[By Theresa Ho— A 3-way between the expert, the patient and the Nosy Parker]
Asians have long coveted the more defined nose of our Western counterparts and in the past decades, there has been a surge in the number of nose jobs or rhinoplasties performed in Asia in a bid to achieve better looking noses that are more coherent with the current standard of Beauty. Having said that, have you ever wonder why some enhanced noses like those sported by the Korean popstars look amazingly natural while others come across as close cousins of Pinocchio or Punch & Judy? With that in mind, RSB had a 3-way convo with plastic surgeon, Dr. Tan Ying Chien with the SW1 Clinic (formerly from The Sloane Clinic Plastic Surgery Centre @Novena) and real time patient, Ms. Chloe Lai, to find out more about what it takes to transform a typical flat bridge, flared tip Asian nose to an aesthetically pleasing one.
RSB: Hi Chloe, I wouldn’t have guessed if you didn’t let the cat out of the bag! Great job, Dr. YC! Now tell me Chloe, what were your hopes and concerns before the procedure?
Chloe: Thank you, Theresa!
It’s very natural looking, isn’t it? Well to begin with, that was my main concern, that the surgery won’t give me a nose that looks obviously fake even from a mile. There’s a lady working in my same office building and she was nicknamed “Eiffel Tower”. I certainly wouldn’t want that to happen to me! I mean, I’m not too shabby to begin with (*shy smile) but my naturally big eyes and flat, broad nose really restricted the kind of “looks” that work for me. It’s disappointingly frustrating as I like fashion a lot. A broad nose limits the kind of hairstyles that’ll look good on me and without a decent nose bridge, I could never strut around in Jackie-O style sunnies without having to push them up every so often as they slipped! I could do ‘pretty’, ‘sweet’ and ‘kawaii’ but never sexy, edgy or femme fatale.
RSB: So Dr. YC, can you share with us what are the flaws of Chloe’s old nose that many Asians are concern with?
Dr. YC: Thanks for having me, Theresa.
Looking from the bottom up, the nostrils of the Asian nostril appear more rounded compared to the tear-drop appearance of the Western nose, projecting a wider nose with a broad base.The cartilages of Asian noses are smaller, weaker and softer, such that they tend to have a more oblique to vertical lie, creating the flatness effect. The challenge is to create a higher nasal bridge with more tip projection and narrower alar bases, whilst retaining the Asian ethnicity look without overt “westernization” of her features. Taking into account the anatomical differences, this means that a surgery that works for the Caucasian may not be the most ideal one for the Asian nose.
RSB: I see…. Can you elaborate on the different approach, Dr. YC?
Dr. YC: A great option for many Caucasians and some Asians who already have a relatively nice nose to begin with, but want it higher, will be a simple, straight-forward L-shaped silicone implant. Also known as Simple (or closed) Rhinoplasty, this is a relatively easy procedure whereby the implant is cleverly inserted via a small incision through the nostril to help elevate the nose bridge and tip.However, this option won’t give the best outcome if there are other flaws such as a broad base with flare nostrils that need correction.
If this method is used for Chloe’s case whereby her nose was already short to begin with, there will be tenting of the overlying skin in order to achieve satisfactory height, leading to the much dreaded “wooden puppet nose”. In addition, the nostrils which were not surgically re-fashioned might even end up looking more exaggerated and unpleasant in their new position. With such cases, the whole architecture of the nose will need a delicate make-over with a multi-step surgery such as the Hybrid Rhinoplasty, specially designed to incorporate the expertise and techniques perfected by the Koreans, will help Asian noses achieve ultimate refinement and proportion.
RSB: Interesting! Can you tell us more about what is done during surgery?
Dr. YC: Hybrid Rhinoplasty is a total nasal makeover that will not only give height but also push the “hidden” columellar (the middle of the nose perpendicular to the lips) downwards for a more ideal nasal side profile. This is achieved by harvesting the patient’s own ear cartilage to create a more beautiful and natural looking nose tip which won’t result in tenting as opposed to an inaccurately-sized implant. The nose bridge is also gently enhanced with the use of a customized implant to elevate and define the nasal structure. Finally, to perfect the 3-dimensional picture, the base of the nose can be reduced with alar revision, so that the nose is optimized to the ideal width and height to strike a balance with the other facial features such that it’ll suit the candidate in the best possible way.
RSB: So Chloe, how did this work out for you?
Chloe: At first, I was only prepared to do a simple rhinoplasty cos an open rhinoplasty just sounded so major! But after a very detailed consultation with Dr. YC, I realized that the Hybrid Rhinoplasty was certainly what I needed in order to achieve the kind of results that I’m after. The surgery itself took 3 hours but when I was unconscious under sedation, it felt as if I just took a very sound short nap, definitely no horror stories such as being able to hear what was going on around you but unable to move or vocalize!
