Reshaping Asian Noses
Asian Nasal Reshaping  (Asian Rhinoplasty)

Asian Rhinoplasty represents the art of reshaping a nose of Asian ethnicity while maintaiining the ethnic identitiy.  I have found that although the use of nasal implants with artificial material is quite common, it leads to an artificial harsh appearance to the nose.  In addition, some patients complain about artificial implants causing pain, mobility, and they can actually extrude from the nose.

My philosophy of Asian noses is to preserve many of the ethnic features of the nose and make a nose which has softer highlights and looks natural.  I do not use artificial implants because I believe that they do not create a good looking nose, can lead to infection and rejection by the body.  I only use natural materials from a person's own body such as nose cartilage, ear cartilage or costal cartilage and create a nose which is softer looking in appearance, durable and natural. 

The difficult nature in that what I do takes longer than placing an implant.  Each portion of cartilage is precisely carved and placed so that the nose will be as supported and look as good as possible.  It is much more technically difficlult than the use of a nasal artifical implant.  I have two scientific papers highlighting the areas where surgeons can carve grafts more effectively. 

Figure. Demonstrating Asian Female nose (Before Image on Left) which now has slight augmenation of
bridge and increased tip definition while maintaining a soft nasal shape.


Frequently Asked Questions:

Is rhinoplasty the same for Asians as Caucasians?

While basic rhinoplasty principles apply regardless of race, there are some key differences.  Many Asian patients seek a stronger bridge and more refined nasal tip , while caucasian patients often seek reductive procedures.  A simple augmentation of the nasal bridge will often not achieve satisfactory goals.  More commonly, a combination of tip supportive mechanisms and reshaping in combination with subtle bridge
augmentation lead to more natural and aesthetically pleasing surgical results.  Many of the tip maneuvers used on Asian patients are quite different due to the combination of weaker lower lateral cartilages and thicker nasal skin.

How does Dr. Shah accomplish the surgical goals?

Dr. Shah creates a surgical plan based on an in depth discussion with each patient.  He uses photographic imaging software to create a virtual nose.  He then will show what is and is not surgically possible and to deliver results specific for each patient.  Dr. Shah's goal is to give patients the nose they desire, not  to impose his
vision on the patient.

I see on the internet that most physicians prefer artificial implants in the nose like silicone or Gore-tex.  Why doesn't Dr. Shah believe in the use of an artificial implant in the nose?

An artifical implant can be rejected by the nose.  Any surgeon who uses enough of these implants will tell you that they can and do get infected.  If a nasal implant extrudes from the skin of the nose, it will create a permanent scar because it damages the soft tissue of the nose.  It can also create scar contracture of the entire nose of the patient including the nasal tip and dorsum.  The repair of such a deformity requires extensive experience in costal cartilage and revision rhinoplasty technique. 

Furthermore, an artificial implant will look, well artificial.  Silicone implants create a shrink wrap effect to the nose and overaugment the nasal profile on almost every patient.  It is very easy to see an implant placed in a patient with silicone, shiny skin, narrow dorsum, artificial appearing nose.   Gore-tex can become infected just as easily.  I have seen many patients with infections in their nose from Gore-tex.  Many of these infected implants have come from reputable surgeons whose name in rhinoplasty or Asian rhinoplasty is signficant.  This does not mean that every patient with an implant can have an infection, but it does mean that the risk of infection in an artifically implanted patient is much higher than a non artificially implanted patient.

The question on why many surgeons do use artificial implants has more to do with the technical demands required of using autologous implants and the extra time it requires.  A rhinoplasty with an artificial implant takes much less time.  A silicone or gore-tex implant in the office can take as little as 15 minutes.   To reconstruct a nose with your existing tissues, septal cartilage and/or ear/rib cartilage will take longer but the results justify the time and precision it requires.

There are a handful of surgeons in the world who can use costal cartilage in the setting of a rhinoplasty at a high level.  This makes finding a surgeon who can use all of the best available techniques a challenge.  Fortunately, Dr. Shah has performed over 100 costal cartilage rhinoplasties and has coauthored 2 seminal articles on costal cartilage rhinoplasty (aka rib rhinoplasty).  Not every Asian patient will want or need a costal cartilage rhinoplasty but only a surgeon who performs this procedure will be able to determine this.

Does Dr. Shah perform revision rhinoplasty?

50% of Dr. Shah's rhinoplasty patients have had rhinoplasty performed by an outside surgeon and they have now come to Dr. Shah to correct their appearance and/or breathing.  Dr. Shah is one of the few surgeons who use costal cartilage grafting (rib grafting) when necessary to create natural appearing nasal results dramatically
increasing the reconstructive options available to his patients.

How do I know if the Dr. Shah will understand and create what I want?

As Dr. Shah performs many redo operations of rhinoplasty performed by outside surgeons, he believes one critical factor necessary prior to every operation is communication and understanding.  In order to facilitate understanding between Dr. Shah and his patients, he uses computer imaging to show the proposed changes to your nose.  If Dr. Shah thinks there is a disconnect between the patient and himself, he will not operate on the patient.

Does insurance cover nose changes?

If there are breathing difficulites or a history of trauma, that aspect of the surgery may be covered  by insurance company.  However, aesthetic improvements are not covered.

Why should I chose Dr. Shah as my surgeon?

Dr. Shah has extensive experience in advanced techniques in all aspects of rhinoplasty.   He has written and published over 20 articles alone on the nose and nasal function.  He has  lectured on a local, national, and international forum on facial plastic surgery andrhinoplasty.

Dr. Shah is committed to creating a unique, nose specific for your face face and needs.  Dr. Shah's attention to detail is seen in every aspect of the surgery.  Dr. Shah has many examples in the office of a wide variety of noses which he has changed.

What are the advances in Asian rhinoplasty in the last several years?

Improved knowledge of dorsal augmentation has also changed, although embraced by a select number of surgeons.  Earlier efforts at augmentation would often augment the nasal bridge, making the bridge start at the level of the forehead.  Aside from overly augmented nasal bridges, Dr. Shah sees patients who have had infected nasal implants, extruded nasal implants, mobile nasal implants.   Nasal augmentation which starts to close to the nasal tip will lead to fullness and detract from the nasal profile.

In addition, many surgeons became preoccupied with the nasal bridge and have not addressed nasal tip position and shape adequately.  There is not one operation fits every patient mindset.  The nasal tip may
need to be lifted, projected, deprojected, made more symmetrical and midline, narrower, complete reshaped, etc.  A wide variety of advancedrhinoplasty techniques are required to accomplish the necessary aesthetic goals.

Global awareness of Asian beauty has dramatically changed the look desired by patients.  Earlier on, many patients and surgeons mistakenly tried to make turn every Asian nose into a Caucasian nose. This created many unhappy patients with unnatural results. The goal is to create a natural appearing Asian nose.

I want to change my nose but I still want to look Asian?

Dr. Shah will show a virtual image of your nose to help communicate what the surgical result will look like.  He also will show a variety of different noses which help demonstrate natural appearing results, specific to Asian culture and ethnicity.

Asian Male Rhinoplasty

Asian Female Rhinoplasty

Filipino Rhinoplasty

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Male Rhinoplasty
Asian Rhinoplasty
Revision Rhinoplasty
Auricular Cartilage Grafting in Rhinoplasty
Costal Cartilage Grafting in Rhinoplasty
Nasal Obstruction
Septoplasty
Open Versus Closed Rhinoplasty
Alar Retraction
Crooked Nose Deformity
Augmentation Rhinoplasty
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Indian Rhinoplasty

"The nose should fit the face"
A strong jawline would suggest a stronger nose.