Question: What are the most common changes you make when performing rhinoplasty in Asian patients and how do you make these changes?

Answer: Most Asian patients desiring rhinoplasty want a more significant dorsal profile and they want thinning of their otherwise relatively flattened wide tip. To accomplish this, I typically place a dorsal implant, which currently is a Gore-Tex-coated silicone implant that is placed over the bridge of the nose to enhance this area. I then take their own native cartilage from their septum and add it to the columella, which is the area of the nose between the nostrils and can thus advance and thin the tip and give them more projection of the tip, which means the tip will be further out away from their face and the combination of these 2 approaches will give them a very nice esthetic appearance.

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Question: Will I need to have someone stay with me at home after my rhinoplasty surgery and if so, for how long?

Answer: Most surgery centers or hospitals recommend that someone stay with the patient overnight if they have undergone general anesthesia or sedation, which you would if you had undergone a rhinoplasty procedure. So someone should stay with you for the first 24 hours and then you should be able to take of yourself.

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Question: I have heard about otoplasty procedures in the past, but was not exactly sure what they entail. What types of ear problems does otoplasty surgery fix?

Answer: Otoplasty for the most part fixes protruding ears or ears that stick out too far away from the head. There are subtle nuances, such as an overly large earlobe that can also be corrected and if someone has a malformed ear, but there is nonetheless a significant amount of cartilage to the ear then this can also be corrected through what would be considered an otoplasty procedure. If someone has an overly small ear or an ear that had not developed due to a birth defect, this would be considered a different type of procedure than an otoplasty.

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Question: A lot of surgeons seem to be against the use fillers for nonsurgical rhinoplasty. Why is this and are there every any times when it is a good option?

Answer: I think most rhinoplasty surgeons are against fillers for a couple of reasons. One being that the rhinoplasty surgery is a permanent result and will last a patient a lifetime, whereas the filler is typically a short term result, maybe a year or 2 and then will have to be performed again. Furthermore, the far majority of rhinoplasties I perform are on patients with a significant dorsal hump and widening of the nose in the tip and fillers can only add volume to a nose, where in those circumstances they really need removal of volume in their nose and therefore we are trying to create an optical illusion using the fillers and it is never nearly as effective as the actual rhinoplasty procedure. Furthermore, if certain fillers are used, this can create a complication of a reaction to the filler and this can be very difficult to correct depending on what type of filler is used. The times when I feel that a filler is good for treating a nose is in a case where a patient may have a very minor depression or irregularity in the nose and the filler does a really nice job of filling this area in and the depression really does not warrant a surgical intervention or this may even be after the patient has undergone a rhinoplasty and this is just to touch up a small area to give them the result that they desire.

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Question: Can fat injections be performed on the cheeks for added volume?

Answer: Yes, fat injections can definitely be used in the cheeks for added volume and it is one of the most common areas that I place fat in my patients. Fat injections overall work quite well and we can add quite a bit more volume than we typically would with filler injections due to the high cost of the filler compared to harvesting fat. Some of the fat; however, does disappear over time and we typically therefore add a little more fat than we would like in the area, expecting approximately half of it to dissipate over the first 6 months to a year.

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