Operative techniques in Asian rhinoplasty.

Rhinoplasty in patients of Asian descent presents a different set of challenges for rhinoplasty surgeons. Most Asian noses are characterized by a thick skin envelope, low radix and dorsum, bulbous tip, weak lower lateral cartilages, and a short columella. In this article, the authors describe an autogenous approach to Asian rhinoplasty that achieves aesthetic results comparable to the use of silicone implants without the associated risks observed with alloplastic implants. The technique consists of the following: (1) harvesting of grafts, (2) an open approach with skin defatting, (3) septal harvest, (4) placement of a septocolumellar graft, (5) nasal tip refinement, (6) radix and dorsal augmentation, (7) osteotomies, (8) alar base modifications, and (9) closure and casting.