The archetypal Asian nose discussed in this chapter is typified by
the Asian Malay nose or the East Asian (Chinese, Japanese and Korean)
type of nose. There is indeed a spectrum of these noses, with
northerners e.g. from north China and Korea having higher dorsums
compared to their Asian southerners with lower dorsums. The Asian nose
primarily discussed here is typified by petiteness and flatness. The
overall mid-facial bony components and nasal septum can be thought of
as being "underdeveloped". Hence the radix tends to low with a low
rhinion and low mid-third dorsal profile height. The shorter nasal
septum with a less projected anterior septal angle results in a nasal
tip that lacks projection. A less projected tip, in turn, is more
rounded with less tip definition. There usually is also relatively
thicker skin overlying the nasal tip and lobules. The ala basal width
is also wider.
From the basal view, the nostrils of the Asian
nostril appear more rounded compared to the tear-drop appearance of the
Western nose. This is due to the lack of projection. The columella may
appear short and retracted, lacking support from the caudal septum.
Internally, the cartilaginous septum of the Asian nose is generally
less generous which explains the deprojected tip; this smaller size
will impact upon the availability of septal donor material too. The
medial and lateral crura of the lower lateral cartilages are smaller,
weaker and softer than Caucasian noses, and tend to have a more oblique
to vertical lie. The upper lateral cartilages are similarly small in
size too.
Overall the description of the Asian nose is one of
petiteness and flatness. Asian clients seeking rhinoplasty therefore
not surprisingly request for higher radixes and dorsums with more tip
projection and narrower alar bases. The contemporary trend is to request
for augmentation and tip projection whilst retaining their Asian
ethnicity.
In a small sample study by the authors at The Chinese
University of Hong Kong, nasal pictures of Chinese male and female
individuals were evaluated to determine their aesthetic outcomes. These
subjects with a group of independent local Chinese male and female
judge observers, were requested to freely simulate with computer
software, the nose they would wish to have. There was notable agreement
and concordance on the final nasal profile simulated i.e. everyone had
the same aesthetic endpoint. What this sample work demonstrated was,
whilst all these Asian clients and peer judges preferred higher radixes
and dorsums with greater tip projection, the measured parameters
differed significantly from accepted Western aesthetic references (see
Figure 1 - Graph of Asian aesthetics). This suggested that even though
Asian individuals wanted a pointier and higher nose, they wanted to
retain their "Asian" sense of aesthetics.
With
this in mind, the following subchapters discuss in more detail the
commoner techniques for Asian rhinoplasty surgery. The discussion below
is not intended to be comprehensive due to surgeons' preferences, the
wide availability of products and techniques. Readers should instead
focus on the underlying principles to permit a more flexible practice
of Asian rhinoplasty, as this field and product technology develops.
The
information aims to provide educational purpose only. Anyone reading it should
consult ENT Specialists before considering treatment and should not rely on the information
above.
