Ethnic Rhinoplasty: Understanding What is Involved
Article by C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
Ethnic Rhinoplasty is a common cosmetic procedure for refining the appearance of the nose of patients of ethnicities including: African American, Hispanic, Asian, and Middle-Eastern.
Most recognized aesthetic proportions for rhinoplasty are derived from the Caucasian nose, and pre-operative analysis and planning become complex when applying these aesthetic “ideals” to patients of another ethnicity.
The goals of ethnic rhinoplasty are to enhance a nose to give it more definition, or to reduce the size of the nose so that it harmonizes with the patient's other facial features -- all while maintaining and respecting the patients ethnic heritage.
Nose job surgery for patients with a non-Caucasian nose is challenging. When approaching the non-white patient, it is of the utmost importance to understand the patient's goals and desires. At the center of this dialogue should be the patient's expectations of whether or not he or she wishes to maintain nasal features of their ethnic heritage or if he or she desires a nose that tries to conform to the "norms" of the white nose. For ethnic patients who do wish a more white nose, it is equally important to address the issue that a "Caucasian" nose may not be in harmony with the rest of that patient's ethnic facial features.
Utilization of computer morphing software or drawings on tracing paper overlying the patients preoperative photographs are invaluable tools for communicating the planned changes from rhinoplasty and can help ensure that patients goals and expectations are realistic.
Different ethnicities require different techniques. Noses in African American and Asian patients frequently require building up (augmenting) the nasal bridge and narrowing the nostril base via alar base resection. This involves removing a wedge shaped piece of tissue where the nostril walls meet the cheeks. The overall result is a nose that doesn't appear as wide from the front.
Hispanic and Middle Eastern noses typically require reductive techniques -- removal of bone and cartilage to give a more subtle appearance to the nose. The techniques used include hump removal, tip refinement (narrowing of the tip) and tip reshaping.
The goals of ethnic rhinoplasty should therefore address the patient’s desire for preservation or alteration of ethnicity, balance of surrounding features, and adherence to patient desires.