenging problems to correct. Many different techniques have been described, yet none are ideal, especially for the purpose of aesthetic improvement.

Methods: Local flaps are designed from the subnasale region extending into the nasal floor.

A cadaveric analysis of the ideal costal cartilage graft for Asian rhinoplasty.

Augmentation rhinoplasty of the Asian nose may be effectively accomplished with alloplastic materials. However, certain circumstances mandate the use of autologous grafts (e.g.

Secondary rhinoplasty of the Asian nose: correction of the contracted nose.

The contracted nose is a unique entity that follows primary rhinoplasty in the Asian patient. The proposed reasons for this complication are capsular contraction from a silicone nasal implant, pressure necrosis of the lower lateral cartilage resulting from the nasal implant, and infection after alloplastic implantation. The two principal anatomic constituents that must be addressed at the time of secondary rhinoplasty are the lower lateral cartilages and the skin envelope.