Today I was answering a question on Realself.com. A very pretty oriental looking girl was inquiring about what she needed to ask when she goes for a rhinoplasty consultation. From the pictures that she had posted, I could see that she was very pretty and her face had a certain balance and harmony of which I would have recommended not to disturb, if she had seen me for a consultation. It reminded me of all the bad oriental rhinoplasties that I had seen in my carrier. Most of these bad results were due to the fact that too much dorsal augmentation had been done and the nasal dorsum was made too straight. The Asian or oriental face has several characteristics that in my opinion have to be maintained. I would only change some of these traits if they are exaggerated and cause an aesthetic problem. In orientals, typically the nasal bridge is lower, the tip has less projection, the nostrils are more flared and the tip is rounder and less angular. These statements are obviously more true in the south eastern Asians. There is no question that some of the requests for rhinoplasty by the Asians are influenced by the desire to have more Caucasian features. The plastic surgeon has to council the oriental patients against these Caucasian characteristics, because they create disharmony in the oriental face. I would analyze the oriental face in it’s own context and only change what is necessary. We don’t want to create a straight nose when every other element of the face is curvilinear. If we keep these principles in mind, we will be able to create the changes in a subtle way with autologous materials like the septal cartilage or ear cartilage and would rarely need alloplastic implants. The use of computer imaging is highly recommended so that both plastic surgeon and patient could see the proposed changes and agree on what needs to be done.
