Asian Rhinoplasty Before & After Photos

Asian Rhinoplasty Before & After Case 1

Septorhinoplasty is an effective way to improve breathing for somebody with a deviated septum and/or collapse of the internal nasal valve.

A good test for the internal nasal valve is to gently pull towards the side the skin of the nose, or try a nasal breathing strip. If breathing noticeably improves, then use of spreader grafts and tensioning of the cartilage in the area is likely to help.

A deviated septum is often visible by feel or touch, but occasionally a CT scan is helpful for the deeper parts of the septum that are not as easily seen.

Here, a small dorsal hump and drooping tip were also improved during the same procedure.

He is seen here at 1 month. Swelling will continue to improve over 9-12 months.

Asian Rhinoplasty Before & After Case 2

The timing and techniques used for our patients with clefts are tailored to each patient.

Here, the upper jaw required greater than 10mm of advancement to correct his occlusion.

Thus, we performed a Le Fort 1 internal distraction: the maxilla was mobilized, and hardware placed to gradually bring the bone and teeth forward 0.5mm at a time.

This incremental movement stretches the scar tissue, blood vessels, and nerves, giving them a chance to catch up a little bit every day and adapt. Otherwise, the advancement in a single surgery can be limited, and the maxilla is at risk of collapsing back.

Once the new bone solidifies, we return to retrieve the hardware and double-check stability of the new bone.

Here, he had continued difficulty breathing through his nose, and desired improved symmetry and contour.

Given his ongoing nasal obstruction — a closed septorhinoplasty was performed at the same time as the hardware removal.

MTF rib cartilage was used as a dorsal onlay graft, cantilevered with a septal extension graft. Tip grafts and diced cartilage helped provide some further tip definition and contour.

He is healing wonderfully at one month, with the swelling already much improved.

Asian Rhinoplasty Before & After Case 3

Early post-op results after a cleft rhinoplasty.

Bringing the alar base forward is especially challenging if not released and augmented at the time of the primary lip repair.

Volume can be added with a rib cartilage graft (self vs MTF), but the lining required release and some recruitment from the surrounding tissue.

The asymmetry in the lower lateral cartilages can be more pronounced in some patients. (Some authors say the two sides are the same size, but I don’t think so.)

Additional bulk here can be achieved with an additional alar batten graft on the cleft side.

Asian Rhinoplasty Before & After Case 4

Rhinoplasty for patients with a history of a bilateral cleft can be challenging because of the tightness of the scar tissue.

That resistance can be compounded in people of Asian, Hispanic, and African-American descent (generally speaking) by:

– relatively weaker support of the nasal cartilage, and

– thicker skin and subcutaneous tissue.

To give enough support to increase projection and reshape the nostrils, rib cartilage (a patient’s own, or from a donor like from @MTFBiologics) provides a strong foundation.

Nasal septal cartilage can usually provide some useful grafts, too, and my partner Dr. Carlos Raul Barcelo often makes good use of ear cartilage when desired for a supported but more pliable nasal tip.

These results are relatively early at 3 months, with another 9-15 months for the swelling to completely go down.