3 demonstrates profile and basal views of the nose after on-top augmentation with a silicone implant. All the structures below the roof, including doors and windows (comparable to nostrils), are proportionally deformed. Often, the augmented roof is too heavy, and the framework of the house is not able to bear the weight. The whole new house is tall, but the old doors and windows (comparable to nostrils) are still low and short. Undoubtedly, it makes a house taller, but the whole house looks strange or unnatural: The new “on-top” house and its components are disproportionate. 2A demonstrates the effect of on-top augmentation to a house, compared with the ideal house ( Fig. 2A) we call this “on-top augmentation.” Fig. Most of the augmentation rhinoplasty procedures typically done decades ago are similar to putting things on top of the roof ( Fig. The low-profile nose of Asians is comparable to a short house as shown in Fig. For the nasal framework-to make things more obvious in terms of structure-we could compare the nose with a house. 4 The nose is a complex structure composed of two major components: a three-dimensional framework and a soft tissue envelope. Currently, there are three types of materials commonly used in augmentation rhinoplasty: (1) alloplastic implants, (2) autologous grafts, and (3) homologous grafts. 3 Surgeons who perform Asian rhinoplasties deal with noses with weak structures and deficient volume therefore, adding materials for volume and support is a necessity. In contrast to Caucasians, the problems of Asian noses include a low dorsum, low radix, bulbous tip, underprojected tip, hanging alar, and an upturn.
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