Oriental Nose Occidentalization and Perinasal Shaping by Augmentation of the Underdeveloped Anterior Nasal Spine

Abstract

Background:Augmentation of an underdeveloped anterior nasal spine (ANS) occidentalizes the Oriental nasal shape. The objective of this study was to investigate the effect of ANS augmentation using an injectable filler, assessing volumetric changes with 3-dimensional images and measuring 2-dimensional images.Methods:Forty Japanese patients were treated and evaluated before and after the augmentation. Local anesthetic was injected on the ANS for analgesia. To augment the underdeveloped ANS, approximately 0.5–1.0 ml of calcium hydroxylapatite filler was injected between the medial crura footplates and the ANS. Two-dimensional measurements and superimposable 3-dimensional volumetric assessments were performed pretreatment and 7 days posttreatment. Patients rated their satisfaction using a 5-point scale.Results:A significant decrease in nasal width and nostril axis inclination and an increase in nasal tip projection and columellolabial angle were observed by 2-dimensional measurements. Superimposable 3-dimensional color images reinforced the results of the 2-dimensional measurements and showed volumetric soft-tissue changes in the nasal and perinasal areas and the lower cheeks. Ninety percent of the patients were either “satisfied” or “very satisfied” with the results. Posttreatment traction pain and edema resolved in 5 days. Side effects such as hematoma, nodules, and skin necrosis were not observed.Conclusions:Objective assessments showed significant effects of this treatment, with good patient satisfaction and minimal levels of discomfort and side effects. Together these results demonstrate that this treatment is safe and effective for Oriental nose occidentalization and perinasal shaping and is also useful for predicting rhinoplasty results.

Safety and early satisfaction assessment of patients seeking nonsurgical rhinoplasty with filler

“…Consequently, the amount of HA to be injected to remodel the dorsum will be less; only at the end, the tip is injected to create the suvra tip break. The same issue, however regarding nose occidentalization, has been already reported by Tanaka[ 5 ] regarding Oriental nose occidentalization by augmentation of ANS. The author reported how also in aging Western patients, a drooping nasal tip can occur secondary to atrophy of the underlying bone support and, at the same time, a relative dorsal hump can be resolved only by injecting above ANS.…”

“…Several articles regarding Asian nose augmentation with fillers have been published;[ 3 4 5 ] however, in Western countries also, the so-called “nonsurgical rhinoplasty,” often called “rhinofiller,” is often performed although with different end points.…”

Reshaping of the Anterior Nasal Spine: An Important Step in Rhinoplasty

“…In these cases too, careful analysis can reveal hypoplasia of the ANS as the primary cause. 16 Use of the lateral crural steal procedure combined with a tongue-in-groove technique or the insertion of a robust columellar strut is sufficient to eliminate the deficiency of the nasal spine and give the tip the correct degree of projection. Unfortunately, in cases where this underprojection is due to a very severe deficiency of the ANS (as in the Binder syndrome), the surgical procedures described above prove insufficient and something else is required.…”

Premaxillary Deficiency: Techniques in Augmentation and Reconstruction

“…25 The increased use, and corresponding experience of physicians, has resulted in the utilization of fillers for continually evolving indications. [26][27][28] The use of injectable filler such as hyaluronic acid, calcium hydroxyapatite, autologous fat, or collagen have become increasingly used in correction of premaxillary deficiency.…”