One of the sessions I recently attended at the Facial Cosmetic Surgery Symposium in Las Vegas, Nevada featured the pre-eminent Plastic Surgeon Dr Wuffles Wu who practices in Singapore. He discussed his current practice with regard to Asian rhinoplasty, bridge augmentation and tip refinement. Though he had used silicone implants for many years he stopped using them altogether 7 years ago due to the frequent long term complications that he encountered. This included implant shifting, infection and extrusion. The later problem can be quite disastrous as the extruded implant erodes through the nasal tip skin.

This follows the findings I have seen in my career of long term problems with such grafts necessitating removal. My bias is to use a patient's own tissue (autogenous graft) such as septal, ear or rib cartilage. Although it takes a little bit longer to obtain the graft, there is excellent long term safety with these types of grafts. Another option that Dr. Wu has had success with is to use specially formed straight gortex implants. Depending on how much augmentation is needed a thicker, laminated implant can be used. He avoids L-shaped implants due to a concern with creating an unnatural tip and the long term risk of tip skin erosion. Gortex does have a long track record of safety as a medical implant. When used properly in the nose it has worked out well so far for many surgeons.

To improve tip definition more safely Dr. Wu uses the fibrofatty tissue that is common in Asian noses (under the skin). I too have found this fibrofatty tissue to make an excellent graft and very safely allows for tip augmentation and improved definition. It is soft and very naturally builds up the area without the problem of creating sharp, unnatural edges.

Would you like to learn more about rhinoplasty for Asian/Non-caucasian noses?