Does my ethnicity affect how my rhinoplasty is performed?

This is an excellent question and one that is very close to my heart. Ethnicity is very inter-linked with rhinoplasty. The key is to not try to erase the beautiful features of each ethnicity, but rather to naturally refine the nose. The nose is the center of the face. It needs to be balanced with the skin tone/color as well as proportionate with the rest of the facial features. This means that the ethnic features of the face need to be matched with the new nasal features created through rhinoplasty. I have been invited to speak on this topic and have written several articles and chapters on the topic so I will go into some detail. The term "racial incongruity" is an important one. This refers to the balance between nose-face-ethnicity that I mention above. However, just as with any cosmetic procedure, the wishes and personal desires of the patient need to be taken into account. I WILL advise against anything that I feel will create a fake, over-operated, and RACIALLY INCONGRUOUS NOSE. This requires not only an intimate knowledge of rhinoplasty but a step beyond, an understanding of various ethnicities. These mainly consist of Asian, Hispanic, Middle Eastern and African-American. Each requires different evaluation, treatment, and techniques. For example, most Asian and African-American patients need augmentation to the dorsum (hump) while many Hispanic and Middle Eastern patients need reduction of the hump. Middle Eastern Rhinoplasty I have written on the Topic of Middle Eastern Rhinoplasty which reviews many of these points. While there is a variation between noses within each ethnic subgroup, each subgroup shares certain features. One Ethnic Example: The Middle Eastern Nose tends to have long and wide nasal bones, thick/sebaceous skin, drooping and dynamic nasal tip, un-refined and bulbous/wide nasal tip, and moderate to severe dorsal hump. All these require different treatment and a step-wise approach so no irreversible changes are made in the WRONG direction. Each change is made step-by step and the nose is constantly re-evaluated during the surgery. "Baby steps" Another feature of ethnic noses, is that, for the most part, they require support and addition of cartilage. Cartilage preserving techniques (tip shaping through sutures) need to be used, and what cartilage is there should be shaped with minimal cutting or removal. Adding cartilage helps strengthen and refine the nose. The thick skin usually needs to be de-bulked also. Conclusion This is a complex topic, however if a patient goes to a surgeon that is experienced with "ethnic rhinoplasty" then a more natural, balanced result will be produced that matches with the patient's ancestry.