Rhinoplasty, Nose Job, Nasal Reshaping In The Philippines :Affordable Cost, Before and After Results

Published: 19th August 2009
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Nose Augmentation/ Rhinoplasty/Alar trimming/Tip Plasty

Rhinoplasty is not a single standard procedure that may address all the features or needs of an Asian or Caucasian nose. There are several types of rhinoplasty procedure. And it will be difficult for the Cosmetic Surgeon to recommend what procedure will best suit a particular patient with out doing a thorough physical examination. It is best that patient visit their cosmetic surgeon to know all their options.

Rhinoplasty is a highly individualized form of cosmetic surgery. Nasal reshaping aims to restore facial balance. Asian patients will usually need an implant (silicone, Gore-Tex™, cartilage) to augment the nasal dorsum

Rhinoplasty or cosmetic nose procedure enhances the features and contour of the nose. Each individual have different nasal features. The nose of each patient requesting for rhinoplasty surgery, have specific characteristic that is greatly influenced and dependent on their racial origin. Caucasians for example, they often have a high bony bridge that may be accompanied with dorsal hump, crooked bony bridge and drooping nasal tip. While for Asians, they often have low bony bridge, round or bulbous nasal tip, wide and flaring alar base with overhang of the alar rim. These gives a strong facial feature. This is why most Asians have a more masculine nasal profile.

These less pleasing features of the nose, may affect self-esteem of some patients and the way other people look, appreciate, and accept them. This can be corrected and enhance by rhinoplasty procedure. Rhinoplasty is not a single standardize procedure for all patients requesting aesthetic improvement of the nose area. There are several procedures that can enhance the features of the nose and theses are; infracture rhinoplasty, reduction rhinoplasty, tip plasty, augmentation rhinoplasty and alar trimming. This can be performed alone or combined together to satisfy the needs of the patient.

To better evaluate the nose, this is divided into 3 general parts or region, the nasal dorsum or bony bridge, nasal tip and ala or alar lobule. The type of cosmetic enhancement procedure of the nose that a patient will need varies and depends on the area of the nose that is of great concern to the patient.

For Caucasians that have a dorsal hump or crooked nasal dorsum, they would need infracture rhinoplasty to straighten and smoothen the bridge of their nose. While for a drooping nasal tip, they will need a tip plasty to increase their tip projection.

However for Asians, rhinoplasty is a more challenging procedure. There are numerous features of the Asian nose that may need correction or enhancement with rhinoplasty. Very common among Asians is a low nasal bridge because of a less prominent or not fully developed nasal bone. This can be enhanced with augmentation rhinoplasty. This is performed by inserting a nasal implant, either silicon or gortex, through an incision inside the nose. The nasal implant is inserted into a pocket created under the skin and on top of the bony bridge. This will increase the height of the bony bridge or dorsum of the nose.

A round or bulbous nasal tip, which is also a common feature of an Asian nose is due to a well develop and large cartilage at the nasal tip. This cartilage widens the tip of the nose and making it less defined. This is corrected with tip plasty procedure that excises the excess cartilage at the tip of the nose. With this, the tip will narrow down and will have more definition. Tip plasty also increases the projection of the nasal tip, which is very much needed in Asian nose because of the deficiency in height at the nasal tip.

For the alar region of the nose, ideally the width of the alar base should not go beyond the medial end of the eyes. And an aesthetically appealing nose when viewed from the side, the collumela of the nose should be exposed and not covered by an overhanging alar rim. It is very common among Asians to have a thick and overhanging alar rim with a wide and flaring alar base. This can be enhanced by alar trimming surgery, this procedure narrow down the alar width of the nose and remove the excess or overhanging alar rim, thus exposing the collumela.

Nasal implants are soft, solid material. These can be in many forms and composition e.g. silicon block, gortex, medpore etc. These implants are biocompatible, does not cause toxic reaction to the body, it can be sterilize, the shape can be contoured and it can be remove when needed. Silicon oil that has been used in the past, for injection to augment the bridge of nose, is different from silicon implants. Silicon oil is liquid in form and had been associated with many complications, and these are infection, extrusion, inflammation and contour deformity. Results with silicon oil injection are very unpredictable and complications rate is very high, this is the reason why most trained Cosmetic Surgeons don't perform this procedure.

Rhinoplasty patients need to prepare prior to surgery. They are required to avoid the following for 2 to 3 weeks; smoking, alcoholic beverages, aspirin, steroids, NSAID's pain medications like mefenamic acids and naproxen, Vitamin E supplements, herbal tea, herbal medications, blood thinning medications like coumadin and heparin. This medications and social activity will make patients bleed a lot during surgery and delay their healing. Patients must be of good heath to be a good candidate for surgery. Patients with any medical illness like asthma, allergies, hypertension, bleeding disorder, emphysema, poor wound healing, and others will require further treatment and work up prior to surgery. This is best discussed with your cosmetic surgeon.

The rhinoplasty procedure is commonly performed under local anesthesia in a doctor's office or outpatient surgical facility that is accredited by the Local Health Department. Patients that are agitated before the procedure may request sedation for more comfort and relaxation during surgery. Patients may be required to wear a splint in the form of tapes or Plaster of Paris on your nose for approximately a week or longer depending on the type or extent of operation and surgeon's preference. Some bruising and swelling should be expected on the first 2 to 3 days after the procedure but will subside after 1 to 2 wks. This is only transient and patient's nose is usually socially presentable by the 7th to 10th day. It may take several months for your nose to fully settle, so it takes time before you may appreciate the full effect of the procedure. Sutures are usually removed on the 3rd to 4th day after surgery.

For the rhinoplasty procedure, patients are advice to allot 8 to 10 days. This period of time is enough for consultation, laboratory, surgery, follow up, suture removal and recuperation. After these patients are safe to travel back home or work since all of the wounds are dry and healed.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

The decision to have rhinoplasty is extremely personal and you'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Possible risks and complications:

• Infection

• Poor wound healing

• Anesthesia risks

• Bleeding (hematoma)

• Nose asymmetry

• Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system

• Change in skin sensation (numbness)

• Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose

• Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication

• Pain, which may persist

• Unfavorable scarring

• Skin contour irregularities

• Skin discoloration and swelling

• Skin perforation by nasal implants or implant extrusion

• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal

• Possibility of revision surgery

For more information on affordable cosmetic procedure, selecting qualified cosmetic plastic surgeon and to know all your options for the procedure you want to have you may visit www.philippinecosmetic.com/ or www.cosmeticplasticsurgeryphil.com .


Dr Rino Lorenzo is a Filipino Plastic Cosmetic and Reconstructive Surgeon based in Manila, Philippines. He is a Board Certified and fully trained Cosmetic Plastic Surgeon, with 6 years of formal training in the field of Aesthetic, Reconstructive and Burn Plastic Surgery. Dr Rino Lorenzo is a Fellow of the Philippine Association of Plastic Reconstructive and Aesthetic Surgeons.

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