History of ethnic rhinoplasty
Modern rhinoplasty was developed in response to antisemitism in Europe prior to World War II. There was a market for people to look less Jewish. In essence, cosmetic nasal surgery started off as ethnic rhinoplasty. As rhinoplasty surgery matured, surgeons started publishing articles on the perfect proportions of the ideal nose. Perfect proportions have even been described by DaVinci in the Vitruvian man.
Idealized facial proportions
These proportions were primarily based on the facial proportions of Caucasian patients. As rhinoplasty developed, it was soon evident that the proportions that worked for a Caucasian patient may not necessarily work for an African American patient or an Asian patient.
This idea that the natural nose needs to be modified for different ethnic populations was the basis of the ethnic nose job. The ethnic nose job surgery takes all of these special details into account to achieve a harmonious and natural result.
Three different examples of ethnic rhinoplasty procedures are discussed below.
Persian rhinoplasty is a broad category that describes patients from Iran, the Middle East, India, Pakistan, and places such as Greece and Turkey.
Most of these patients share a similar look with respect to what their nose looks like. Furthermore, most of these patients have similar anatomical features.
Externally, these patients usually have a dorsal hump, the tip is under-rotated (droopy), a tension septal deformity with the nasal septum being too tall for the nose, broad/bulbous tip, and no supra-tip break. Internally also, these patients have very similar characteristics. These patients usually have excess septal cartilage and the septal cartilage is thick and has good integral strength. They also have strong, narrow nasal bones.
Black/African American rhinoplasty
The facial features and structure of African American patients is different from Caucasian or Persian patients. The facial shape is more round, cheek volume is more pronounced, the projection of the maxilla to the mandible and the nose is more pronounced, and chin projection is generally less than in Caucasian patients. The characteristics of the nose, in general, are wider, lacking dorsum projection (weak bony and cartilage bridge of the nose), lacking tip projection and definition, and the tip can be over-rotated.
Internally, these patients may have sufficient cartilage, but the cartilage quality is soft, and unable to withhold significant stresses. Finally, the soft tissue envelope in these patients is usually thicker, with increased skin thickness and a thicker subcutaneous fat layer.
Asian rhinoplasty deals with nose surgery in individuals originally from China, Vietnam, Korea, Japan, etc.
This is a broad category of patients, and patients from each of these areas have very different characteristics.
If we try to generalize these patients, these patients usually have an insufficient dorsal height, insufficient tip support, insufficient tip definition, insufficient tip projection, and the tip is usually over-rotated. Internally, these patients have insufficient septal cartilage, with the septal cartilage being softer and weaker. The soft tissue envelope in these patients is usually moderate and not overly thick.
Why is this important?
Each of us has an ethnic background, even those of us who call themselves Heinz 57! This ethnic and cultural identity is in our DNA and makes us who we are. The vast majority of my patients (>99%) do not want to change who they are. They want to change small characteristics to bring their nose and face into greater proportion.
Understanding these nuances is important for the rhinoplasty techniques that will be used in each of these individual cases. Also, things like recovery time are different when doing ethnic rhinoplasty. Caucasian and Persian rhinoplasty may have a large percentage of their final result within weeks after surgery. Asian and African-American patients may need months to see their final results.
This is exactly why it is important to see a surgeon who has experience in ethnic rhinoplasty. Dr. Athre’s experience in rhinoplasty and ethnic rhinoplasty is unsurpassed. This experience allows him to analyze your face, analyze ethnic variations, and even know what anatomic variations he will face in the operating room to create a rhinoplasty blueprint that will balance your face in the most natural and harmonious way.
“Dr Athre did an amazing job on my nose. His staff treated me like family and I felt very comfortable getting the work done. He was very intuitive on what I was trying to accomplish and knowledgable enough to work through the issues involved to get the result I wanted, especially considering it was a revision surgery. The whole experience was great and helped me so much!”