Asian Cosmetic Surgery
Asian Double Eyelid Surgery
Asian eyelids differ in that the skin is thicker and often contains more fat. This in combination with the shape of the orbit results in eyelids that have almost no eyelid crease show and minimal opening.
Double eyelid surgery or Asian eyelid surgery involves the creation of an eyelid crease. This crease is lower than in Caucasian patients and can be done by two main methods, incisional and non incisional Asian eyelid surgery.
This involves an incision in the eyelid to create an adhesion and eyelid crease. The technique is similar to a Caucasian upper eyelid procedure whereby the incision is placed at the desired location of the eyelid crease. Tarsal fixation and a controlled cicatrix (scars) are made to create a skin eyelid crease or fold.
This approach also allows removal of skin and excess fat to open the eye up. The adhesion or crease is created with sutures that extend from the tarsus to the orbicularis muscle and skin.
This procedure is appropriate for all age groups.
Is a faster Asian upper eyelid technique for the younger patient where excess skin is not an issue. This involves the placement of tarsal sutures without an open incision. Small incisions are only made for the placement of sutures.
As part of the differing anatomy of an Asian eyelid, many patients have epicanthal folds that are folds of skin that protrude between the corner of the eyes and nose. This is a typical feature of an Asian upper eyelid medical canthus area.
Patients may wish to minimise the hooding and this is achieved with a complex Z-plasty that aims to smooth the transition between the upper eyelid skin and internal nasal skin (medical canthus).
Asian Double Eyelid Surgery
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An Asian Rhinoplasty aims to augment the nasal bride, tip and narrow the alar base. This specifically addressed the Asian nose morphology which consists of a wide unsupported tip and flat bridge.
The principles of Asian Rhinoplasty are similar to any Rhinoplasty and include proportions, structural engineering and artistry.
Augmentation of the Bridge
The gold standard is to use the patients own cartilage (ear or rib) to create a graft that will augment the bridge. The amount of cartilage to augment the individuals bridge is pre-determined by using a x-ray template and, a piece of cartilage is then sculpted to resemble the nasal bridge that aims to correct the flatness of the nose. The cartilage can be one piece wrapped in fascia to smooth the graft or in multiple pieces rolled up in fascia like a cigarette. This represents a diced cartilage graft. The end goal to augment the bridge.
Other options include use of “off shelf” silicone implants to augment the bridge.
Augmentation of the Tip
Cartilage graft harvested for the bridge is also used as traditional Rhinoplasty grafts to augment the tip. Cartilage grafts are fashioned into spreader grafts that extend to the septum (Septal Extension Grafts) which attach to a columella strut. The grafts are shaped and positioned to rotated and increase the tip projection. On-lay grafts can be used for further augmentation.
Alar Base Reduction
The wide alar base of an Asian nose can be narrowed in width and height. Through a careful excision of skin and fibrofatty tissue at the junction of the cheek and lateral nostril (alar) the alar base width is reduced in size.
Non Surgical Asian Rhinoplasty
The bridge and tip can be augmented with Filler for those that want an office based solution that is temporary. Many patients opt for this approach for a few years before embarking on more a permanent surgical solution. Injections in the nose require the experience of an expert