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Rhinoplasty
Rhinoplasty alters the structure of the nose to address functional, aesthetic, or combined concerns.
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It may be appropriate where nasal form or airflow causes persistent dissatisfaction or limitation. ​The focus is on determining whether surgery is suitable and what degree of change is appropriate.
Rhinoplasty (nose reshaping) refines nasal form and proportion while respecting individual anatomy, with a focus on structural balance and long-term stability.
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​My Approach
The nose sits at the centre of the face, both literally and emotionally. Rhinoplasty, when done with respect for anatomy and structure, should enhance facial harmony rather than create distraction.
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My approach follows the principles of preservation rhinoplasty, using autologous tissue and gentle contour refinement to deliver natural, long-lasting results.
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 believe that most noses do not require radical reconstruction. Instead, beautiful rhinoplasty begins with preservation:
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I prioritise minimal disruption to soft tissues, preserving native ligaments and blood supply
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I favour closed (endonasal) techniques when appropriate, to reduce scars, swelling, and recovery time; open approaches can and will still be used when indicated
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Interventions are always based on proportion, not fashion. I reshape, refine and restore balance.
This philosophy is similar to how I treat hand fractures: if alignment can be restored without unnecessary exposure, that is the safer and smarter approach.
Tissue, Grafts & Cartilage Strategy
In general, cartilage is used to improve rotation and projection of the nasal tip, as well as augmentation in height of the dorsum (nose bridge).
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My preference is autologous tissue only - no implants, no synthetic grafts or materials.
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Septal cartilage: In many Asian noses, the septum offers limited cartilage and is critical for long-term support. I adopt a septal-sparing graft philosophy, avoiding overharvest (if at all) to preserve structural integrity.
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Ear (conchal) cartilage: For mild to moderate refinements, harvested ear cartilage is often sufficient as it is soft, adaptable, and affords low morbidity.
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Rib cartilage: Reserved only for major reconstructive needs (severe collapse, trauma, major revision). It is never routinely used.
This strategy keeps the nose's natural structural support intact while providing safe, stable refinement.
Dorsal & Radix Refinement - Diced Cartilage & 3D-Printed Splint Support
For patients seeking subtle bridge or radix enhancement without implants, I may offer a technique using finely-prepared (aka diced) cartilage. This achieves natural dorsal contouring with minimal grafting, avoiding harsh edges or foreign materials.
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To optimise healing and contour stability, I may support this with a custom 3D-printed nasal splint, designed to gently conform to your anatomy and guide soft-tissue settling in the early postoperative period.
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Together, these allow for refinement that feels natural, integrates with your own tissues, and supports long-term structural health
Planning the Nose as a Complete Structure - Not Just the Bridge
While the bridge (dorsum) and radix often receive the most attention, rhinoplasty is never just about raising or lowering the bridge, which is a common misconception, especially in Asian rhinoplasty.
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For example, a nose that appears “large” or "flat" is not always due to projection problems. Sometimes, it reflects underlying issues with the bony skeleton, cartilage and hence tip support weakness, alar flaring, and a thick skin envelope - all of which may require different strategies.
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​Careful pre-operative analysis thus allows the surgical plan to address the nose as a three-dimensional structure, rather than focusing on a single isolated feature. Additional techniques may include nasal osteotomies, septal extension graft, septoplasty, cartilage reshaping sutures, alar reduction, turbinate reduction etc.
Skin & Soft Tissue Management
Thick, sebaceous nasal skin is common, especially in Asian patients. This can blur nasal definition and reduce tip clarity. Instead of aggressive surgical thinning (which risks devascularisation, fibrosis, and unpredictable healing), I advocate for safe, evidence-based skin optimisation:
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medically guided retinoids for gradual skin remodeling
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selective CO2 laser therapy for sebaceous hyperplasia or oily skin
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careful skincare and postoperative skin maintenance
This combined tissue + skin approach helps preserve vascularity while improving final definition for results that age gracefully.
Recovery & Expectations
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Day 0: Most patients return home the same day after surgery
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Day 1-2: Bruising and swelling (esp below the nose) typically peaks around now. You will look your worst at this time but it will get better as this is not the final result
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Day 7: Splint comes off and overall swelling is much improved except for the nasal tip as it is not covered by the splint. Avoid wearing glasses.
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Day 14: Some bruising around the eyes (especially if osteotomies were performed) may still persist but can be covered with makeup. Continue to sleep with your face up and most desk jobs and simple exercise can be resumed.
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Week 6: Swelling and bruising should be much reduced at this stage although the nasal tip can still be slightly swollen. Breathing should be unobstructed, or improved even, if there were additional procedures done during surgery.
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Week 12: More or less back to normal activities, some swelling of the tip may persist. Ongoing subtle changes in the overall nasal profile and tip and this can take up to a year.
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6-12 months: 90-95% of swelling should have resolved by now. Final results as the skin and soft tissue has now settled over the refined, underlying cartilage framework and bones.
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A custom 3D-printed splint may be used to support healing and contour stability when indicated
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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​
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 for attentive, discreet, and consistent care throughout the recovery journey.​
Frequently Asked Questions
1. Will I still be able to breathe normally after surgery?
Yes, one of the goals of thoughtful rhinoplasty is to preserve or improve nasal airflow. Function is considered alongside aesthetics during planning.
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2. Why do you use a preservation approach?
Preservation rhinoplasty focuses on minimal disruption of soft tissues, maintaining native ligaments and blood supply to achieve natural, proportionate, long-lasting results. If necessary, I will still use an open approach as indicated.
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3. Will there be visible scars?
With closed (endonasal) techniques when appropriate, there are no external scars. Your incisions are placed inside the nostrils, and healing typically leaves no visible surface scarring.
Related Reading
Learn more about:
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Non-surgical rhinoplasty, an alternative approach for nasal refinement in appropriately selected patients
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My blog posts on
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rhinoplasty issues I commonly see following overseas procedures
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why technique in non-surgical rhinoplasty matters more than product
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how I plan for surgical rhinoplasty by considering structure, function and biology
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Achievements in Rhinoplasty
Dr Ng’s work in rhinoplasty has been recognised internationally - he was awarded the ISAPS Bronze Medal for Rhinoplasty (2025) and Best Abstract Award (2024) at the London Rhinoplasty Course, Techniques in Rhinoplasty with an Integrated ENT-Plastics Approach for his contribution to advancing closed preservation methods for tip reshaping. He has also served as faculty at the SEASON Aesthetic Conference in Singapore in 2025, teaching non-surgical rhinoplasty in the cadaver lab, as well as sharing his insights on this topic in Eastern and Western patients.
