The ENTific Centre
The authors' approach to Asian rhinoplasty
We prefer an autologous solution to achieve the rhinoplastic results wherever possible. This approach may incorporate the septum, conchal(see Figures 2a-c) and/or costal rib cartilages. If autologous rib cartilage is harvested, then there is usually sufficient cartilage to fulfill the rhinoplasty requirements for that patient.
Some of our clients do not prefer the idea of an autologous rib harvest and solution. If dorsal augmentation is deemed necessary, we prefer to use sculptured Gore-Tex for the upper- third to two-thirds of the nose whilst septal and conchal cartilage grafts are preferred for caps and camouflaging of the lower two-thirds (see Figures 15 a-c and 16a-c).
The list below represents our alternative options for Asian rhinoplasty:
|Radix augmentation||autologous rib or sculptured Gore-Tex|
|Nasal dorsal mid-third||autologous rib / septum or sculptured Gore-Tex|
|Spreader graft||autologous rib / septum / concha|
|Caudal septal extension||autologous rib / septum / concha|
|(With/without polydiaxone foil reconstruction)|
|Columella strut||septum / Medpor columella strut if stronger tip projection desired|
|Cap graft||septum / concha / secondary injectable|
|Shield graft||septum / concha|
|Lateral crural batten grafts||septum|
|Supratip graft||septum /concha / injectable filler|
|Rim grafts||septum / injectable filler|
Injectable solutions are offered as a primary option for the client who is unable or unwilling to undertake a formal surgical rhinoplasty. We would prefer to inject the reversible injectables as the initial treatment for all the reasons mentioned previously.
Injectables are also offered for minor touch ups after rhinoplasty as required. This would and should be discussed with the patient prior to the primary rhinoplasty surgery, as part of the informed consent process.