Beverly Hills Rhinoplasty Surgery Blog

Plastic surgery today has become widely accessible and more socially acceptable. The result has been a much wider public understanding and acceptance of plastic surgery across the spectrum, including the various ethnic populations that make up the world and, particularly, the United States. As a result we see patients from around the world that make up almost any ethnicity one could think of. The key to good outcomes for all of these patients is an individualized approach that seeks to identify the nose that would best suit each person’s unique face. In general, the traditional “reduction” rhinoplasty that is done for Caucasian patients is usually not best for many ethnic patients who have thicker skin, but for us this does not mean that the costs for this surgery needs to be more. Occasionally, anesthesia costs or facility costs may be higher, simply because it may take longer to harvest needed cartilage to build the bridge, but the difference in fees from standard rhinoplasty is generally nominal.

Is there a possibility that you may someday be able to have your botox without the annoying needles? According to one ongoing study, it may just be. Granted, the study looking at the effectiveness of a topically-applied botulinum gel, has only just finished a phase II clinical trial. But, the study’s lead investigator, Dr. Michael Kane, has reported that a large number of participants showed positive results. The final answer on this interesting question is not in, but we’ll keep you posted on this potential new formulation as we hear more.

We have recently heard from a couple of prospective patients who are concerned about having open rhinoplasty to narrow the tip and a nostril narrowing procedure (alar base reduction) at the same time. They had been to see other surgeons who had advised against this because of fear of risk to the blood supply of the nasal tip.

Quite frankly, we were a little surprised by this recommendation. The beauty of surgery is that it is not an exact science and there are many ways to arrive at the desired goal. However, the concern that tip rhinoplasty and nostril narrowing, when done together, might compromise the blood supply to the tip skin is really unfounded. In fact, most surgeons who make rhinoplasty a focus of their practice will tell you that they routinely perform these procedures together without issue. That has been our experience.

Some surgeons also advocate waiting to do nostril narrowing as a second procedure so that they can better assess how much narrowing is needed. To the contrary, we have found that we can very readily assess at the time of the initial tip work how much nostril reduction is needed if at all. To our minds, the initial surgery is the best time at which to make these desired changes to create a tip that is balanced and harmonious by reducing nostril width, flare, and asymmetry. We leave this part of the procedure to the very end so we can best determine how much nostril width and flare is still an issue after the other tip enhancements have been achieved. In experienced hands, the minimal swelling that occurs during surgery is not a factor.

There’s no real harm in waiting, of course, other than having to go through a second procedure later on. It can be done fairly easily under local anesthesia. In rare cases, when we feel that someone is very borderline in terms of need for nostril narrowing, we’ll wait. We almost always find later on that indeed it was not necessary. But, our overriding philosophy is that we want our patients’ first rhinoplasty with us to also be the last time they need anything done for their noses. So, when alar base reduction would be beneficial, we want to take care of it at the same time.

There was an interesting article in Science Daily reporting on the preliminary results of a combination therapy of LED lights and a cream with Green Tea Extract. LED lights have long been used for phototherapy to help heal any number of inflammatory skin conditions.

However, LED exposure, like any light energy exposure can also increase the production of free radicals that can injure the skin. Green tea was added to the mix because it contains a potent antioxidant that combats this harmful effect. The results? According to the German study, the same level of wrinkle improvement occurred in only one-tenth the time it took when treated with LED light alone. This underscores the importance of addressing inflammation and free radical injury as part of any effective anti-aging regimen.

We often see ethnic patients wanting a more defined nose. Many ethnic noses tend to have thicker skin. Achieving the definition, narrowing, and refinement you desire has everything to do with how that thick skin wraps around the cartilage structure underneath. If the cartilage structure is well-defined and well-supported, you can achieve excellent definition. If the cartilage lacks shape, your tip will look the same- bulbous, wide, full, and lacking in shape. On top of that, ethnic patients often have a thicker layer of tissue under the skin that lays on top of the tip cartilage. In these cases, it is necessary to carefully ‘thin out’ the thicker pad of tissue under your skin so that the newly-defined cartilage can show through.

Ethnic rhinoplasty depends more on cartilage grafting (using your own cartilage to create definition where it is lacking) than does traditional rhinoplasty. So, you should see a rhinoplasty expert who has experience in ethnic rhinoplasty to ensure your chances at a great result. We have found that a combination of tip cartilage suturing/grafting and soft tissue thinning, along with augmentation of your bridge and nostril narrowing, if required, can produce a beautiful and natural result. You’ll see some examples of the results you can achieve on our website.