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.