Question: I am nineteen, female, and Indian. I have always hated the hump on my nose, and now that I am an adult, I can get the nose job I have always wanted. I know that it is important for me to go to an ethnic rhinoplasty specialist, but how is removing a hump from someone of my ethnicity more difficult, than say, someone of European descent?

Answer: I personally do not feel that it is more difficult to remove a hump off of somebody with an Indian heritage rather than European ethnicity, and in fact overall, I feel that every person’s nose is quite different from another, and whether that person may consider themselves to be “ethnic” or not, in my opinion, is rather irrelevant. We simply have to appropriately analyze the person’s facial and nasal features and then make a customized treatment plan to appropriately adjust the undesirable features of their nose so that the nose has more harmony with the rest of their face. This is, often times, accomplished in similar ways, whether the patient would consider themselves to be ethnic or not. Ultimately, I feel that it is important to have a well-experienced rhinoplasty surgeon, as opposed to a rhinoplasty surgeon that specializes in ethnic noses.

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Question: My parents are different ethnicities. My dad is African American, and my mom is of Japanese heritage. I have always hated my nose, and I would like to get a nose job. I know there are specific techniques used for ethnic nose jobs, but I am worried that no doctor will know what to do with my nose. How are biracial nose jobs typically approached?

Answer: I approach biracial rhinoplasties in the exact same manner as I do every rhinoplasty that I perform, and that is by creating a very customized approach that is dependent on the patient’s specific anatomic concerns and anatomic variations. Just because a patient has what they consider an “ethnic” nose, does not mean that I am going to be performing particular surgical maneuvers any different than I would on a run-of-the-mill Caucasian nose. Ultimately, I feel that it is the customization of the rhinoplasty technique that is most important, and I personally feel that computer-generated imagining not only helps me to achieve the look that we desire, but I feel it also helps the patient be able to see the expected outcome on a computer screen so that they have a better idea of what they will look like with their new nose.

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Question: I am a twenty-nine-year-old African American woman. I do not like my wide flaring nostrils, as they detract from my femininity. I would like to get them narrowed with rhinoplasty, but I am concerned about scaring in the nostril area. Where are incisions to narrow the nostrils made?

Answer: In most circumstances, incisions to narrow the nostrils are made at the junction of the ala, or base of the nose, and the cheek. Essentially, an incision is made right in the curved area where the nose connects to the cheek there, and oftentimes, the incision will then continue around to the bottom of the nostril, and in cases where a patient’s nostril opening is overly large, we will also remove some of the actual floor of the nostril, and when this is closed, not only does the base of the nose get brought in, but also the overall size of the nostril is decreased. Ultimately, this is a rather customized treatment, as everyone’s nostrils and ala are different, and we need to customize the area of incision so that we end up maximizing the overall esthetic improvement for each individual patient. Classically, this incision, though it is theoretically visible, heals so well that it is seldom a cosmetic concern.

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Question: I am an Asian female, and I am interested in getting a nose job to make my nose slightly taller. I have been reading up on ethnic rhinoplasties, and I was surprised to find that Asians often have weaker cartilage in the tip. Since I am probably going to need a graft, I am a little concerned about that. Can weak cartilage affect the success of a graft?

Answer: Yes, the structural integrity of the cartilage can definitely affect the end result. If someone has excessively weak cartilage, and we use that weak cartilage as a graft, then the graft may not be able to stand up to the pressures of the healing process and/or the structural support that it is supposed to be able to uphold. Most Asian rhinoplasties that I have performed have adequate structural integrity in their septal cartilage, and this is what I then use to reinforce the tip of their nose to give them more projection. More often than not, I will use an alloplastic implant for augmentation of their nasal dorsum, but I do not like to use alloplastic materials in the tip due to the fact that I feel they have a very high propensity of complication, infection, and later extrusion. Ultimately, I would recommend that you seek out a rhinoplasty surgeon with experience performing these procedures on Asian noses, so that ultimately you get the outcome that you desire.

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Question: I am a twenty-three year old African American male. I have wanted to get a nose job for a long time, and recently I started scheduling consultations. One of the offices I called said that the doctor did not do ethnic rhinoplasties; that he did not “specialize” in them. Do many doctors refuse to do ethnic rhinoplasties? Isn’t the process essentially the same as a Caucasian rhinoplasty?

Answer: I assume by your question that some surgeons must not feel comfortable doing ethnic rhinoplasties, even though I do tend to agree with you that they are simply an adaptation of an otherwise normal Caucasian rhinoplasty. I have certainly seen Caucasian patients with a nose shape that would be considered ethnic, and therefore, my surgical approach to their rhinoplasty would be very similar to an ethnic rhinoplasty. Ultimately, you personally need to be very comfortable with whomever you chose to have a rhinoplasty procedure with. I personally prefer computer-generated imaging, so that both the patient and myself can get a good idea of what the expected outcome will be, and I can therefore create a customized treatment plan to achieve that goal in greater than ninety-five percent of cases.

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