This rhinoplasty is also known as Asian American rhinoplasty, Asian Canadian rhinoplasty, Chinese rhinoplasty, Non Caucasian, Ethnic rhinoplasty. These patients have the appearance that suggests some ancestry from the East. There are also a large group in our diverse culture of mixed race ancestry. The surgeon must have experience with rhinoplasty in all ethnicities to understand the challenges to obtain the result the patients desire. Although it is impossible to characterize a group of people, some similarities may exist. The rhinoplasty surgeon must be familiar with these characteristics to have the potential to optimize the surgical outcome. The surgeon must have a fundamental understanding of the anatomic variations. The bone in the midline of the nose is called the nasal septum, based on its development the nose may protrude or be less prominent. It is not uncommon in patients of Asian descent that the nasal tip is less projected. The nose may have a more wide tip. The dorsal height of the nose may be lower. These features all have an underlying anatomic basis. The rhinoplasty surgeon must be aware of this and have techniques to restore the balance and proportion of the nose.
The skin and soft tissues can also vary widely between groups. The skin may be thicker and different techniques may be needed to make sure the rhinoplasty procedure is successful. Over reduction of the underlying cartilage in these patients can lead to an amorphous nose with poor shape.
It is important that the surgeon not use a cookie cutter approach to the nose. In fact, many patients who are all considered of “Asian” heritage may have very different noses. They may have very different skin thickness. Failure to understand these nuances may lead to sub optimal results. The surgeon cannot simply lump all the patients into one group and perform the same procedure. Dr. Robert A. Mounsey holds the view that the rhinoplasty result should be natural, enhancing the physical appearance and improving the breathing. Surgery should not attempt to change the appearance of the nose by making changes so dramatic that it is obvious that a rhinoplasty surgery was performed. Aggressive over resection of tissue is avoided.
The most important role of the rhinoplasty surgeon is to make sure the nasal function is preserved or enhanced. This means the surgeon must understand nasal physiology and anatomy as it relates to the nose. The surgeon must obtain the aesthetic result desired, while at a minimum maintaining the breathing. If possible breathing should be improved.
The starting point of the nose below the forehead may be lower. This must be understood. The skin between the nostrils (the columella) may be relatively short.These rhinoplasty procedures can be the most challenging for an experienced surgeon to obtain the results the patient desires.