Asian Rhinoplasty in Korea When the Nose Needs Length

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A plan is drawn from the face in front of the surgeon, not from a reference photo. Preferences differ widely between people and cultures, and a good consultation asks what you want kept as well as changed. The points below are measured from the side and from below.

No single number defines a good nose. The measurements show how the parts relate to each other and to the forehead, lips and chin, so one bridge height can suit one face and look heavy on another.

Height can be added under the skin fairly easily; length is harder because the skin, lining and scar must stretch to cover a longer frame. A graft fixed to the end of the septum pushes the tip down and forward, and the soft tissue must hold that position.

Thicker skin, which is common in many East Asian noses, is less elastic in some people and hides fine detail. Surgeons therefore aim for a modest change in length and judge the outcome only after swelling has settled, which can take a year or longer in thick skin.

A contracted nose is one that has shrunk and lifted after inflammation, infection or heavy scarring, often around an old implant.

Repair usually means removing the implant and scar tissue, releasing the lining and rebuilding the frame with cartilage, because a new implant placed into the same scarred pocket risks repeating the problem. When infection was involved, surgeons generally wait until the tissue has calmed down before rebuilding; the waiting period is set case by case.

• Shorter nasal length than before the first operation
• Tip rotated upward and nostrils more visible
• Firm skin over the tip that moves little
• History of redness, discharge or implant removal

When the septum has already been used or is too small, and a patient prefers not to have rib cartilage taken, some surgeons use irradiated homologous costal cartilage: rib cartilage from a donor, processed and sterilized for grafting. It avoids a chest scar but is not the patient's own tissue.

In a 2013 study in the Annals of Plastic Surgery, Suh and colleagues followed 30 Seoul patients with contracted noses for more than two years after donor cartilage was used as a septal extension graft. In the Suh study, nasal length rose by an average of 8.5% and was maintained at two years, with no noticeable warping or infective absorption. Three patients needed revision: two for graft fractures and one for mild blockage. The authors called for longer follow-up.

Lengthening and tip support often use septal cartilage, and the septum also holds the airway open. Taking too much, or fixing a long graft off center, can narrow one side. A careful plan tests airflow first, records any blockage and states whether septal work is for function, support or both. Mention allergies, snoring or a past nose injury.