Dr. Joseph M. Perlman Advanced Plastic Surgery Centre


Houston is indeed a melting pot, blending many cultures into our daily life. We have a large Hispanic population as well as Asian. I am seeing more patients that are Hispanic, Asian and African-American who are interested in improving the appearance of their nose. Some want a gentle refinement, but still retain their natural appearance, whereas others want a more radical change to give their nose more Caucasian characteristics. By that I mean, a narrower nose with a straight dorsum, and a proportionate nasal tip.

It’s important, when seeing a patient in consultation, to carefully evaluate their physical characteristics, as well as their goals. The characteristics of an Asian nose are different from African-Americans and Hispanics. Within the Asian population, there are certain variations. Some patients have a shortened nose, as well as a concave or recessed nasal dorsum. The vertical deficiency is more prevalent in the Asian type of nose than it is in the African-American and Hispanic nose. There may be a depression, at the upper end of the nose between the eyebrows, which needs to be corrected. The columella, which is the skin bridge between the nostrils extending from the base of the nose to the tip, may be very short. In addition it may be recessed up between the nostrils. The nostrils may be flared or enlarged and the cartilage support for the nasal tip may be very thin.

In performing cosmetic surgery on the “ethnic nose” it’s often required to augment the nasal dorsum, and lend support to the tip, with grafts. I try to use the patient’s own tissue, either rib cartilage grafts or ear cartilage grafts, whenever possible. Sometimes it is necessary to use nasal implants to support the framework, but I prefer not to use these, since they are a foreign body and can be prone to infection or extrusion (rejection by the body). Some patients have a wide base to the nose so the nostrils have to be brought closer together and sometimes decreased in size.

It’s important to be conservative in the approach to treating the ethnic nose. I take a lot of time discussing what the patient’s goals are and what I think I can achieve. Patients need to understand, as with every surgery, that there are risks involved and the final outcome may not be exactly what they expected. This is particularly true in cosmetic nasal surgery than it is in other cosmetic facial surgery.

Frequently Asked Questions

Why are more Houston patients interested in ethnic rhinoplasty?

Houston is a diverse city with a rich tapestry of ethnic backgrounds. Patients are increasingly interested in ethnic rhinoplasty to enhance their nasal aesthetics while preserving their unique cultural and ethnic features. This interest stems from a desire to achieve facial harmony and confidence without compromising their heritage. Additionally, advancements in surgical techniques and the availability of skilled surgeons in Houston make ethnic rhinoplasty a viable and appealing option for many.

What are some considerations for ethnic rhinoplasty surgery?

Ethnic rhinoplasty requires a tailored approach that respects and maintains the patient’s ethnic identity. Key considerations include:

  1. Preservation of Ethnic Features: Surgeons aim to enhance the nose’s appearance while retaining characteristics that are unique to the patient’s ethnic background.
  2. Skin Thickness: Patients with thicker skin may have different healing processes and outcomes compared to those with thinner skin.
  3. Cartilage Structure: Understanding variations in cartilage structure across different ethnicities is crucial for achieving optimal results.
  4. Patient Expectations: Clear communication about realistic outcomes is essential to ensure patient satisfaction.
What surgical techniques are used in ethnic rhinoplasty?

Ethnic rhinoplasty employs a variety of specialized techniques tailored to the patient’s unique nasal structure and aesthetic goals. These techniques include:

  1. Tip Refinement: Adjusting the nasal tip to achieve a more defined and aesthetically pleasing shape.
  2. Dorsal Hump Reduction: Smoothing or reducing a prominent nasal hump while maintaining a natural look.
  3. Nasal Bridge Augmentation: Enhancing a low nasal bridge to achieve better facial balance.
  4. Alar Base Reduction: Narrowing wide nostrils for a more refined appearance.
  5. Structural Grafting: Using cartilage grafts to support and reshape the nose, ensuring long-term stability and natural results.
What is the surgeon's philosophy on ethnic rhinoplasty?

A skilled surgeon’s philosophy on ethnic rhinoplasty revolves around respecting and preserving the patient’s cultural identity while enhancing their nasal aesthetics. The goal is to create a harmonious and natural-looking nose that complements the patient’s facial features. This involves:

  1. Personalized Approach: Understanding each patient’s unique facial anatomy and aesthetic goals.
  2. Cultural Sensitivity: Being aware of and respecting the patient’s cultural background and preferences.
  3. Balance and Harmony: Striving for results that enhance facial balance and overall harmony.
  4. Patient-Centered Care: Prioritizing patient satisfaction through open communication and realistic outcome discussions.
What are the risks involved?

As with any surgical procedure, ethnic rhinoplasty carries certain risks, including:

  1. Infection: Post-operative infections can occur, though they are rare and typically manageable with antibiotics.
  2. Scarring: While efforts are made to minimize visible scars, some scarring may occur, particularly in cases requiring external incisions.
  3. Asymmetry: Achieving perfect symmetry is challenging, and minor asymmetries may persist.
  4. Nasal Obstruction: Changes to the nasal structure can potentially affect breathing, requiring further intervention.
  5. Revision Surgery: In some cases, additional surgery may be needed to achieve the desired results or address complications.