Rhinoplasty (Preservation / Closed Approach)

My Approach

The nose sits at the centre of the face - both literally and emotionally. Rhinoplasty, when performed with respect for anatomy and structure, should enhance harmony rather than create distraction. My approach follows the principles of preservation rhinoplasty, performed whenever possible through a closed (endonasal) technique.

This approach keeps the natural soft-tissue envelope intact while reshaping the underlying framework. It allows smoother contours, predictable healing, and a natural result that complements each patient’s features.

Other procedures that may enhance facial balance include chin augmentation and, in selected cases, jaw surgery (orthognathic surgery, not offered by Dr Ng but for which a referral can be facilitated).

Planning & Technique

I learned the closed preservation approach in London and Paris, where I was taught that precision and restraint often produce more refined outcomes. Working through incisions hidden inside the nostrils, I reshape bone and cartilage while preserving the skin’s native attachments and blood supply.

This philosophy is similar to how I manage hand fractures - if alignment can be restored without opening the skin and risking scarring, adhesions, or nerve injury, then it should be done that way. Less disruption means less swelling, better preservation of function, and a more natural expression.

Asian Rhinoplasty Considerations

Many Asian patients have thicker skin and a lower nasal bridge, which can obscure definition and projection. In these cases, cartilage grafts - harvested from the septum, ear, or rib - may be used to enhance support and definition.

Further adjuncts such as retinoids or lasers may be recommended for patients with sebaceous hyperplasia or oily skin, as thicker skin can blur the dorsal aesthetic lines and alar creases.

I avoid cadaveric allografts or implants, as they are not part of one’s own anatomy and carry risks of infection, extrusion, and unnatural rigidity. The goal is subtle, proportionate enhancement that respects individual character.

Recovery & Expectations

Most patients return home the same day. Nasal breathing is usually maintained, and swelling settles over one to two weeks.

When appropriate, I may use a personalised 3D-printed splint, which can further reduce swelling and support healing (PRS Global Open, 2023). Once the splint is removed, light bruising can be covered with make-up. Glasses should be worn for no more than one hour at a time to avoid pressure on the nasal bridge, and sleeping with the head elevated at 45° during the first week helps minimise swelling.

Final definition continues up to one year as the skin conforms to the refined framework. In around 10% of cases, minor irregularities may occur due to natural cartilage and bone remodelling - these are easily refined with a small amount of filler, often producing a permanent smoothing effect (Aesthetic Surgery Journal Open Forum, 2023).

Post-operative care extends beyond routine reviews - it is an integral part of Dr Ng’s surgical philosophy. Through Doctor Stitch, an aftercare service founded to ensure seamless continuity and comfort, every patient is followed up personally by Dr Ng. Whether at home or in clinic, he provides attentive, discreet, and consistent care throughout the recovery journey.

Rhinoplasty (Preservation / Closed Approach)

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