Q: I am Vietnamese and want a rhinoplasty. The rhinoplasty I would like to have done is a higher nose base (i think its call dorsal augmentation), have the tip more pointy (is that call narrowing?), as well as nostril reduction. I was also wondering if I need “nasal bone osteotomies”? And for a dorsal augmentation, please can you let me know what is the difference between a cartillage and a synthetic implant. And please if you could let me know the average cost of a rhinoplasty so I could have a better idea. I have attached a fromt picture of me for you to see what my nose looks like. Thanks so much!
A: Thanks for sending the picture. While its clarity is satisfactory, it is not a good image to judge the effects of a rhinoplasty. At the minimum, two facial views are needed…a front and a side view. A non-smiling front view is needed as smiling distorts the nostrils and makes them even wider. The effects of dorsal augmentation can not be seen at all in a front view and requires a side view to see that part of the result.
There is no question that what you are looking for in your rhinoplasty is dorsal augmentation, tip narrowing amd nostril reduction. These are very typical changes that are requested in rhinoplasties of your ethnicity.
The biggest decisiion to make in your rhinoplasty is that of the augmentation material for the dorsum. This is a classic debate between a synthetic implant and your own cartilage. Cartilage for your dorsal augmentation, due to the volume needed, would have to come from the rib. Your septum is inadequate for your dorsal augmentation needs. While there is no question that a small piece of rib cartilage is much better for you over your lifetime and will not give you any healing, infection or rejection problems, it is not appealing in a primary rhinoplasty to harvest it. This is why many such Asian rhinoplasty patients choose a synthetic implant even though there are higher rates of long-term problems with them.
Nasal osteotomies means cutting the base of the nasal bones to try and narrow the broad width of the upper part of the nose. With an adequate dorsal augmentation, this would not be necessary as when the dorsum is built up it makes the base of the nasal bones look more narrow.
The average cost of a full or more complete rhinoplasty, all fees included, is in the range of $ 6500 to $ 8500.
Dr. Barry Eppley