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Rhinoplasty performed on Filipinos and other Asians has the same goal as rhinoplasty performed on Caucasians, which is to build a natural-appearing structure that blends harmoniously with the face. Usually, Asians require augmentation of the nose, while Caucasians usually require reduction. Southeast Asians (Filipino, Malay, southern Chinese) typically require the most augmentation.
In Filipinos and other Asians, the nasal bridge is often low. The nasal tip is also low and thick, and the base of the nose is wide. Hence the most commonly requested nasal surgery in the Philippines is the "noselift." Most Filipino plastic surgeons use solid silicone L-shaped implants in order to increase the height of the nasal bridge and to increase the projection of the nasal tip. The bend of the L forms the new tip. In contrast, American plastic surgeons generally prefer the use of cartilage grafts or bone grafts to augment the nasal bridge and tip. Their limited experience with silicone nasal implants has been one-sided, i.e., generally limited to complications, such as extrusions of nasal implants through the nasal tip. Such extrusions were mainly due to inadequate dissection and limited space created for the implants. These complications however have occurred in the early years of silicone implant augmentation of the nose.
The alternative to silicone implants is the use of cartilage grafts and bone grafts. However these grafts have been known to resorb and decrease in size over a period of time. Moreover, Filipino patients also do not want an extra operation on another part of their body in order to harvest cartilage or bone.
Many Asian patients will also need an alar plasty operation to decrease the wide nasal base. A skillful surgeon will use a technique to remove small wedges of skin to bring the nostrils closer together and which will result in natural looking nostrils.
Most American patients request reduction rhinoplasty for large noses and hence most American plastic surgeons have less experience performing noselifts as compared to Filipino plastic surgeons.
It has been around 40 years since the use of solid silicone implants for nasal bridge augmentation started becoming popular. Filipino plastic surgeons have accumulated a lot of experience since then. There are fewer incidences of extrusions of silicone implants taking place. The most common "complication" of noselift or augmentation rhinoplasty that can be seen at present is the unnatural looking nose. The unnatural looking nose in the Filipino usually has the following characteristics: a high take-off beginning at the area between the eyebrows; a prominent bulging outline of the silicone implant that is visible through the skin; and nostrils which are angular at the sides because of improperly done wedge resections of the alar tissue.
The skillful surgeon takes great care in creating the look and feel that is most suitable to your face and features. Implants are individually sculpted to personally suit the shape of your face, resulting in a more "natural" look.
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