How is an "African American rhinoplasty" (i.e nose surgery on blacks) different from a caucasian rhinoplasty?
African American Rhinoplasty - Black Rhinoplasty
Doctor Answers 34
Generalized ideas about African American Rhinoplasty that may not relate to you
The term "African American rhinoplasty" does not adequately reflect the significant diversity of nasal types that are often found within this population.
The African American population comes from a wide background of countries and geographic regions of the world. Patients' noses and their overall appearance often reflect this multicultural history.
However, most African American patients seeking rhinoplasty want a generalized narrowing of the nose, with more tip definition and a narrower bridge. Included in this is usually narrowing of the nostrils.
Due to the fact that African American patients often have thicker skin and small or thin cartilage components, different types of grafts are usually required in order to provide strength and definition to the nose. This technique is generally referred to as Augmentation Rhinoplasty and may include grafts to the nasal tip, the bridge of the nose, and the base of the nose. These techniques are also used in non-African American operations with great success.
With that in mind, most patients want a natural result that retains the essence of their ethnicity and pre-operative appearance. The balance between a patient's aesthetic desires and the increasing complexity of the maneuvers required to achieve a certain result is the most important decision that both the surgeon and patient need to make.
African American Rhinoplasty is Augmentation Rhinoplasty
When people speak about African American rhinoplasty, in general they are referring to Augmentation Rhinoplasty, and by that we mean that rather than trying to make the nose a lot smaller, we try to refine and define the nose. But to narrow African American rhinoplasty to something so general is, in our opinion, missing the point.
In general, people have always identified African American noses as ones with a wide, short nasal bridge with wide nostrils. However, in point of fact there is tremendous variability in every parameter of the African American nose, including: nostril shape and flare, nasal length, skin thickness, columella length, nasal projection, and bridge height. Unfortunately people continue to try to “pigeon- hole” African Americans into one type.
All this being said, what we at Profiles have found is that if we were to compare our average African American nose to our average Caucasian nose, we find that our African American patients tend to have:
- Wider nasal bridges
- Lower nasal bridges
- Thicker skin
- Wider, more bulbous nasal tips
- Thicker soft tissue overlying the nasal tip
- Softer cartilage
- Nasal tips that appears to droop
- Shorter nasal tips
- Wider variability in nostril shape
- Greater nostril flare (bigger nostril curvature)
So what does all of this mean to you if you are considering surgery?
It means that it is very important that you find a surgeon who is comfortable operating on people of different ethnicities. It is important for your surgeon to understand how thick skin differs from thin skin when dealing with rhinoplasty. It is also important for your surgeon to be able to individualize your surgery to achieve your goals. And most importantly, it is important for you to know what you want to achieve with the surgery.
We take all these factors into consideration in planning your surgery and in explaining to you, our patient, what can be accomplished with your surgery. We will sit with you in consultation as we work together to define what your goals are using computer imaging. Based on your desires and your individual anatomy, we will then determine a surgical plan which is best suited to achieve your individual goals.
African American versus Caucasian rhinoplasty
1) Differences in the anatomy: Stereotypically, African Americans tend to have a thicker skin envelope and thinner nasal cartilages than Caucasians. However, in today's society, there are many exceptions to these "rules" and every patient must be individually assessed.
2) Differences in the desired result: There is a greater push for preservation of ethnic features. Not everyone looks good with a Greco-Roman nose. I find it better to make subtle enhancements that maintain ethnic identity while creating an improved look.
It behooves any patient to make sure their goals and expectations are in line with that of their surgeon.
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What's Different about African- American Rhinoplasty?
Whether 'Black', 'White' or 'Asian', all Rhinoplasties are are unique. African -American nasal anatomy comes in all shapes and sizes. However, the 'Classic' issues that are involved in many African-American noses involve reduction in nostril size, narrowing of the base of the nose, elevating the height of the nasal bridge and defining the tip of the nose better. Having said this, these issues are not entirely unique to one ethnic group. Issues with tip projection are frequently seen in many Latinos, Asians and Middle Eastern patients. Depending upon how many concerns a patient has and what their unique anatomy is will determine how involved the procedure is.
