Rhinoplasty: Chinese vs. Western version

Rhinoplasty is the name given to the surgical procedure to improve the appearance of the nose. It is one of the most common plastic surgery operations in both China and the Western Hemisphere. Next to the eyes, the nose is the most important focus point of the face. If the nose is significantly out of proportion with the rest of the face, it then becomes an unattractive focus of attention.Although the techniques vary, the goals are the same in the Asian and Western Rhinoplasty.

Asian women do not like the appearance of a flat nose.

The nose should be harmonious in relation to the eyes and mouth, not too wide, and relatively straight from front and profile.

Smaller dorsum vs. larger dorsum

The goal of the nose procedure is the same in China and the West: to make the nose more attractive and harmonious with the face. However, the surgical techniques are different because they address different problems. For example, in the West, it is very common to make the dorsum of the nose smaller, whereas in China it is very common to use a silicon insert to make the dorsum bigger. Why is this? What is considered “attractive” may be different in China than in the west. This is true of the feminine facial profile, where in China the ideal is a more delicate oval contour. In the west, more pronounced angles at the chin and jawline are preferred.

In the case of the nose, the ideal seems to be very similar. The dorsum of the nose should not be too broad when viewed from the front, and relatively straight when viewed from the side. The nasal tip should be narrow enough to be in harmony with the dorsum when viewed from the front. From the side, Westerners prefer the tip to be slightly turned up.

Bump in the nose vs. a flat nose

In practical terms, for a Westerner, a Rhinoplasty usually means taking the bump out of the nose, making it thinner, and making it look straight from the side view. The Asian nose usually does not have a hump, but instead tends to be flat in appearance. Thus Asian patients ask for more projection. Surgeons enhance the nose by augmenting it with a silicon insert to get it to look “straight” from the side view. This enhancement eliminates the flat look.

When the nose is remodeled with a silicone insert, the nose look thinner. Surgery of the tip is also different because in the western patient one has to reduce the size of the tip cartilage and put sutures in it to narrow the shape. When using the silicon insert in the dorsum, the tip is usually pulled up and the shape of the nostril is refined as it becomes narrow and taller. In a few cases the tip cartilages may require sutures, but usually the procedure is simpler than in the western nose.

Rhinoplasty recovery time

Because of differences in the skeletal structure, the techniques used in China and the West are different. The Asian techniques do not require surgeons to separate the bones. For the Chinese patient, this usually means a simpler, less invasive procedure with quicker recovery times and less postoperative swelling. The Chinese technique also requires less sedation. Accordingly, the Rhinoplasty is much more commonly performed in China than in the West.

Surgical result of the Rhinoplasty

With either technique, the nose should be harmonious in relation to the eyes and mouth, not too wide, and relatively straight from front and profile. When done correctly, it has a dramatic impact in the whole facial appearance of the patient. After surgery, it is not uncommon for a patient to say “This is the nose I should have been born with!”.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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