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The nose goes global

The Caucasian, or European, model for the ideal nose is out and a global approach to rhinoplasty, considering patients’ ethnicities, backgrounds and facial structures, is in. That’s according to facial plastic surgeons who will be presenting at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Advances in Rhinoplasty Meeting in Chicago from May 4 to 7.

Dr. Most“Surgeons should realize that many of the ‘nuances’ that we’ve taught over the years were really done by surgeons 40 years ago, who were looking primarily at Caucasian patients. It’s not really completely fair to use that ‘ideal’ for every facial structure,” says meeting co-chaire and facial plastic surgeon Sam P. Most, M.D., chief of facial plastic surgery at Stanford University.

Rhinoplasty has evolved, according to J. Regan Thomas, M.D., a facial plastic and reconstructive surgeon who will be moderating a panel at the meeting, which will discuss diversity of cultural and ethnic norms for the “ideal” nose.

“There has been a very positive evolution in our understanding that facial beauty comes in many fashions. If you look at the celebrities that impact us and the models in key fashion magazines, they come from a variety of backgrounds and ethnicities. So, it’s a matter of understanding that, for example, a Latino patient’s nose or an African American nose are beautiful, but their structural aspects are different than, perhaps, a Caucasian nose,” says Dr. Thomas, chairman of otolaryngology, head and neck surgery and facial plastic surgery at the University of Illinois.

Dr. ThomasNot only are aesthetic surgeons embracing this more global concept of the ideal nose, but so is the public, Dr. Thomas says.

Aesthetic physicians can get a better idea of ethnic and cultural ideals by leafing through Vogue or other fashion magazines, Dr. Thomas says.

Related: Nonsurgical rhinoplasty of the Asian nose

“You’ll see models with all kinds of beautiful faces, but with very different ethnic anatomic aspects. For example, the African American nose tends to be wider and broader, with larger nostrils, a wider base to the nose and a wider tip. Trying to narrow that to make it fit in a pattern of a different ethnic aesthetic [isn’t the goal],” Dr. Thomas says.

Rather, that’s a big picture view. Next, it’s a matter of what’s best for the individual patient, Dr. Most says.

NEXT: What Patients Want

 

What Patients Want

“Of course, weigh the patient’s concerns first. Usually they ask for some guidance and I think the guidance should be what I call ‘ethnocentric.’ In other words, it should bear in mind the cultural background or ethnicity and structural features of a given patient,” Dr. Most says.

In a careful discussion with the patient, consider the person’s concerns and ethnocentric characteristics to arrive at the patient’s ideal. The goal, Dr. Most says, is to perform a rhinoplasty that’s structurally sound, will last for the patient’s lifetime and remain harmonious with the rest of the patient’s face.

In the end, today’s patient tends to want more natural results.

“By that I mean, something that doesn’t look like you’ve had a rhinoplasty. It should look like the nose you were born with,” Dr. Most says. “Having said that, on a Caucasian or somebody with an Asian or African American background, there are things you can do to a nose that make it look prettier or more handsome, but still look very natural for that face or that person.”

In essence he says, the ideal nose is the nose that looks best and most natural on any given patient.

Disclosures: Drs. Thomas and Most report no relevant confilicts of interest.

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