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Ethnic Rhinoplasty Overview

Ethnic Rhinoplasty is a term used to describe rhinoplasty procedures on non-caucasians. Among rhinoplasty surgeons, ideal nasal proportions have historically been based on Caucasian white females, and because of significant media biases, most non-Caucasian individuals have adopted Westernized standards when considering rhinoplasty. However, the standards of beauty have been gradually changing, and they are increasingly being defined by more multicultural standards. The current trend is to improve features while maintaining an ethnic look. As a result, 2 aesthetic standards of beauty -- "ethnic" vs "Caucasian" -- are inadequate. "Ethnic rhinoplasty," in my point of view, is an outdated term.

There are tremendous differences among different ethnic groups, and there are significant variations within the same ethnic group of patients.

We strive to maintain your ethnic look while improving outstanding features.

Here is what Dr. Azizzadeh believes to be a good "non-Caucasian rhinoplasty" classification to consider for surgeons and patients. This is obviously not an all-inclusive list.
•Caucasian: Anglo Saxon, Germanic, Latin (Greek, Roman, French), Slavic, Mediterranean
•African American
•Asian: North American, Korean, Chinese, Japanese, Filipino
•Middle Eastern: Persian/Iranian, Arab, Indian, Pakistani
•Hispanic: Castilian, Mexican American, Mestizo

How Do We Preserve Ethnic Identity?
As a rhinoplasty surgeon, Dr. Azizzadeh encourages his facial plastic surgery residents to create a balanced aesthetic outcome that preserves the patient's ethnic identity. The surgeon must be familiar with variations in facial and nasal anatomy and listen to the patient's needs. Other important factors include the length of time that a person has lived in the United States and the level of assimilation. Within certain cultures, desired patient aesthetics are different depending on what country the patient has immigrated from. We do not want to box the patient into a generic ethnic rhinoplasty category. The aesthetic appearance of the nose must be in tune with the patient's original racial features to achieve harmony.

Dr. Azizzadeh has noted several trends affecting non-Caucasians who seek nasal reshaping.
•Ashley Simpson: The transformation of Ashley Simpson after her rhinoplasty has increased the desire to avoid creating a ski-slope nose in Middle Eastern and Hispanic patients.
•Michael Jackson: Michael Jackson's appearance had a significant effect on African American patients, who now want to avoid an overly aggressive Westernized nasal appearance. Most patients desire subtle changes to preserve a natural ethnic appearance.
•The Asian population generally desires a more Westernized nose.
•The Middle Eastern patient population no longer minds strong nasal profiles.
•The Hispanic patient population generally wants noses that look finer and thinner but not necessarily bigger.
•Non-Caucasians who present for revision rhinoplasty generally feel that they have lost their ethnic identity after primary rhinoplasty because of an overly resected profile (ski-slope appearance known as saddle nose deformity) and overly narrowed tip cartilages (pinched tip).

In conclusion, creating an ethnically appropriate nose is a paramount consideration when performing rhinoplasty in non-Caucasian patients (Figure). Special care must be taken to discuss these issues at length during the consultation process. Creating the Right Look for You
When you choose cosmetic surgery, it's important to find a surgeon who can create a harmonious, balanced look that is right for you.

Unfortunately, many cosmetic surgeons have little experience working with a broad range of ethnicities. Without the experience, training, and aesthetic sense for the patient's unique qualities, your rhinoplasty results are likely to appear incongruous and inharmonious with your overall appearance.

Ethnicity and physiology

In addition to cosmetic differences among different ethnicities, there are physical differences to take into account as well. Factors that may differ significantly according to ethnicity include:
•Thickness and fatty content of the skin can vary significantly by ethnicity
•The angle at which the nose projects from the skull, referred to as the radix or root, varies among different ethnic groups
•The nasal bridge, or top part of the nose, can vary in size, proportion, and angle
•The tip, or end of the nose, can differ in size, shape, and proportion
•The base and nostrils may vary in angle, thickness, and shape
•The nasolabial junction, where the base of the nose meets the upper lip, is typically different among different ethnic groups
•The maxilla, or the upper jaw that connects to the nose, can vary in size, shape, and placement

Ethnic Rhinoplasty Consultation with Dr Azizzadeh
To get the best possible rhinoplasty results, it is important that you choose a surgeon like Beverly Hills plastic surgeon Dr. Azizzadeh, who has the experience and the skills necessary to evaluate all of these and other factors in planning and completing your cosmetic work.

