An Experienced Hand: Ethnic Rhinoplasty
In parts one and two of our blog series on rhinoplasty, our experienced plastic surgeon in Toronto, Dr. Lawrence Tong, reviewed typical patient goals and concerns as well as the three keys to successful rhinoplasty surgery. This final installment will explain why rhinoplasty surgeons must take ethnicity into account when performing the surgery and how to achieve the best results possible.
Toronto has been previously recognized as one of the most ethnically diverse cities in the world. Having a practice located in Toronto means that there is a very diverse mix of patients seeking rhinoplasty. Thus, it is important to appreciate that performing rhinoplasty among different ethnic groups requires different strategies. There are often unique anatomic traits and cultural characteristics among ethnic groups that a surgeon must take into account. For example, some ethnic groups have certain anatomical features that necessitate particular rhinoplasty techniques. Additionally, cultural influences within an ethnic group may shape their outlook and opinion about nasal aesthetics. Understanding these issues and applying the appropriate surgical principles is required for success in ethnic rhinoplasty. It is also important to note, however, that every patient is unique, and may not necessarily follow any anatomic or cultural patterns.
A key tenet in ethnic rhinoplasty is that most patients want to maintain their ethnic identity. Although these patients want a look that is closer to the ‘western’ ideal of beauty (straight, proportionally sized bridge, refined tip, narrow nostril width, etc…), they rarely want a completely westernized nose. Thus, it is important to discuss this issue, and when a patient wishes, maintain ethnicity by preserving elements of their ethnic character during rhinoplasty.
In my practice, a significant portion of my rhinoplasty patients are of Asian descent. Asian rhinoplasty is quite different from Caucasian rhinoplasty, as it often involves augmentation as opposed to reduction. Augmentation of the bridge of the nose and adding height to the nasal tip are very common requests from Asian patients. Asians also commonly request refinement of the nasal tip and thinning of the nostril width. The approach needed is unique and much different from Caucasian rhinoplasty. I usually recommend using cartilage as opposed to silicone implants for augmentation whenever possible, as cartilage produces a more natural look and stable long term results.
When I was practicing in southeast Michigan, the geographic location allowed me to perform many rhinoplasty surgeries for people of middle-eastern descent as well as many African-Americans. These patients also have significant and unique anatomical characteristics that require special expertise and experience in order to achieve an optimal surgical outcome. Middle-eastern patients have a tendency for humps on the nasal bridge, and long, drooping tips. African-American patients often have wide, fleshy noses, with flat, rounded tips, and weak nasal cartilages. In both these patient groups, the unique anatomy and cultural perspectives of nasal aesthetics demands surgical approaches that are different from either Asian or Caucasian rhinoplasty.
Regardless of the ethnicity of my patients, they must maintain realistic expectations of what can be accomplished with rhinoplasty. I can improve the appearance of the nose, but no surgeon can make a patient’s nose look like someone else’s – a specific celebrity, for example. Rhinoplasty is the most challenging aesthetic procedure, and if you are considering the surgery, I encourage you to spend time researching the experience and past work of your surgeon. My advice is to make sure that you communicate your goals clearly, consider the recommendations, and be certain that you are comfortable with your prospective surgeon.