AFRICAN AMERICAN RHINOPLASTY

Pros

• In the hands of an expert surgeon, this nose reshaping procedure can create a result that boosts your confidence, while retaining the features that align with your ethnic identity. 
• Nose surgery can address both aesthetic and functional needs, like helping you breathe more easily.  
• Reviewers on RealSelf give African American nose surgery a consistently high Worth It Rating.

Cons

• You’ll see early results as soon as your bandages are removed, but it can take up to a year for all the swelling to resolve so you can see your final rhinoplasty results.
• Side effects, including bruising and swelling, can last longer for patients with thick nasal skin than those with thin skin.
• Facial plastic surgery is costly and not covered by health insurance if it's performed for strictly cosmetic purposes.
• As with any cosmetic surgery, there are risks of complications, including asymmetry, scarring, and keloid formation. 
• It’s also possible you won’t like the outcome. The most common complaint among reviewers who said it was “Not Worth It” was a poor cosmetic result.

• Average Cost:
• $9,204

• Range:
• $5,100 - $14,000

An African American nose job is not a one-size-fits-all operation. The price you pay for the procedure will depend on:  

• the scope and complexity of your procedure, which impacts how long you‘ll be in the operating room
• whether you have complementary procedures performed at the same time
• your plastic surgeon’s credentials, reputation, and level of expertise
• their practice location, which impacts their overhead costs (and how much they have to charge to cover them)
• the credentials of your anesthesia provider

If your surgery is strictly cosmetic, it won’t be covered by insurance. But if you require surgery to repair a defect or to correct medically documented breathing problems, a portion of the cost of your procedure may be covered. Check with your insurance provider.

Most surgeons offer payment plans or accept financing options, like CareCredit.

The African American rhinoplasty photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Like all rhinoplasty surgery, this cosmetic procedure can be performed either under general anesthesia or local anesthesia with sedation. 

Every case is different, but common rhinoplasty techniques performed on Black patients may include the following: 

• narrowing and/or elevating the nasal bridge or dorsum
• removing a bump on the bridge of the nose
• performing an alar base reduction, to narrow the width or flare of the nostrils
• shaving and narrowing the nasal bones, to reshape the nasal structure
• refining or projecting the nasal tip 
• improving the angle between the nose and upper lip

“For African American noses that often have thick skin, we create tip definition by adding a graft of your own cartilage,” explains Dr. Steven J. Pearlman, a facial plastic surgeon in New York City. 

Surgeons may also conservatively “debulk” the tip of the nose by removing excess fat under the skin. 

Dr. Ok notes that it’s not possible to actually remove excess nasal skin, so the underlying structure must be contoured in a way that most elegantly supports it. Thick skin is less elastic, which can make it more difficult for it to adapt to changes in the shape. It can also lead to “tip drop” over time, if the skin isn’t properly supported.  

Dr. Ok’s approach is often determined by the width of the apertura piriformis, the bony opening below the nasal structure. For example, “most patients who have a wide nasal aperture need whole bridge augmentation” with cartilage grafts, often taken from the back of the ear, nose, or rib.

When cartilage grafting is involved, plastic surgeons often recommend an open rhinoplasty approach, which provides the best accessibility and visibility. Open rhinoplasty requires an incision along the columella—the narrow strip of skin separating the nostrils—so the skin can be lifted to expose the interior of the nose. Surgeons typically make a stair-step or V-shaped incision across the columella, because these types of scars are less noticeable than a straight line.

Another advantage of open rhinoplasty: it allows surgeons to use the Piezo method, commonly called an ultrasonic nose job. The Piezo device precisely shapes the nasal bone with ultrasonic vibrations, a much more precise method than using rasps or chisels. This delicate technique results in less bleeding and trauma to the surrounding tissue, so patients have less bruising and a faster recovery than traditional rhinoplasty.

However, a closed rhinoplasty technique can also work well for patients with thick skin and a large nasal tip. This method tends to help preserve the blood vessels, and patients tend to have less swelling and numbness, with a relatively quick recovery.

During your initial consultation, ask your surgeon to thoroughly explain their treatment plan for achieving your desired results, without making your nose look too “operated on.” 

Rhinoplasty is widely considered the most difficult type of plastic surgery to perform well, and even very experienced rhinoplasty surgeons may not have the artistic eye or surgical technique required to achieve a balanced, culturally sensitive result for Black patients.

Most patients look and feel well enough to return to work one week after nasal surgery, but taking two weeks off is ideal. 

You’ll have a splint on your nose the first week, possibly followed by tape the second week. Most surgeons ask patients to refrain from strenuous activities for at least two weeks.

Post-procedure, you’ll feel uncomfortable and congested. Bruising and swelling can range from mild to severe, depending on your anatomy, the extent of the surgery, and how your body reacts. 

The worst of the swelling should resolve within two weeks, and most of it will go down in the first three to six months. However, swelling can linger for a year or more, especially in the nasal tip.

“Full healing takes a year or more,” says Dr. Pearlman. “The thicker the skin, the longer it takes.”

Related: 8 Rhinoplasty Recovery Rules You Should Always Follow

An ethnic rhinoplasty procedure is considered very safe when it’s performed by a board-certified plastic surgeon or facial plastic surgeon who specializes in rhinoplasty surgery.

During your consultation, inquire about the following side effects and risks, which are further explained in this study on the African American rhinoplasty:

• Bleeding
• Prolonged swelling
• Infection at the incision site
• Tip necrosis (tissue death)
• Nasal obstruction
• Septal perforation (a tear in the lining of the nasal septum)
• Hypertrophic scarring or keloid formation at the incision site
• Asymmetry
• Dissatisfaction with unintentional loss of ethnic identity

It’s possible to have a poor cosmetic result that merits rhinoplasty revision surgery, a more complex and costly procedure than a primary nose job.