African American Rhinoplasty 101
African American Rhinoplasty is simply the name given to a nose job performed on an African American patient. The same general principles and techniques of rhinoplasty apply to African American rhinoplasty and other types of ethnic rhinoplasty. Rhinoplasty (including ethnic rhinoplasty) is highly individualized. Because no two patient and no two noses are the same, each rhinoplasty is different, the overall goal is the same -- to produce a nose that is in balance and harmony with the other facial features while maintaining features of the patient's ethnicity.
African American rhinoplasty frequently involves narrowing a wide nose. The nose can be wide across the tip, across, the bridge, and wide from nostril to nostril. For the nose to appear natural, usually the nose must be reduced proportionally.
Nostril reduction surgery (called Alarplasty / Alar Base Reduction) is a procedure that can narrow the width of the nostril base, decrease the amount of nostril flaring, or decrease the size of the nostrils -- common problems in African Americans. The incisions are placed in the crease where the nostril wall meets the cheek. When performed correctly, the scar is hidden in the "new" crease where the nostril meets the cheek. The incisions can remain red for several weeks, but generally heal very well and are not noticable after that time.
it is important, though, to choose a surgeon who has experience performing rhinoplasty in ethnic rhinoplasty patients.
An African-American (AA) rhinoplasty is a nose performed...
An African-American (AA) rhinoplasty is a nose performed on a patient of that ethnicity. Everyone's nose is different, but there are some common characteristics in different races.
The AA nose is commonly wide with large nostrils. The nasal bones are usually short, flat, and wide. The lower 2/3 cartilage structure is weak. The skin is commonly thick and oily.
Therefore the procedure is usually performed through an external of "open" approach using the patients own nasal septal cartilage (or other implants) to build up the structure of the nose. Techniques are then used to narrow the base of the nose, as well as the nasal bones.
There is no standard African-American rhinoplasty as each patient has individual desires for the final appearance of their nose. Dr. P
The major difference in an Afro American rhinoplasty is that most work is strustural in nature and not reduction. Afro American noses in general have thick skin and weak underlying cartilages, The nasal bridge is generally underprojected. Care must be taken to add support , along with osteotomies and the possible need for dorsal onlay grafts. Thinning of the skin ( safely ), Cartilage tip grafts to shape and project the nose is usually necessary, and medialization of the nostrils may also need to be done. While we think of the African-American nose as bigger and wider than the typical caucasion nose, aesthetic rhinoplasty must add support, projection and overall strengthening to get a good result
African American rhinoplasty just another nose job.
For any qualified ,experienced rhinoplasty surgeon, its just another aspect of rhinoplasty. Any surgeon who ethically operates on patients should have the ability to do both an open rhinoplasty and an endo-nasal surgical approach. If you are able to use the above operating techniques you should have no problem operating on African American patients. The issues facing African American patients is as varied as any other ethnic group.
African American Rhinoplasty
African American Rhinoplasty is a specialized form of rhinoplasty that is becoming more and more popular among the African American Community. African American Rhinoplasty falls under the surgical category of Ethnic rhinoplasty, including Asian rhinoplasty and Hispanic rhinoplasty.
African American rhinoplasty is unique because the anatomy of a black nose is different than a caucasion nose:
General Characteristics of an African American Nose :
- Wide vertical and horizontal nostril dimensions.
- Lower and wider bridge.
- Bulbous and fatty tip.
General Desires of African American Patients:
- Narrowing of the nostrils.
- Narrowing and elevation of the bridge.
- Refinement of the tip and reduction of bulbosity.
In order to achieve the desire results open rhinoplasty must be used as well as other surgical maneuvers not typically taught in plastic surgery programs. The reason for this is that in the past, most emphasis was placed on rhinoplasty techniques used in caucasion rhinoplasty. Now that more African Americans and Hispanics are seeking rhinoplasty, there is a growing interest in learning techniques that will deliver desired results.
When you choose a surgeon make sure they can show many examples of their work, talk to previous patients and request computer imaging. Computer imaging can show you what your results will look like after.
Thanks, Dr. S.
Techniques are the same
The surgical principles and techniques are the same. I have found that my African-American patients have smaller, shorter and flatter nasal bones so grafts are necessary to give the appearance of a narrow nose. They rarely require osteotomy (or braking the nose). Cartilage is generally weaker so support grafts are needed. And more of my ethnic patients need narrowing of the nasal base than my Caucasian patients.