AFRICAN AMERICAN (BLACK) RHINOPLASTY (Washington DC, Virginia & Chevy Chase Maryland)
Much discussion surrounds the topic of African American Rhinoplasty, as it does in other areas of “Ethnic Rhinoplasty.”
Some surgeons think that African American patients seeking Rhinoplasty must necessarily be seeking “westernization” or “Caucasian-ization” Rhinoplasty. These surgeons essentially try to forcefully create unnaturally sharply defined noses using plastic implants or over-aggressive Reductive Rhinoplasty.
Tragically, noses of celebrities like the late Michael Jackson and his sister Latoya Jackson are extreme examples of this ill-advised approach. These patients’ unfortunate Rhinoplasty results are clear evidence of the dangers of poorly guided patients relying on unskilled surgeons. Such deformities could likely have been prevented by proper education and counseling of patients, and by Plastic Surgeons who should have been able to refuse surgery to patients with unrealistic goals no matter what they were willing to pay. These Plastic Surgeons try to create noses that do not lend themselves to such extreme alterations, resulting in collapse and pinching, scarring, and obvious surgical deformity.
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Other surgeons have argued that we should be sensitive to ethnicity and retain ethnic features and not try to change them. This is a better approach but it also paints with a broad brush. Although in theory this is a good guiding principle, I would point out to these same Plastic Surgeons the fact that there is a very wide-spread, rich and diverse aesthetic spectrum amongst African American or Black patients throughout the United States and the world. Not only are there significant variations in skin color and texture, there are abundant variations in facial features and noses as well. No two African American or Black patients have the same exact facial features, anatomic features or surgical goals. As in all other forms of Rhinoplasty, “the nose must fit” the face. This is the only true guiding principle in Ethnic as well as non-ethnic Rhinoplasty – THE NOSE MUST FIT.
Oprah Winfrey, Rihanna, Beyonce, Pharrell Williams, Halle Berry, Tyra Banks, Naomi Campbell, Tyrese Gibson, Tyson Beckford and Nelson Mandela all have very different faces and noses, and to group them all into a single type of ethnic Rhinoplasty and to carry out a similar African American Rhinoplasty on each, would be a huge mistake. The nose must fit the rest of the face and the above celebrities do not have the same facial features while they all are African American or Black.
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Of course there are some features that are associated with many but not all African American patients. These anatomic features are crucial to diagnose and plan for before surgery so that there are no intra-operative surprises. These include:
- Low nasal bridge
- Washed out nasal bridge
- Short nasal bones
- Wide nasal bones
- Oily textured skin
- Medium to thick skin envelope
- Broad nasal tip cartilages
- Weak tip cartilages
- Flared nostrils
- Potential for hyper- or hypo-pigmented scars
- Potential for Keloid scars
However, there are significant variations from patient to patient. Some African American patients have very strong “Mediterranean” or “Caucasian” features due to location and origin of birth, while others are due to interracial marriages and so forth. It is important to make sure the new nose, as a result of Ethnic African American or Black Rhinoplasty, does not forcefully or inadvertently alter the heritage or identity of patients.
Computer imaging allows detailed communication between the Rhinoplasty seeking patient and the Rhinoplasty Surgeon. If an African American patient with all of the 10 features and anatomic findings above desires to have a nose identical to Angelina Jolie’s, (which is nearly an impossible and an unrealistic goal) then it is much more fruitful for the Plastic Surgeon to educate and dissuade the patient from undergoing a disappointing Rhinoplasty. This is much more ethical than carrying out an aggressive destabilizing Rhinoplasty and compromising the structure of the nose (i.e. Latoya Jackson). It is also much more sensible to talk such a misinformed patient out of Rhinoplasty than to perform a Rhinoplasty and then tell the patient after the surgery that “this is the smallest or narrowest your nose can get.” Discussion, dialogue, education and informed consent must be provided by the Plastic Surgeon, prior to surgery. After the surgery, explanations are regarded as excuses and often result in disappointed or disillusioned patients.
- This is not to say that significant improvements or beautiful noses are not achievable in African American patients. On the contrary, very beautiful changes can be made to nearly any Black patient’s nose seeking Rhinoplasty; however, only when the Rhinoplasty is performed properly with safe structural technique by dedicated and highly trained Rhinoplasty Surgeons. This is an advance operation that should not be performed by the novice or inexperienced Plastic Surgeon. Despite having carried out very successful Revision Rhinoplasties on African American patients who have had up to 4 previous unacceptable Rhinoplasties, I will firmly tell you that the best time to get the best Rhinoplasty result is during the very first operation.
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