Most Asian patients seeking rhinoplasty exhibit platyrrhine characteristics with a low dorsum and inadequate projection. Typical reductive rhinoplasty techniques are not effective in managing the characteristic anatomy of the Asian patient. Asian patients also tend to have weak lower lateral cartilages with thick sebaceous skin over the nasal tip, leading to a blunting of the nasal contours.
Augmenting the nose and adding structure enables the surgeon to create increased tip projection, a higher dorsum, and improved tip contour.
Cosmetic surgery among Asians has become more common and more socially accepted over the last decade. The history of corrective and aesthetic surgery of the Asian nose during this period is marked by evolution and refinement. Many surgeons seeking improved structure and tip contour have turned to alloplastic implants. Although most patients do well with this type of implant, a minority develop complications including thinning of the skin over the implant, extrusion, infection, displacement, translucency of the implant, and chronic pain. The most common alloplast used in this application is the L-shaped silicone implant, which has enjoyed a long history of safety and efficacy in Asia. Although these implants can successfully increase dorsal height and projection, they are not able consistently to maintain nasal length, and over time the nose becomes shortened. The nasal tip skin can become thinned and atrophic at the genu of the L-shaped implant. Other alloplasts used for Asian augmentation rhinoplasty include Gore-Tex (W.L. Gore and Associates, Newark, Delaware) and Med-Pore (Porex Surgical, Fairburn, Georgia).