Detailed interpretation of The Korean-way of Augmentation Rhinoplasty for the patients that can only speak English !

Asian rhinoplasty(東方人的隆鼻手術)

-Two-pieces of augmentation rhinoplasty (兩段式隆鼻手術)  
-Korean-way of augmentation rhinoplasty(韓式隆鼻手術)
 
作者:曾文尚醫師  
 
Rhinoplasty is a highly specialized field that requires much knowledge and skill on the surgeon to have successful result .The concepts of beautiful nose are different from Asians and Caucasians with respect to ethnic and cultural backgrounds, anatomy of the face and nose, and psychological and aesthetic needs of the patients . Asian rhinoplasty is one of the most common aesthetic procedures in Taiwan. The specialty of Asian rhinoplasty surgery has grown and evolved with the refinement of many innovative techniques and the creation of new procedures.  
 
Orientals have flatter noses than Caucasians because of insufficient bone and cartilage support for oriental nose. The common complaints told by orienta patients are bulbous tip, wide and low dorsum, retracted columella, flat nostril, weak and thin cartilage, and thick skin (thick subcutaneous tissue). We can divide the oriental noses problems into 5 groups:  
short nose, bulbous nose, saddle nose, retracted columella, and insufficient nasal tip projection.  
 
For the augmentation of oriental nose, alloplastic material (L-shape silicone) have been widely used for more than 30 years. Therefore secondary revision procedure is also increased because L-silicone implant are prone to exposure, infection, and displacement . And also in case of lack of skin envelope and short nasal framework , it is not enough to get good result by performing augmentation using L-shape silicone implant . Inadequate surgical technique and overaggressive augmentation with silicone implants have led to the potential of implant extrusion through the incision site, or, worse yet , through the overlying tip skin.  
 
The complications following L-shape silicone implantation include
  1. Infection  
  2. Dislocation  
  3. Mobility of silicone  
  4. Extrusion of silicone ( with L –shape silicon prosthesis )  
  5. Hematoma  
  6. Seroma  
  7. Nasal skin changes ( contractures of nasal tip , intermittent erythematous discoloration )  
  8. Transparent dorsal skin  
  9. Glistening of dorsal skin
 
I often meet the patients with dislocation of nasal tip to one side, or even extrusion of implant after L-shape silicone augmentation rhinoplasty  
 
Which method is good for oriental nose? The critical points of decision for Asian rhinoplasty are selecting appropriate grafting material, control of nasal tip projection, and precise control of dorsal height. In my opinion, the best way for the augmentation of oriental noses is the Two-pieces of augmentation rhinoplasty, i.e. the Korean way of augmentation rhinoplasty . The surgical methods are I-shape silicone or Gortex for radius and dorsum, septal cartilage graft for columella support, and dome suture and ear cartilages for tip projection. I would like to use rib cartilages in some special and difficult cases. So I will talk to my patients that the two-pieces augmentation rhinoplasty ( i.e. the Korean way of augmentation rhinoplasty) is the sculpture of nose individualized! And now the autogenous cartilages ( septal , auricular, rib cartilages ) and alloplastic materials ( I-shape silicone, Gortex) have been widely used !  
 
 
Case 1  
 
Sally, female , 24- year-old. She was born in Taiwan, and now she studys in France. She wants to have a higher radius and longer nose and could make her face more charming! I do the two-pieces of augmentation rhinoplasty ( the Korean-way of augmentation rhinoplasty ) for correcting her nose problems: Gortex( 4 layer, each 2 mm in thickness) for radius and dorsum augmentation, septal cartilage graft for extending the nose length( septal extension graft ), dome suture and ear cartilages for tip projection. She become much more beautiful than before!  
 
 
 
 
 
 
 
 
 
 
 
Case 2  
 
Amy, female , 18-year-old. She just graduated from senior high school and will become the freshman of University. Her mother take her to my clinics for big nose and low radius. After evaluation, the problems of her nose are low radius and big nose tip ( bulbous nose). I do the two-pieces of augmentation rhinoplasty ( the Korean-way of augmentation rhinoplasty ) for correcting her nose problems: Gortex( 3 layer, each 2 mm in thickness) for radius and dorsum augmentation, septal cartilage graft for extending the nose length( septal extension graft ), dome suture, tip skin thinning and ear cartilages for tip projection. Her mother likes her nose change after surgery and says much thanks to me for achieving her dream!  
 
 
 
 
 
 
 
 
 
 
 
Case 3  
 
Catherine, female, year 2 of university student, 21-year-old, She complained her nose is too short. After evaluation, the problems of her nose are low radius and short nose. I do the two-pieces of augmentation rhinoplasty ( the Korean-way of augmentation rhinoplasty ) for correcting her nose problems: I-shape silicone for radius and dorsum augmentation, septal cartilage graft for extending the nose length(septal extension graft), dome suture and ear cartilages for tip projection.  
 
She and her boy friend are very satisfied with the nose.  
 
 
 
 
 
 
 
 
 
 
 
The suggested time schedules for patients that do not live in Taiwan :
  • Day1 (on arrival): consultation  
  • Day 2 (operation):augmentation rhinoplasty  
  • Day3 (OPD): wound care and change the external splint( thermoplast)  
  • Day3~5 (Tour) :arranging local tour in Taiwan  
  • Day 5~7(Tour): arranging local tour in Taipei after removing partial stitches (columellar stitches) and removing tie-over over ear  
  • Day 7~10(Leave):Leaving after removing the residual stitches. ( intra-nasal stitches and posterior ear stitches.)
 
And you can keep in communication with Dr.Tseng by E-mail after going back to your country.  
 
I sincerely hope that you could visit Taiwan frequently and enjoy everything here . I also expect that you can come to my clinic for checking your noses when you come to Taiwan.  
 
Hope all is fine for the foreigner patients.