Eduardo Yap
Consultant
Philippine Society Of Otolaryngology
– Head And Neck Surgery
Philippine
Educational Background
Post-graduate
Work Experience
30 years medical practitioner and surgeon
Saturday, April 17
AFPSS-Correcting Nasal Deformities
Venue:Room B,2F
13:50-14:20
Topic: Rhinoplasty Techniques in Small Asian Nose
Abstract:
Achieveing beauty and function in a small Asian nose is usually a challenge to rhinoplastic surgeons.
Structural framework surgery and soft tissue contour surgery should be highly considered.
In structural support for the tip, a plain columellar strut usually fails. Following the concept of tongue in
groove the septum is extended via septal extension graft f(SEG) or counter rotation and projection of the
tip. The conchal cartilage is a great aid in further supporting the SEG. Sometimes, homograft/xenograft
cartilage or synthetic absorbable polycaprolactone are used is septum is small and weak.
In tip definition surgery, suturing technique will not give a good outcome because of the weak nature of
the cartilage and the thick overlying SSTE thus s strong support with tip grafts from conchal cartilage are
used.
Dorsal augmentation is almost always a part in Asian Rhinoplasty. Because of the volume needed,
several synthetic materials are commercially available from fillers and threads to silicon and e-PTFE.
The Skin and Soft Tissue (SSTE) in Asian Noses is thicker compared to the Western. Usually the skin
profile improved after surgery however sometimes defatting is done to improve the tip definition.
The ala of the nose should be analyzed in 3 dimensions. The alar rim, flare and base. Majority of Asian
noses have flared hanging ala, wide base and these are corrected simultaneously to achieve a good
ala-columellar relationship.
The premaxilla is usually retruded because of hypoplastic anterior spine. The naso labial angle is usually
improved if structural rhinoplasty is done rather than just plain dorsal augmention only.
Though most often than not a good rhinoplasty brings out the harmony of the face however sometimes
supplemental procedures are suggested to achieve a better look e.g. Chin Implant, paranal
augmentation, blepharoplasty, facial bone contour surgery..
