Open Structure Rhinoplasty for Asian Nose
The concepts and techniques of open structure rhinoplasty were introduced by Calvin M. Johnson, Jr., MD and Dean M. Toriumi, MD. The objective is to build a well-formed, structurally sound nasal skeleton to give support and shape to the overlying skin-soft tissue envelope (S-STE). The stronger support, the better projection of nose tip. The corollary of weakening of the nasal skeleton will result in varying degrees of nasal skeletal collapse with poor aesthetic outcome.
We use the concept of structure rhinoplasty to do the Asian Rhinoplasty. We know Orientals have flatter noses than Caucasians because of insufficient bone and cartilage support for oriental nose. The typical characteristics of the Asian nose include thick skin, abundant subcantaneous tissue, weak lower lateral cartilage, and thin septal cartilage. The surgical techniques are using structural grafting methods to strengthen the weaker cartilage framework. We name the operation as ( Open Structure Rhinoplasty for Asian Nose ). Their aesthetic goals are to raise the dorsum, to increase the tip projection , and to refine the tip definition.
The nasal tip must often be strengthened to provide increased support using a variety of grafting techniques ,including the septal extension graft and columellar strut graft . Once the nasal tip has been stabilized, the nasal lobule can be refined using suturing techniques and tip grafts. We use autologous costal cartilage and irradiated homolgous costal cartilage in secondary Asian rhinoplasty .
The critical point for Asian rhinoplasty is to build a structurally stong nasal skeleton to give support and shape to the overlying skin-soft tissue envelope (S-STE). Rhinoplasty is a very individualized procedure , specific to each patient’s anatomy and desires. Pre-operational consultation, detailed operation, and post-operational care are all important.