Archive for the ‘Asian Cosmetic Surgery’ Category

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Best implant in the nose Goretex, silicone for the Asian Patient

Thursday, July 16th, 2009

Goretex implants for Asian Plastic Surgeryare usually made out of sheets and are formed by the surgeon to fit the nasal characteristics of the patient.  Goretex is made up of fibrillated polymer of polytetrafluoroethylene with pore sizes in the range of 22um which allow limited tissue in growth. It has been determined that pore sizes between 1 and 50 um (micrometers) will allow bacteria to get into the pores but not tissue ingrowth to fight off the bacteria.  Hence pore sizes between 1-50 um are not supposed to be good.  But there are a lot of surgeons that have used gore tex in the nose without a lot of problems and it has a proven track record in the nose.  It is a soft implant and allows the tissue to fixate the implant for a more stable feel.  Theoretically the chance of extrusion or rejection of these implants versus silicone should be higher and some studies show that is the case but the chances of this is still pretty low.  I have a good colleague that is very well known and totally believes this is the best implant to use in the nose.  I however based on experience and knowledge of different products believe that silicone is the best implant for the nose during Rhinoplasty.  It is the most compatible of all implants and has a lot of characteristics that come close to the ideal implant.  It allows limited tissue ingrowth but is very stable. Some people believe that the implants allow to much movement, are not as stable, and can look unnatural.  There are ways to fix the implant to the deeper structures that make the implant feel as if it were bone in certain places such as in the nasal dorsum/ bridge.  The silicone implant can also be placed within the tip in a judicious way to augment the tip, raise it and shape it with great success.  The alternative to this is to harvest cartilage from the septum or ear with the drawbacks of these areas. Septal cartilage is sometimes sparse in the asian nose and ear cartilage is often times too flimsy and curvy for the nose. Rib cartilage is sometimes the best natural alternative for the bridge and all the other areas an Asian nose might need.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Asian Cosmetic Surgery, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Best implant in the nose Goretex, silicone for the Asian Patient

Will an Asian Surgeon be better suited to treat the Asian Client?

Wednesday, July 15th, 2009

Race doesn’t necessarily matter but you want someone that understands the Asian Patient and the nuances that this patient presents.  Knowledge of what Asian patients desire and the ability to communicate with them is the challenge.  Many Asian patients today desire to maintain their ethnicity with Asian Blepharoplasty.  This should mean something to the Surgeon doing the procedure and how to do this surgically is very important.  I see many Asian patients that go to Asia to get plastic surgery and they at times come back disappointed.  Hence going to an Asian doctor is not necessarily a cure all.  You have to go to a doctor that has the repertoire of skills that can treat all conditions that Asians present.  Some questions that will need to be answered when discussing Asian blepharoplasty include how high they want the fold, whether the fold should be inside or outside the epicanthus, whether the fold laterally should be parallel or ride higher, whether the epicanthal fold will be dealt with, etc.  Here is video on Asian Blepharoplasty and Medial epicanthoplasty.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Asian Cosmetic Surgery, Asian Double Eyelid Surgery / Asian Eyelid Surgery | Comments Off on Will an Asian Surgeon be better suited to treat the Asian Client?

Rhinoplasty or nose reshaping just by working with the skin?

Monday, July 6th, 2009

The question was whether you could just do surgery with the skin of the nose to change the appearance of the nose:

You can remove the skin around the sides of your nose by your nostrils to make them look less wide in this area. But if you want to make the tip smaller and the nasal bridge smaller, it will take a formal rhinoplasty. This at times will entail breaking the bones to narrow the bridge. Thicker skin near the tip area of your nose makes a little harder to narrow the nasal tip.  Some people reduce the skin from the inside to make the tip more refined, but this is not a safe procedure many times especially when your nose is done in an open fashion.

An open rhinoplasty entails making a incision under your nose to elevate the nasal skin envelope to directly work on the nasal structure under direct vision. Asian rhinoplasty / cosmetic surgery is unique and you should go to someone who has experience with the Asian nose.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Asian Cosmetic Surgery, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Rhinoplasty or nose reshaping just by working with the skin?

One eye smaller after blepharoplasty

Friday, June 26th, 2009

This is a question that I answered for someone who had a procedure by another physician.

There are many reasons why one eye would be smaller than the other. Swelling can be the most likely reason. No matter how well you do the surgery, you cannot control swelling sometimes. The body is a complex thing and many reasons could account for why one side is more swollen than the other after blepharoplasty.

Another probable cause is sometimes, manipulation of the muscle that opens the eye could have caused it to be temporarily tired. This could take months to resolve. Sometimes, if your surgeon has attempted to recreate your crease, there could by many more reasons for your eyes to look differently. This would depend on just what was done. You will have a tired eye just from the manipulation when you recreate the crease in double eyelid blepharoplasty which is done often in Asians.

Sometimes, when you create the crease too high on the muscle, it could tether it coming up and effect the movement of the muscle. You would really have to be seen by your physician to determine just what is going on. But wait it out for now and I wouldn’t worry about it until at least a month.

Dr Young is located in Bellevue near Seattle Washington

Posted in Asian Cosmetic Surgery, Asian Double Eyelid Surgery / Asian Eyelid Surgery, Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags | Comments Off on One eye smaller after blepharoplasty

Crooked nose after Rhinoplasty?

Friday, June 12th, 2009

This is a question that I answered for someone who had a procedure by another physician.

Crooked nose after Rhinoplasty can sometimes be due to swelling.

Asymmetry with Asian implant rhinoplasty in Seattle is one of the most common complications with this type of surgery.  I believe that it has to do with the approach and the fixation that is used to keep the implant in the middle and not asymmetric. Because it was your second time, there was likely a lot of scarring in your nose from the previous procedure. This can leave scar tissue that can serve as an impediment for a straight result.

Another reason for the asymmetry can be due to inherent asymmetry in the nose. An asymmetric nose will like remain asymmetric unless additional procedures are done to straighten the nose along with the implantation of your nasal implant. The crooked nose is one of the most difficult rhinoplasty cases out there.  Although unconventional, I prefer to do all implants through an open approach.  This allows me to clear scar tissue, open the nose and assure that the plane is correct, ensure that the implant is in the middle and lastly I can fix the implant in the middle with sutures.

Typically I fix the nose to the septum near the bone and septum junction and a point lower than that and then I secure the implant to the lower part of the nose and tip at a total of 4 different locations.  This helps cut down on variables that can lead to asymmetry after rhinoplasty. Learn more about Asian Cosmetic Surgery from a Board Certified Facial plastic surgeon in Bellevue.

Posted in Asian Cosmetic Surgery, Procedures, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Crooked nose after Rhinoplasty?

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