In our unique Comprehensive Ethnic Rhinoplasty Consultation, Dr. Azizzadeh will spend a significant amount of time discussing your aesthetics and functional concerns. Your history will be reviewed in detail. A careful nasal and facial exam will be conducted in conjunction with state of the art 3D digital imaging. Special attention will be made to the lips and chin, as these features can have a significant impact on the perception of the nose. Three dimensional Vectra photographic system is used to devise a plan that is most appropriate and to ensure you and Dr. Azizzadeh agree on the desired results.

Ultimately, Dr. Azizzadeh will create a custom treatment plan using a systematic approach. Several components are evaluated and addressed:
•Skin thickness
•Nasal profile
•Frontal aesthetics of the nose
•Tip and base of the nose
•Nasal-lip relationship
•Nasal-chin relationship
•History of trauma
•Breathing system: septum, nasal valves, turbinates, allergies, sinus disease (Note, if you do have a complex breathing problem Dr. Azizzadeh can bring in his partner Dr. Larian, another ENT specialist.)

An Open or Closed Surgical Approach?
An open or closed surgical approach may be used, it depends on the level of complexity and the areas that need to be addressed. An open rhinoplasty involves making a minimal incision between the nostrils and opening the nasal cavities in order to carry out work. This allows a greater degree of precision from the surgeon. A closed rhinoplasty allows surgeons to operate through the nostrils. This technique is excellent for individuals who require mainly 'bridge' modifications. The main decision you will need to make is whether your rhinoplasty is to be open, or closed, and the technique you and Dr. Azizzadeh settle on will depend on a number of factors:
1.What you would like to achieve from your rhinoplasty - are you looking to restructure the bridge of your nose? Change the shape of the tip? Alter your nostrils?
2.Do you require a reconstructive approach - if you have breathing difficulties or a structural abnormality then this technique will be optimal for fixing that.
3.How do you feel about the surgery and recovery time from rhinoplasty nasal surgery? How much improvement could you receive from a non-surgical approach?

Dr. Azizzadeh will help you weight the pros and cons of each option.

Dr. Azizzadeh uses advanced techniques to correct nostril disproportion.

Dr. Azizzadeh uses advanced techniques to correct alar pinching.

What to Expect Before and After Ethnic Rhinoplasty Surgery
The week prior to the surgery, a final consultation is scheduled in order to review the surgical plan and assure that all the patient's questions are answered. At that point, pre and postoperative instructions will be given to the patient and reviewed in detail until you are 100% comfortable.

Rhinoplasty nose surgery is usually an outpatient procedure. The recovery time generally lasts between 1-2 weeks. The patient will have a splint on the nose, which will be removed one week later. Most patients will not have nasal packing, and are able to return to work and normal activity within 7-10 days. Following the surgery, Dr. Azizzadeh will see the patient several times in the first 10 days. The patient will thereafter be seen every 3 months for one year and annually after that. Follow up is a critical component of rhinoplasty, as the nose will continue to improve over the first 12 months. Rhinoplasty, unlike all other cosmetic procedures requires a long-term commitment by the surgeon and the patient in order to ensure a successful and satisfactory outcome.

The outcome of rhinoplasty relies on precise techniques to improve the aesthetics and breathing function of the nose. Preoperative planning is paramount to a successful outcome. Dr. Azizzadeh and his knowledgeable and caring staff can help answer all of your questions.

Babak Azizzadeh, M.D., F.A.C.S.
9401 Wilshire Blvd, Suite 650
Beverly Hills, California 90212
Toll Free: 877-530-4623
Local: (310) 405-1426

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