I don't know where to begin.
37 yr old African American female. Unhappy about the width of my nose, wanting rhinoplasty. Please advise (photo)
Doctor Answers 8
This category of ethnic rhinoplasty is not simple since northern Egyptian-type noses may have a much higher bridge than people of a more equatorial African origin and many people who classify themselves as African American are of mixed race and perhaps inherited some Asian or Caucasian or Hispanic or whatever qualities in their nose in addition to traits from their Black parent. A common denominator in many of my Black patients has been the following:
1] Thick skin (which is not
a bad thing since this skin ages better than thin skin).
Thick skin does not redrape around any reshaped cartilage well and not only requires the surgeon to be savvy to maintain proper tension of the tip area to take up the slack of the skin to keep it from looking amorphous, but also requires perhaps aggressive post op taping which is preferable to steroid injections. I do use steroids judiciously but let’s not forget Michael Jackson who had his skin thinned out to a skeletal state by over use of steroids.
2] Low bridge. Often the bridge looks too wide and flat and the best treatment is a more narrow cartilage graft to give a linear and narrow and elevated light reflex along the dorsum [bridge]. The patient’s own rib or bone can be used as well yet there is some morbidity [pain form the donor site] and I therefore choose irradiated freeze dried bone which comes from a bone bank and can give a dramatic clean bridge to narrow the nose.
3] Wide Nostrils. The nostrils look OK if they are close to the distance between the eyes but may still be wide in comparison to the mouth or a face in general. There is an exquisite technique to reduce the nostril width that must involve a scar yet with a proper zig-zag across the nostril sill and hiding most of the scar in the nostril crease...it is very acceptable and a remarkably good trade-off. By the way, though I am well trained in open rhinoplasty, I choose to perform all rhinoplasties without a scar on the columella [middle skin between the nostrils]. If a patient has a particularly wide nostril area, it is rarely best to consider a second minor procedure to further reduce the width 6-12 months later after the skin has become used to its first reduction.
4] Acute Nasolabial Angle. Often African American patient [as well as many Asian] have the nose crowding the upper lip and the angle between the two is less than 90 degrees and it is a very nice aesthetic improvement to augment the area with cartilage or bone or an implant and, if I use drawing or computer imaging to show them, my patients are routinely in agreement upon visualizing the importance of this often overlooked element of the beauty of their face.
When seeking out a surgeon, make sure to find a one who is experienced with your specific needs in rhinoplasty. Confirm that he or she is board certified by the American Board of Plastic Surgery. Ask to see before and after results of patients with similar issues as yourself and make sure a thorough examination of your nose is conducted. Also, don't be afraid to go to more than one consultation. We recommend seeing two to three surgeons before choosing who is the right match for you.
You will need to do your research online to find a BCPS experienced in AA rhinoplasty. You'd benefit from an open rhinoplasty with reduction of your nasal tip and nostrils with narrowing of your nasal bones. Setup a Skype or in-person consultation with prospective surgeons.
Rhinoplasty , some advices:
Thank you very much for the questions.
The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.
In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.
With this procedure you get a delicate nose, better harmonize with your other facial features.
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Thank you for your question. A rhinoplasty procedure can address the size and shape of the nose. Please keep in mind that many surgeons offer imaging technology whereby the surgeon and patient can preview changes to the nose to better determine the patient's desires. I suggest that you move forward and consult with a board certified facial plastic surgeon.
African American Rhinoplasty
Ethnic and African American Rhinoplasty is by far the most challenging cosmetic operation in cosmetic surgery. This is because the anatomy and skin thickness requires special techniques to achieve desired results. The best way to get a realistic picture of what kind of changes are possible with your nose is to have computer imaging, this will also relay your desire to your surgeon. Feel free to email me your pictures.
Below is a video/website I have created specifically for Ethnic and African American Rhinoplasty.
You can have a more attractive and feminine nose with a rhinoplasty to narrow your tip, nostrils, and nasal bones in a natural and overdone way. See a very experienced AA rhinoplasty surgeon who can show you photos of his work and do not rely on imaging.
In African Americans the nose usually is improved by tip refinement. Since you did not show a side view, I am not sure if anything in your profile needs to be addressed. To reduce the width an alar base reduction is performed. This will also reduce the enlarged nostril size as well. The tip can also be refined by some reduction but also a tip graft can very beneficial. This is where you add a some piece of cartilage to better define the nose.
Hope this helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.