Surprisingly, I felt very normal with much less pain, swelling and discomfort than I’d expected. After putting a face mask on over a nose guard which was applied post-surgery, no one even seemed to notice that I have had something done!
RSB: What was the recovery like? Were you looking like an abused wife?
Chloe: (LOL) Yeah, that was pretty much like what I had imagined it to be but it turned out much more bearable and not half as bad as what others made it up to be. Believe it or not, I was back at work the very next day, but if you are conscious with wearing a nose guard in public, than it’ll probably be wise to wait for 5 days till the stitches are all out. I could go about my normal activities without difficulty. The only important thing is to be very gentle with your face and nose, taking care to keep the nose guard dry. There was never much pain and I didn’t need much of the painkillers Dr. YC prescribed me post-op. The swelling was manageable and I could breathe normally… maybe a tiny bit harder if I want to take in deep breathes. The bruising I experienced was the yellowish type, not those awful deep purplish ones nor panda eyes that many people tend to associate nose jobs with.
RSB: What are the challenges you faced post-operatively, Chloe?
Chloe: The biggest obstacle, for me, was trying to keep my nose dry. For the first 3 days, I did not even dare to wash my face, and kept it fresh and clean by using facial wipes. Washing my hair was a real challenge, which I attempted on the 3rd day as well. I had to make sure my face was kept dry and got the DH to hose my hair down away from face… a terribly unglam reenactment of the famous scene between Meryl Steep and Robert Redford in ‘Out of Africa’ (giggles). Other than washing up, I really didn’t experience any other inconveniences that bothered me!
RSB: Dr. YC, would you say that Chloe’s experience is just about what one would expect from Hybrid Rhinoplasty?
Dr. YC: Yes, the downtime experienced with Hybrid Rhinoplasty is very bearable for the majority. The new nose got to be kept dry till the stitches are removed on the 5th post-op day. Despite the swelling, you can see that Chloe’s nose was already looking a lot better than before, with a gentle elevation of the nasal spine and a narrower and more refined tip. She will continue to improve over the next few weeks as the swelling gets progressively less, with the final shape falling in place in 3 months’ time.
RSB: Did the results meet your expectations, Chloe?
Chloe: All I can say is that I couldn’t have asked for more! Frankly speaking, when I looked into the mirror those 5 days before the nose guard was removed, I at times questioned myself if I’d made the right decision. But now, looking like an ‘improved’ version of myself and not someone radically different, the only question on my mind is, “Why didn’t I get this done earlier?”
This selfie here was taken barely a week after I had my nose done when I attended a girlfriend’s hen night which had totally slipped my mind. I was initially half-hearted about this, but after getting dressed, makeup and all, I was actually quite excited and looking forward to my first social engagement post-surgery! The tiny C-shaped cuts made along the natural curvature of the corners of the nose healed remarkably well and were a faint pink color easily camouflaged with a tad of concealer. Dr. YC assured me that they will continue to improve in appearance over time and will be close to invisible in a couple of months. In any case, if the scars aren’t satisfactory looking by then, they can be easily improved with V-Beam Perfecta laser treatment.
RSB: I’m sure you received tons of compliments at your debut outing! Thanks for taking time off to share your experience with us. Any last words for our reader, Dr. YC and Chloe?
Dr.YC: As far as rhinoplasties are concerned, it is not a ‘one surgery fits all’ situation. I cannot emphasize enough on the need to have a detailed pre-operative consultation between doctor and patient to discuss about the needs and expectations. Be open to ideas and suggestions but make your decision wisely without being made to feel like you’ve been ‘cornered’ or ‘pressurized’ to do so.
Chloe: Before I leave, I would love to thank Dr.YC for making me beautiful! It is indeed my luck to have him operated on me. He is so caring and humble and really took time to answer my thousand and one queries (including things like when can I squeeze the blackheads on my nose? Should I really avoid seafood for the wound to heal well?). If a simple rhinoplasty can’t tackle all aspects of your nasal makeover, do not be put off by open surgery and explore options with a licensed and experienced practitioner. If budget is your concern, I would rather you save up for the best, rather than go through a cheaper, sub-optimal correction that’ll require one or more revision surgeries at a later date with no promise of definite satisfaction!
Chloe is 27, and a mother of one adorable little girl and a tiny Yorkshire terrier. She enjoys cooking, singing and is a self-confessed Hallyu or Korean pop culture lover from music to TV to fashion and food.
If you too would like to sniff out the real deal and learn more about the different types of nose jobs, Dr. Tan Ying Chien formerly from the Novena Plastic Surgery Centre of The Sloane Clinic and currently heading the Plastic Surgery wing of the SW1 Clinic can be reached here for his professional advice on how best to do it!