Asian-American rhinoplasty

Background: Although a number of studies have discussed rhinoplasty of the Asian nose, few have focused specifically on the Asian-American nose, which incorporates characteristics from various Asian nationalities and/or ethnic groups. Objective: The authors propose a classification system for aesthetic correction of the Asian-American nose and outline surgical techniques with general application to this patient population. Methods: Patients were classified into 3 categories based on morphologic characteristics, as follows: type I (vertical deficiency), type II (vertical deficiency and broad nasal width), and type III (type I or II with glabella deficiency). The treatment protocol included cartilaginous augmentation of the tip, columella, and dorsum for type I patients, using the ear as a donor site. Type II patients underwent similar augmentation and also reduction of the tip and nasal bone, and in some cases reduction of the nasal base. Type III patients received the same treatment as type I or II cases, but in addition required glabella augmentation with hydroxylapatite. Results: Representative case studies and results are illustrated for each of the 3 types of patients. Conclusions: A successful approach to Asian-American rhinoplasty should be based on preservation of the patient's ethnicity and achievement of facial balance while refining individual facial features. Augmentation of vertical deficiencies is essential to an aesthetic outcome, while glabella correction can be crucial to the overall result in type III patients.