Ethnically Tailored Rhinoplasty
When I am performing rhinoplasty, I consider the entire face, not just the nose. I consider how to maintain balance and a natural aesthetic when altering the structures of the nose. In America, the standards of beauty are fairly Westernized and can typically conform to more Caucasian standards of symmetry and attractiveness. However, when performing rhinoplasty on a patient who is not Caucasian, I realize that needs and aesthetic goals can differ.
While there is no ethnic facial standard, it is common to see trends in facial anatomy among certain ethnic types.
It is important that a plastic surgeon considers these features when performing rhinoplasty. The nose should create harmony with the rest of the face. Additionally, ideas of what is most attractive can shift between ethnicities, and it is important that we preserve people’s identity.
Even among patients of Asian descent, there is a large variety of nasal types; these different types generally depend on where in Asia a person is from. Those of Eastern Asian descent tend to have wider faces and more narrow nostrils, whereas Southeast Asians are known to have lower nasal bridges and wider nostrils. The lower profile of the nasal bones tends to result in flatter faces.
When performing rhinoplasty for patients of Asian descent, the focus is typically on augmentation rather than reduction. The nasal tip is often addressed to create a more narrow, projected, and defined end. The nasal bridge may also be elevated to restore a slimmer appearance to the nose overall. Additionally, we can narrow wide nostrils to help provide balance to the general appearance of the nose.
African American Rhinoplasty
While there are various aspects among the nasal structures of those of African or Afro-Caribbean descent, there are some general, overlapping similarities. African American patients tend to have flatter bridges and wide nostrils that they would like to have corrected. They may lack a prominent nasal bridge or have a flattened nasal tip. In some cases, the nostrils have excessive roundness or appear overly flared.
For African American patients, careful attention is paid to the tip of the nose. Grafts may also be used to create a higher nasal bridge, which narrows the whole shape of the nose. Additionally, narrowing the width of the nostrils helps control flaring and creates a more proportionate nasal appearance.
Hispanic or Latino patients often have a normal or low-profile nose with a wider nasal bridge. A small hump may be created from a poorly supported tip, which may be long or angled downward. Poor projection of the nasal tip can result in less than a 90-degree angle between the nose and lip. The tip may also lack definition, and the nostrils may be wide or flared.
Sculpting a Hispanic or Latino nose usually starts with addressing issues of the tip. The nasal end may be rotated upward, improving the long, drooping appearance. The bones in the nasal bridge may be narrowed, and humps can be shaved down. In some cases, we can reduce nostril width or flare.
Indian people, especially women, tend to have a shorter, more narrow mid-face, which causes their features to appear larger. The nose itself may have a lower nasolabial angle with little shape between the tip of the nose and the top of the lip. The nasal tip cartilages tends to be broad, creating the appearance of a wider nose. Some patients have presented with a prominent nasal hump.
Subtle changes can have a dramatic effect on the Indian nose, and there are certain structural features that many Indian patients feel are part of their ethnic identity. The size of the nasal hump is often reduced, and we can adjust the positioning of the nasal tip.
Middle Eastern Rhinoplasty
Middle Eastern patients often complain of a prominent hump on the bridge of the nose with a droopy, poorly supported tip. The nostrils may be wide as well. These patients benefit from removing the hump and supporting and rotating the nasal tip to shorten the nose. Nostril reduction often improves the aesthetic outcome also.