COSMETIC TOWN JOURNAL



Expert Doctor

Ethnic Rhinoplasty

Posted November 14, 2018

Ashkan Ghavami, MD

Beverly Hills, CA

Ethnic Rhinoplasty

Ethnic rhinoplasty is a nose job performed on non-Caucasians to improve the shape, size and appearance of the nose without compromising the ethnic identity of the patient. Ethnic rhinoplasty keeps the external features of the patient’s nose in mind while considering the internal structure in order to achieve the look desired by the patient. Since some ethnicities have rounder noses, excessive nostril width and nasal tips, the surgeon must consider these factors. By sculpting the nose with these factors in mind, the results will maintain harmony among the facial features and appear more balanced.

Am I a Good Candidate for Ethnic Rhinoplasty?

A good candidate for ethnic rhinoplasty is anyone with obvious ethnic features who is dissatisfied with the shape or size of their nose. Ethnic rhinoplasty patients can include:

  • African-Americans
  • Hispanics or Latinos
  • Asians
  • Patients of Middle Eastern descent
  • Mediterranean patients

Ethnic patients with thicker skin that consists of more fatty tissue that wish to thin the size of their nostrils are good candidates. Some patients with a wide nasal bridge, or a lack of dorsal bridge definition, may cause the bridge of the nose to look flattened. Lack of a nasal tip, or a weak tip cartilage, can cause patients to appear deficient in their nasal definition. Also, a person experiencing discomfort or breathing problems due to structural abnormalities can be a good candidate.  There are a number of pros and cons to ethnic rhinoplasty and they include:

Pros:

  • Natural results
  • Improved functionality
  • A nose that balances the features while maintaining the ethnic identity of the person

Cons:

  • The patient being unhappy with the results because of unrealistic expectations
  • Results that remove or alter the ethnic appearance of the person
  • Although rare, the need for a revision surgery if the desired results are not achieved

How is Ethnic Rhinoplasty Performed?

Rhinoplasty can be performed as an open or closed procedure.

Closed Rhinoplasty - Typically preferred due to the fact that all surgical incisions are made on the inside of the nose which eliminates the possibility of external scarring. This technique can be used to address a wide range of cosmetic and structural concerns including issues pertaining to the bridge of the nose.

Open Rhinoplasty - Allows greater access to the cartilage and bone of the nose but this method does leave some scar tissue. With open rhinoplasty, an incision is made across the columella which is the area of cartilage between the two nostrils. The surgeon lifts the skin off the tip of the nose and shapes the cartilage in a particular way. Tissue can be removed to thin down the nose or grafted to bulk up the area. Open rhinoplasty is generally used when making small adjustments to the nasal tip. After the alterations are made, the lifted skin is placed back over the new contour and the incision is closed. Although this method leaves a scar on the underside of the nose, it will be very small and insignificant.

Patients should stop all blood thinners two weeks before and after surgery and this includes smoking, aspirin, and Vitamin E and herbal supplements. They should have a family member ready to drive them home after surgery due to the anesthesia used during the surgery. Patients should also make sure to have some help around the house for the first couple of post-op days and nights.

Each patient is different so the extent of surgical refinements varies per person. In order to sculpt the nose in unity with the rest of the facial features, there is generally more than one area of the nose which needs to be treated. Technique options include:

  • The nasal tip can be sculpted using cartilage grafts taken from the ear
  • A high powered micro-sanding tool can be used to smooth the edges of the grafts in order to provide a rounded tip
  • To sculpt the bridge of the nose, the surgeon may use cartilage grafts or an implant
  • If the base of the nostrils are wide, the surgeon may reduce the size of the nostrils by making an incision on the inside of the nose
  • High power tools can be used to make tiny alterations to the bone

Ethnic rhinoplasty can be combined with other procedures in order to maintain balance with the facial features. Chin augmentation and chin reduction are two of the most common treatments combined with rhinoplasty. Cheek augmentation via implants, fat grafting or dermal fillers is also a way to enhance the look of rhinoplasty.

What is the Cost of Ethnic Rhinoplasty?

Ethnic rhinoplasty requires a distinct set of surgical skills and a keen insight of various cultures. The total cost depends on the complexity of the procedure. In general, the cost is in the range of $3500-$9000.

Recovery and Downtime

RECOVERY can take several weeks due to excessive swelling. Patients can also expect severe breathing issues during the first few days of recovery due to the packing placed in the nostrils just after the surgery. The packing material helps reduce bleeding and keeps the septum in place. The patient will also be fitted with a nasal splint to retain the new shape of the nose.

During the first 48 hours, patients are instructed to sleep with their head elevated and their face as still as possible. Cold compresses can be used on the nose and mid-face to alleviate pressure and reduce swelling. Patients should avoid blowing their nose and consume soft foods for the first few days. Warm baths should be taken instead of showers while the bandages are in place. The packing will be removed in 3-5 days and, approximately one week later, the splint will be removed. Patients should not take aspirin for two weeks following the surgery as it may cause excessive bleeding. Patients experiencing any pain should call their doctor and request pain medication.

Patients need to take extra care to avoid bumping their nose following the surgery. Any swelling can take several months to dissipate. Open rhinoplasty has a longer downtime due to the fact that a greater magnitude of blood supply is disturbed. Therefore, swelling will be more extensive and will take longer to subside. After 2 weeks of DOWNTIME, patients can generally return to light work. However, they should avoid strenuous exercise until their surgeon gives them permission to resume activities. Sunscreen and hats should be worn for several months to promote healing as well as prevent additional swelling.

Results

Patients will not see immediate results due to excessive swelling and bruising around the eyes and nose. The amount of swelling generally depends on whether there were minor or significant alterations performed on the nose. Most of the swelling and bruising should subside within 2 to 3 weeks but some of the swelling can last up to a year before the final results are visible. The results from rhinoplasty should last a lifetime unless there is a substantial injury to the nose following the procedure. There might be a few subtle changes to the shape and size of the nose as a person ages but it will not greatly alter its appearance. Sometimes revision rhinoplasty is performed if the patient is not happy with the results of the first surgery. However, this can be avoided if the patient has realistic expectations entering the surgery.

Limitations of Ethnic Rhinoplasty

Ethnic rhinoplasty limitations include:

  • The amount of thinning or building up which can be done while maintaining facial balance. Too much rhinoplasty can make the nose look abnormal
  • The amount of change that can be made while still providing natural results. After the surgeon performs the initial facial exam, he or she must be very candid with the patient when describing the expected results.

Risks of Ethnic Rhinoplasty

Some of the risks of ethnic rhinoplasty include:

  • Difficulty breathing
  • Perforated septum
  • Nosebleeds
  • Infection
  • Scarring
  • Numbness
  • Asymmetry

To minimize risks and complications, patients should follow all pre-surgical and post-surgical instructions. The restrictions set by the surgeon will help minimize discomfort and speed the healing process.

Physical and Mental Benefits

Ethnic rhinoplasty provides physical benefits as well as psychological benefits. People who are dissatisfied with the size or shape of their nose often feel self-conscious about their appearance which can cause low self-esteem. After the surgery, many patients report a significant boost in confidence.  Anyone looking to have ethnic rhinoplasty should consult with a board-certified surgeon trained in treating patients of many ethnicities.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview provided by Dr. Ashkan Ghavami of Ghavami Plastic Surgery in Beverly Hills, CA.

Article Last Updated on November 14, 2018