The most common complaints in Asian patients are a flat nasal bridge, a round and bulbous tip, and a short, wide nose. Dr Huang uses modern and refined open rhinoplasty techniques involving the use of cartilage grafts for the nasal tip and silicone or Medpor implants for the nasal bridge to create enhanced but natural looking noses.
Cartilage grafts are most commonly harvested from the nasal septum, which is the wall in the midline of the nose that divides the nose into right and left sides. Alternatively, the ear is also a good source of donor cartilage.
It is not uncommon for patients seeking rhinoplasty to also suffer from nasal airway obstruction due to deviation of the nasal septum. This condition causes obstruction when breathing through the nose. Correction of this condition to improve nasal breathing is a medical procedure that can be covered by insurance and Medisave.
Open rhinoplasty can be performed under local anesthesia with oral sedation, or for maximum comfort, under intravenous sedation. It is usually a day surgery procedure. The length of the procedure depends on how much work is done, and it can range from three to six hours. The basic steps are as follows. Incisions are made along the inside of the rim of each nostril and connected in the midline structure known as the columella. The cartilages in the nasal tip are identified and modified to make the tip narrower. Cartilage grafts are harvested from the nasal septum or the ear. The grafts are fashioned into precise shapes and sizes, added to the tip and positioned carefully and secured with fine sutures to create a new tip that is longer, narrower, and more defined.
An implant of suitable dimensions is then placed on the bridge of the nose directly on top of the nasal bones to increase the height of the bridge and create an aesthetically pleasing profile between the beginning of the bridge at its junction with the forehead (the radix) and the area just before the tip (the supratip). If necessary, the sides of the nose are then reduced and narrowed using appropriate techniques. The wounds are accurately and meticulously closed to produce optimal healing and scars. Finally, tapes are applied over the nose to minimize swelling and maintain the implant in the correct position.
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