An approach to aesthetic rhinoplasty in the non-caucasian nose

The problem of augmenting the nasal dorsum and columella in the exaggerated Negroid or Oriental nose is presented. Augmentation of the nasal dorsum is routinely performed using polyamide mesh. The lengthening and lowering of the short and sometimes retracted columella and narrowing of the alar bases is performed by making a columellar splitting incision and extending it along the alar sills. A septal cartilage graft is sewn into the new columellar space, and the alar sills are advanced into the columella, thereby lengthening the columella and changing the axis of the nares. The columellar advancement is done after the dorsal implantation is performed, and the projection of the tip is advanced to whatever amount necessary to aesthetically match the dorsal profile line.