There was a time when plastic surgeons performed rhinoplasties following a limited set of beauty standards, with a narrow emphasis on the so-called “American” nose type. Fortunately, that’s largely a thing of the past.
These days, patients seeking nose reshaping surgery are far more likely to insist that their distinct ethnic characteristics remain preserved. Facial plastic surgeons are happy to oblige, tailoring their approach to each individual’s background. This trend in ethnic rhinoplasty aims to restore a harmonious balance to the patient’s ethnic traits, rather than erase or hide them.
With that being said, people of a given ethnicity do often share certain physical characteristics and seek rhinoplasty for many of the same reasons, as follows.
In many cases, patients of Mediterranean or Middle Eastern heritage have inadequate cartilage support. One of the effects of this is a weak nasal base. It also tends to make the nasal tip look undefined and can make it more challenging for the surgeon to fashion successful nasal grafts.
Another obstacle faced by surgeons performing rhinoplasty on Mediterranean/Middle Eastern patients is thick nasal skin, which sometimes has the effect of making the nose appear larger and can make it challenging for the surgeon to create a refined-looking nasal tip.
Nevertheless, experienced rhinoplasty surgeons are able to successfully address these issues using a variety of advanced techniques, including the following:
Nasal Hump Reduction or Refinement
The main objectives of nasal hump reduction are to make the nasal bridge appear straight from the profile and to achieve a subtle transition between the upper and lower portions of the nose. It is essential that any revisions made during nasal hump reduction are subtle. Reducing the bridge too drastically can lead to a lack of harmony between the nose and other features of the face.
Nasal Tip Lifting and Correction of Nasal Drooping
This can entail crushing and then extracting small pieces of cartilage, shaping the cartilage and tissues that remain and placing grafts to raise or rotate the tip upward. The surgeon uses whichever methods are necessary to rotate, narrow or increase the size of the tip, as needed. Bulbosity of the tip can also be addressed.
Narrowing of the nostrils is usually achieved via nostril and alar base reduction. These methods are a common step during both primary and secondary rhinoplasty for Mediterranean/Middle Eastern patients. These changes are made in order to improve the appearance of the nose from the profile view and achieve a more balanced, harmonious facial appearance.
As with any ethnic or racial group, Asian noses can differ markedly from one person to the next. However, also like other groups, rhinoplasty patients of Asian heritage often share certain nasal characteristics, including the following:
- Triangular shape
- Thick nasal skin
- Low nasal bridge
- Bulbous nasal tip
- Wide base
- Subtle tip projection
- Sharp nasolabial angle
- Lack of definition in nasal tip
- Very little dorsum projection
Common goals among Asian rhinoplasty patients include adding definition to the nasal tip, narrowing the nostrils, adding length to the nose and/or building up the nasal bridge. Special techniques are required to accomplish these goals. Three of the most common are grafting, nasal tip refinement and reducing the nasal base.
Grafts are often used in Asian rhinoplasty procedures for the purpose of lengthening the nose. Usually the grafts consist of cartilage harvested from the septum or ear.
Nasal Tip Refining
The lower lateral cartilages are the main factor in determining the shape of the nasal tip. Thus, giving the tip a new shape is largely a function of shaving and reshaping the lower lateral cartilages. This often entails removing cartilage, propping up the tip and, in some cases, the use of grafts.
Alar Base Reduction
Alar base reduction is a complicated technique involving carefully placed incisions. It is typically the last of several techniques used during Asian rhinoplasty. The rhinoplasty surgeon must pay careful attention not to narrow the nostrils too much and to make sure that the result is symmetric. To achieve this, the nasal shape, the width of the base and other factors must be taken into consideration.
Like other racial and ethnic groups, African Americans often have their own unique combination of factors that must be taken into consideration when performing rhinoplasty. These include flatness, thick nasal skin, a low nasal bridge, wide nostrils and an overall wide nose.
Many African Americans have a depression between their eyes that begins around the bridge of the nose. Whereas patients of certain other ethnic groups often have high, narrow bridges, African Americans more often have wide, relatively flat nasal bridges. As a result, it is fairly common for African Americans to complain of breathing problems or functional issues with their nostrils.
Another common trait of African American noses is short cartilage around the lower lateral portion of the nostrils. African American noses often have a prominent tip, and many African American patients complain about the angle between their nasal base and their upper lip.
Because African American patients typically have thick nasal skin, certain precautions must be taken to prevent excessive scarring. Also, since thick skin has a higher fat content, a technique known as “tip defatting” may be performed.
As always, the methods used depend on the individual patient’s anatomy and aesthetic concerns. For example, patients who are unhappy with the size of their nostrils often benefit from techniques to reduce or narrow the nostrils or reduce the nostril sidewalls. And for patients complaining of a flat or low nasal bridge, a technique called dorsal augmentation with cartilage grafts can be used to give the bridge more height.
The Latino/Hispanic community possesses a huge variance in nasal characteristics — perhaps more than any other racial or ethnic group. This is a result of the fact that many Latinos possess a combination of Spanish, indigenous American, African, Portuguese and other ethnic heritage.
Nevertheless, certain patterns do exist. For example the Latino nose is often narrower than the average African nose and wider than the typical Caucasian nose. It is also common for Latinos to have thick nasal skin, wider nostrils and a rounder tip than the average Caucasian nose.
Below are just a few common traits of Latino/Hispanic noses and the techniques used to treat them.
Relatively Flat Nasal Bridge
Many Latinos have semi-flat nasal bridges. When altering a flat nasal bridge the surgeon has to be careful not to reduce the bridge too much. The goal is typically to make the nose look straighter from the profile and create a subtle transition between the bridge and lower portions of the nose. Some Latino patients that have a flat nasal bridge may benefit from cartilage grafts for structural support.
Flared Nostrils and Wide Base
Many Latino rhinoplasty patients complain of a wide nostril base. It is also common for Latino noses to have a round shape at the base of the nostrils. A number of different techniques may be used to reduce and narrow the nostrils and nasal tip.
A prominent dorsal hump is another common characteristic of Latino noses. In some of these patients the hump consists mostly of bone, with only a minimum of cartilage. An overly prominent dorsal hump is usually treated by shaving the cartilage of the dorsum.
Thick Nasal Skin
Thick skin can make the nasal surface look undefined, since the cartilage and bone below the skin don’t show through like they do with thinner skin. Treating thick skin usually means reshaping the cartilage by shaving some areas, as well as cartilage grafting.
While Caucasians are not always included in discussions involving ethnic rhinoplasty, the fact is, like other races, many Caucasians share certain nasal characteristics that may need to be taken into account when performing rhinoplasty.
Many Caucasian noses are long and narrow, have thin nasal skin, strong cartilage and a narrow tip.
However, this is by no means always the case.
Here are some of the issues that patients of Caucasian ethnic heritage often seek to address:
- Bump on the nasal bridge
- Nose not in proportion with other facial features
- Undefined or misshaped nasal tip
- Uneven or asymmetrical nostrils
- Congenital issue that interferes with breathing
Caucasian rhinoplasty can include one or more of the following actions:
- Reduce or get rid of a nasal bump
- Reduce the width and/or alter the shape of the nostrils
- Change the angle between the upper lip and nasal tip
- Repair injuries and other issues affecting breathing
One challenge faced by surgeons when treating Caucasian patients is the fact that they usually have very thin nasal skin. This can make it difficult if the patient wants to enhance the nasal tip or bridge, since any grafts used to achieve this effect may show through the skin. As a result, the surgeon must take special precautions to disguise the grafts.
On the other hand, patients with thin skin usually see results sooner and have less swelling after surgery.