Ethnic Rhinoplasty
There is no simple category that can be lumped together as "Ethnic Rhinoplasty." This is, of course, a term that was created by American and European cosmetic plastic surgeons who had and have Caucasian people as the vast majority of their patient population. In very ethnically diverse cities like Sacramento, where half of my patients are not of Anglo-Saxon heritage, a busy nose surgeon like myself can begin to appreciate the unique differences between the Hispanic and the Black nose, and between the Persian and Arabic nose, and the Asian nose, as well as the uniqueness of all the increasing blends of ancestral nationalities. The Eurasian nose has different qualities than a pure Asian nose and ditto for the noses of the partial Black and partial White noses. Why, the skin thickness and nasal bridge hump elevation may vary significantly even within a given ethnic group. The American Indian from a tribe originating in the northeast such as the Iroquois will be very different than that of the Navajo. The Japanese nose will be different from the Korean and even each Japanese, Vietnamese, or Chinese patient will have qualitative differences from others from their same country.
Having said all that; the skin in the lower half of the nose and especially the tip area will be thicker in most of these non-white people of color - Asian heritage, African heritage, Hispanic and Middle Eastern heritage, etc. This thick, less defined tip will also commonly be associated with weak tip cartilage, usually requiring cartilage graft support to put some tension under the thick carpet of skin in order to narrow and define the tip.
Another frequent characteristic of these "Ethnic" noses is a regression or receding at the junction of the columella [the skin between each nostril] and the upper lip. This creates an acute angle between the nose and the upper lip and the solution is some form of augmentation to bring out this angle...it might require bone or cartilage [and I use safe bone bank bone rather than create a donor site by taking the patients own rib cartilage or skull bone] or an implant. In the Asian and Black nose there is one more common, but not constant, trait - a low, flat-appearing bridge, which a good surgeon can make to look more narrow and elevated by placing bone or cartilage or an implant onto the nasal dorsum [bridge]. What is the common theme in all these cases? We are talking about building up weak aspects of the nose with augmentation by use of the bone or cartilage or implant. And...contrary to what you might intuitively think, this augmentation does not make the nose look bigger [God Forbid!]...it actually makes the nose look smaller in that it becomes more narrow and refined; it also gives the amorphous thick nose a more refined shape and elegance.
An exception to the need to build up the bridge is most often seen with the Middle-Eastern nose. Often the bridge is too high and patients are made happy by lowering the high hump...and often at the same time the tip may be thick as described above and may need augmentation in just this tip and possibly also at the Naso-labial junction. A characteristic of the Black nose may be wideness of the nostrils and correction of this issue should be included in any discussion of "Ethnic" noses. We all want to avoid the unfortunate unnatural appearance of Michael Jackson over reduction of the nostrils, and it is quite possible and very probable that the reduction of width can maintain a nice natural rounding of the nostril as it joins the cheek. The scar can be well planned to prevent notching of the nostril floor and to render the scar almost invisible and certainly a good trade-off.
Of utmost importance is that the surgeon does not impose his/her own ethnic preferences upon the patient [although he or she may well suggest classic and widely accepted standards of international beauty]. The patients should not be afraid to tell the doctor what they prefer and not hesitate to tell the doctor that they do not agree with some of the changes that are suggested. Perhaps the patient does not want as much hump reduction as the doctor may show on computer imaging. Be open and tell the doctor your concerns.
Remember...every nose, from whichever gene pool, must be evaluated on its own unique merits and demerits. A surgeon with a broad experience in working with all types of noses will be invaluable.
All of these images are actual results of Dr. Clark's patients, and have not been simulated or altered in any way.
| Before | After 6 weeks |
 |
|
All of these images are actual results of Dr. Clark's patients, and have not been simulated or altered in any way.