Hi I'm Dr. Donald Yoo and today I'd like to
discuss revision Asian rhinoplasty and revision Asian nose job. Lynn
is a very pretty patient who came to me
seeking a revision because she had rhinoplasty
surgery about two years ago with a very
well-known surgeon, who is an excellent
rhinoplasty surgeon but someone who does
not specialize in Asian rhinoplasty. So I
got my first rhinoplasty around like
three years ago and I wasn't really happy
with the result from the first nose job. I wanted a revision
where I could achieve a higher bridge
and a little more tip definition. Asian
rhinoplasty and Asian nose job surgery is a little bit different
not only because of anatomic differences
but also because the aesthetic goals and
aesthetic desires of the patient are
often different from the standard
rhinoplasty patient. We discussed the
things that would help her to achieve
her initial goals which was to create
more definition of her bridge, to give
her more refinement and narrowing of her
tip and nostrils. Dr. Yoo was able to
explain to me exactly how we would
achieve that. He was very realistic and he
told me that improvement was what
you were looking for not perfection. So he
explained the whole process and made it
really straightforward and easy to
understand. Often in Asian patients it's
necessary to build or augment the bridge
of the nose because that is the way to
achieve both a more balanced profile and
also a nose that looks more refined with
better definition from the front.
In most cases the nose can be improved,
especially when seeking out a
rhinoplasty specialist the nose can be
reshaped and changes can be made to
enhance it in ways that will make the
nose look prettier and more attractive
and enhance the attractiveness of the
patient overall. However, it can never be made
to be perfect, and so the best candidates
for rhinoplasty are those candidates who
have realistic expectations and are
looking for improvement, not perfection.
For Lynn I recommended using cartilage
that was stronger, straighter and more
abundant than what was available inside her nose, and thus i recommended using
rib cartilage from a 2-centimeter incision
on her right rib. The incision hides
very nicely in the crease below the breast
It's a small
incision that ends up as a thin line and
through that incision I'm able to take
some of the rib cartilage from the sixth
rib and use that to create grafts that
will support the cartilage that's
already inside her nose. That way her
nose would be projected,
lengthened and also refined a significant
amount. In addition to that I recommended
using faccia or some of the covering of
her temporalis muscle, which I take
through a little incision above her right or
left ear in the hair, without shaving
any hair. With that I wrap the cartilage
from her rib diced into small pieces and
use this DCF(diced cartilage fascia) to augment or build up the bridge of
her nose.
Using the rib cartilage then I was able
to create grafts made of her own
cartilage so grafts that are going to be
incorporated into her nose to rebuild
and reinforce her nose and give it the
structure that it needs to have the
definition she was looking for. The
surgery itself took about six hours so
it does take time precisely create all
those grafts and to take those grafts
from her own body and then to shape them
and secure them to the tissue in her
nose.
She underwent revision Asian rhinoplasty surgery, which went
fantastic, about three-and-a-half months
ago and she's been recovering
beautifully. I'm going to be 3.5 months
post-surgery and I really like my
results. My bridge is higher and my tip
is a lot more refined. Dr. Yoo told me that
the swelling will go down even more
after a few months so I'm really excited
to see that looks like then.
In terms of recovery, the great thing about using
rib cartilage and temporalis fascia is that it
doesn't prolong recovery after
rhinoplasty because all those areas
heal simultaneously. I also feel like my nose
balances my face better and with my
bridge higher it also makes wearing
glasses or sunglasses a lot more easier
for me.
So being three-and-a-half months into
recovery a lot of the initial swelling
has come down, but she's far from fully
healed and as she continues to heal,
more of the swelling from the surgery
will resolve and she should achieve even
greater definition and refinement to the
bridge of her nose the tip of her
nose.
I think when choosing a revision
rhinoplasty surgeon it's difficult
because after having gone through one
surgery and not achieving the results
that you want as a patient you're
hesitant to trust your nose and your
beauty and your face to another surgeon, and
so it is important to do your research
and make sure that your surgeon is
experienced and technically capable of
creating the nose that you want but also
to meet with them in person to make sure
that you're on the same page in terms of
expectations