Revision rhinoplasty of Asian noses: analysis and treatment.
OBJECTIVE
To analyze postrhinoplastic deformities in Asian noses and the differences between noses of white and Asian patients. For a successful revision rhinoplasty, one of the most difficult and unpredictable procedures in plastic surgery, an accurate diagnosis and analysis of error are needed.


METHODS
A retrospective study of 84 revision rhinoplasties performed by the senior author (C.H.P.) from January 2001 through December 2006.


METHODS
Tertiary care rhinology clinic.


METHODS
The study population comprised 84 patients (28 men and 56 women), with a mean age of 36 years (range, 20-58 years).


METHODS
The postrhinoplastic deformities were divided anatomically into the upper, middle, and lower thirds of the nose with further subdivision of the deformities within each group.


RESULTS
In the 84 patients studied, the mean number of rhinoplasties per patient was 2.3. Of the 84 patients, 75 (89%) underwent revision rhinoplasty for upper-third deformities. Overall, deviated dorsum was the most common deformity, followed by irregular dorsum and asymmetric tip. Most of the upper-third deformities were treated with a rasp, camouflage graft, and expanded polytetrafluoroethylene (Gore-Tex; W. L. Gore & Associates Inc, Flagstaff, Arizona) augmentation. To correct lower-third deformities, mostly tip problems, we used transdermal and interdermal sutures.


CONCLUSIONS
In Asian noses, unlike noses of white patients, the most common cause of revision rhinoplasty is upper-third deformities. As most upper-third deformities in Asian noses result from inadequate insertion or dislocation of the augmentation graft material, we must be careful in our selection of implants and augmentation.
Park
Chan Hum
CH
Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, 153 Gyo-dong, Chuncheon, Gangwon-do, 200-704 South Korea. hlpch@paran.com
Kim
Il Woo
IW
Hong
Seok Min
SM
Lee
Jun Ho
JH
D000328:Adult; D044466:Asian People; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*