“Beauty is in the eye of the beholder”. The old adage may be true, but what happens when we find ourselves not loving what mother nature gave us? For many Americans who grew up playing with Ken and Barbie, it’s hard to look past the things that make us unique when others don’t find those things attractive. From movie stars to sports icons, it seems that everywhere we look our self-image is bombarded with societies idea of what beauty should look like. Size 2 runway models grace every fashion magazine while hunky movie stars are plastered on countless billboards. For many, sensible diets and rigorous workout routines can change the things we don’t like about ourselves. Unfortunately, you can’t hide every part of your body, not even strategic make-up techniques can mask an unsightly nose. The face is the most visible part of the body making the appearance of the nose something we all have to live with the rest of our lives.
Crooked noses either from injury or just what we were given at birth, humps that make the nose unshapely, flaring nostrils, flat bridges that impair breathing, are just a few of the things that make us want to hide our noses. Though few find themselves with noses of Cyrano de Bergerac fame, having the ability to change mother’s natures handiwork is a blessing. Thankfully, surgical treatments have been developed to correct such a prominent feature and improve facial harmony. In one days’ time, we are now able to correct anatomical issues giving a much-needed boost to our self-confidence and helping us to look and feel our best.
What is Rhinoplasty?
Plastic surgery has come a long way, some modern-day procedures have roots dating all the way back to Ancient Egypt. Rhinoplasty is no different; nasal surgery techniques appear early in recorded medical text and many different countries and cultures helped to shape the procedure we know today.
Rhinoplasty a cosmetic procedure of the nose used to correct the size, shape, or a specific feature such as asymmetrical nostrils, bumps on the nasal bridge or a droopy or upturned tip. The surgical procedure is so effective it can also be used to correct anatomical defects that hinder the ability to breathe and restore the nose of patients who have suffered traumatic injuries to the face. Even minor changes to the size and shape of the nose can improve facial balance to boost one’s self-esteem and confidence. Specialization in cosmetic plastic surgery should be of high importance when it comes to your decision for rhinoplasty surgery. Focus on the principles and techniques that have been developed to correct issues is the goal of Dr. Ali Sajjadian.
How is a Rhinoplasty Performed?
Rhinoplasty is an invasive procedure that is generally performed on an outpatient basis. While the procedure usually takes between one and three hours, the length of surgery will depend on your specific plan of treatment. During your consultation, Dr. Sajjadian will discuss with you at length your medical and aesthetic goals. With these goals in mind, individualized treatment is crafted to ensure optimal results.
There are two techniques utilized for this procedure, open and closed rhinoplasties. In a closed rhinoplasty, all incisions are made within the nose to eliminate any visible scarring. In contrast, the open technique includes a short incision across the strip of skin separating the nostrils. While this technique gives the surgeon increased visibility and precision, it does leave a tiny scar. In either procedure, the necessary modifications are made and could involve removing cartilage or adding a graft to build up the nose, smoothing a bump or hump on the bridge of the nose and other subtle changes that improve the overall appearance or shape of the nose. If necessary, a deviated septum can also be repaired during this procedure.
Recovery usually takes a few weeks during which time mild bruising, swelling and soreness can be seen. Over-the-counter medications can be used to alleviate any post-operative discomfort. While it can take several months for swelling to completely subside, subtle changes can be seen within the first few weeks, however, permanent changes may take several months to be noticeable.
What is Multicultural Rhinoplasty?
As is to be expected, all ethnic groups, ages, and sexes are candidates for rhinoplasty. While each population has its own motive for the procedure, it is necessary to consider the unique needs and aesthetic values of each demographic. Rhinoplasties must be done in an extremely meticulous way paying close attention to other facial features otherwise the result would be a face that is out of balance. People who are of non-Caucasian descent have unique facial characteristics making procedures that look good on Caucasians unnatural when performed on other ethnicities and vice versa.
A well-balanced face is a key to achieving a natural looking profile. When the forehead, nose, and chin make up equal thirds of the face when viewed from the front, the face is considered to be balanced. Balance is also considered from the profile. If the nose is out of alignment, changes can be made to make the features more harmonious. Without knowing the subtle difference between ethnic groups, the balance will not be achieved leaving patients unhappy with their results. While there is really no such thing as either a Caucasian or Ethnic rhinoplasty there is only a surgeon who understands the multicultural needs of rhinoplasty patients. Those surgeons cater to the individual needs and address the subtle differences in ethnicity so that surgical results ultimately appear natural and in balance.
