Ethnic Rhinoplasty

The Asian facial anatomy traditionally differs in size, shape, skin texture, structure, and appearance from other ethnic groups. These appearances might be slight to the untrained eye; however, these variances are extremely important when it comes to rhinoplasty or nose surgery for Asian patients. Asian rhinoplasty is considerably different because Asian noses have different attributes (thicker, more sebaceous skin, flatter bridge, wider base) than Caucasian noses. With Asian noses, traditionally, procedures focus on augmentation as opposed to reduction. Traditionally, Asian noses have flat bridges, sometimes with less definition and wider nostrils. They may also have a minimal tip. Most Asian patients who want to redefine their noses with rhinoplasty wish to enhance their nose symmetry while creating a more defined, stronger bridge and tip. They often want to narrow their nostrils, which can be done during surgery.

Most African-American/black rhinoplasty (“nose job”) patients seek to enhance the appearance of their nose without erasing their heritage and identity. Typically, requests include lifting the bridge, narrowing the nostrils, and enhancing the profile. It takes skill and sensitivity to achieve a cosmetic result that beautifies the face while respecting and preserving ethnicity.

Refining an ethnic nose requires special consideration because of technical challenges. A plastic surgeon must be aware that African Americans often have broader and somewhat flatter noses than Europeans. They also have thicker skin (as do Hispanics), which makes refining the nasal tip more challenging. In addition, African-American nasal bones are comparatively short, requiring special care.

Iran has been named the nose job capital of the world, with seven times more operations carried out there than in America, despite the high cost of the surgery. The reasons behind the surgery include self-esteem and marriageability, medical issues, and the fact that with modest attire, women’s faces are sometimes the only visible part of their bodies, with the nose being the central focal point.

Surgeons must recognize the ethnic features that make a person unique. The nasal proportion guidelines that plastic surgeons in North America are taught have not traditionally taken different ethnicities into account. Therefore, Dr. Kassir has learned and mastered techniques to recognize and accommodate ethnic features to achieve a result that retains the patient’s ethnicity. He operates in the Middle East every year and has broad experience with Middle Eastern noses (Persian, Lebanese, Palestinian, Jordanian, Syrian, Israeli, Iraqi, and Turkish)

“Hispanic” or “Latino” often refers to people with Spanish, Portuguese, South and Central American heritage, and some Caribbean countries such as Puerto Rico, Cuba, Costa Rica, and the Dominican Republic. Three categories are used to differentiate between Hispanic noses:

Mestizo nose: a mix of European and native Indian-American elements. This nose is usually broad-based, with a wider tip, and has quite a thick skin. This is the most difficult nose of all three types of Latino noses in terms of enhancing its appearance through rhinoplasty surgery. The surgeon has to graft the patient’s dorsum of the nose, then extend the tip graft and revise the nose tip.

Castillian nose: This Spanish nose (originally from Spain and some Caucasian noses) has a high bridge. It is often adjusted by performing dorsal reduction and tip revision.

Mexican-American nose: a mixture of the Mestizo nose and Castilian nose. This type of nose usually has a low radix (the root of the nose) with a normal bridge and drooping tip definition. This type of nose surgery requires grafting of the radix or the dorsum and a tip revision with a columellar graft.

From these three categories, the Mestizo nose and the Mexican-American nose require a highly skilled surgeon to perform rhinoplasty surgery on them. Dr. Ramtin Kassir is a triple board-certified facial plastic surgeon in New Jersey who has performed many nose surgeries on Hispanic and Latin American patients. He does not believe in the “one nose fits all” idea but instead in revealing every person’s uniqueness, which should manifest while performing a rhinoplasty surgery. He adjusts the tools and techniques used to achieve an overall harmonious look.