Detailed descriptions of the ideals of columellar aesthetics and nostril shape are conspicuously lacking from the medical literature. Achieving an aesthetic nasal base is critical to an optimal rhinoplasty result. Deviations in the columella and variations in its width and height lead to distortion of nostril shape and frequently compromise function. Six types of columellar disproportion are presented with detailed explanations of how to treat each. By properly recognizing and addressing columellar deformities, the surgeon can optimize both the aesthetic and functional results that are achieved.
The cutaneous alar rotation flap is an effective and reliable surgical option to correct severe alar retraction. Advantages of this technique include a single-stage approach, ease of design, tissue match, and rich blood supply. Scar from the flap design can be kept inconspicuous by precise placement of the incision within the junction of the ala and the nasal dorsum, following principles of the aesthetic nasal subunits.
Within the past decade, Asian economies have grown exponentially, resulting in increased personal wealth and subsequent consumption of cosmetic procedures. Asian cosmetic surgery procedures in Western countries have also seen a growth pattern parallel to Asia. As this growth continues, facial plastic surgeons in Western nations will inevitably witness increased Asians in their patient population base. To meet this demand, the surgeon must incorporate a set of different aesthetic norms from the traditional Western philosophies. In addition, the plastic surgeon must also understand the unique cultural motivations for surgery. The Asian face has distinguishing features that are unique. As such, surgical techniques and aesthetic goals for a particular cosmetic procedure will be different than those for other ethnic groups. This article will review three of the most common cosmetic procedures unique to the Asian face: Asian blepharoplasty, lower facial contouring, and Asian rhinoplasty.
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