Unfortunately, some surgeons lump all non-Caucasian nose reconstruction together not taking into account the diverse differences between ethnic groups. Knowledge and understanding of the difference in facial structure and skin are essential to effective cosmetic rhinoplasty. Surgeons that do not pay attention to those details often find themselves with a face that is not aesthetically pleasing and patients who will need revision procedures.
Different Ethnicities and Their Unique Qualities
Typically, when one thinks of rhinoplasty, we envision the stereotypical Caucasian nose such as that of Michelangelo’s statue of David. The nose is narrow or thin and long with a pronounced bridge and a slender tip surrounded by thin skin and firm cartilage. Fortunately, not all Caucasians are identical and many patients whose noses look like this aren’t happy. Rhinoplasty usually involves altering the skin, underlying cartilage, bone and lining of the nasal structure. Numerous techniques may be used to achieve specific results depending on the patient’s individual needs.
Understanding ethnic differences will help ensure positive surgical outcomes. Patients of Asian descent have features that require special consideration during rhinoplasty. Their facial cartilage tends to be weaker making it less likely to stand up to extreme reconstruction changes. Because of this, different techniques need to be used when doing rhinoplasty on these patients. Typically, Asian rhinoplasty requires implants to reshape the existing nasal cartilage. Though other ethnicities aim to reduce the appearance of the nose, people of this ethnicity often seek to enlarge certain aspects. Many find themselves with a flat bridge so heightening that area to raise the nose is common. Altering the tip or nostrils are also other common requests among Asian patients.
African-Americans also have unique differences that require surgeons to treat them differently than Caucasian or Asian patients. Thicker skin, which is more susceptible to scarring, delicate cartilage requiring additional support and shorter nasal bones are just a few of the issues that need to be addressed in order for the results to look balanced and natural. Most often, patients of African-American descent request treatment to correct wide nostrils. Correcting this issue is a delicate procedure that requires special consideration. In Caucasian patients, excision of the nostril skin to reduce flaring will make them appear smaller. However, this approach in African-American patients can lead to a nose that looks overly operated on and can cause the nostrils to appear like an upside-down V instead of the natural curve of an untouched nose. Probably one of the most famous examples of this would be that of Michael Jackson. After his rhinoplasty, many people thought that his nose turned out too thin giving him a hollow appearance. Though it is not known if the results of his many surgeries were what he wanted or if it was due to a surgeon that didn’t understand the unique differences between ethnicities. However, what is known is that strategically reshaping the entire nostril would have been a more appropriate procedure to reform the nostril than the extreme thinning.
Patients who are of Hispanic descent share similar characteristics such as thicker nasal skin, nasal hump, wide nasal bridge and a bulbous nasal tip that can be under projected with a wide base and flaring nostrils. As is seen in other ethnicities, the Hispanic nose tends to have weaker cartilage and a drooping or hanging nasal tip. Understand these unique features is important to performing a successful rhinoplasty on a Hispanic patient.
Although every patient is unique, they possess their own cosmetic desires. Much like African-American patients, Middle-Eastern or Arabic patients share some of the same desires. Often Arabic patients have a nose that is too large, prominent, long or wide with a bulbous, downturned turned nasal tip and poor cartilage support like that of African-Americans. However, while African-American noses typically look short and thick, Middle-Eastern or Arabic noses usually appear disproportionately elongated as well. Understanding the anatomical differences will help sculpt the Middle Eastern nose so that it has a balanced appearance while still maintaining the unique characteristics.
Treating All Patients as Individuals
Because of the diversity of patients, facial plastic surgery plans should be made to suit the individual however, every care should be made to understand the unique differences that set non-Caucasian ethnicities apart. Treatment that is typical for Caucasian patients is not appropriate for others. The goal of any cosmetic procedure is to leave patients with a self-image that is natural looking, aesthetically pleasing and not like it was reconstructed and certainly not fake. Everyone deserves to look and feel as if they are a unique person.
Dr. Sajjadian has spent a great deal of his life learning about the anatomical differences between many ethnic groups. He understands that living in a multicultural society mandates an understanding and strict adherence to preserving the uniqueness that sets ethnicities apart. Working individually with his rhinoplasty patients to create a balanced aesthetic outcome Dr. Sajjadian believes that will not only preserve their ethnic identity but it will ensure an aesthetically pleasing outcome that is balanced and flattering.