Ethnic Rhinoplasty in Turkey

What is Ethnic Rhinoplasty?

Ethnic rhinoplasty is somewhat misleading if it is not used as a terminology only as a title. In fact, ethnic rhinoplasty is a general term with many complexities. This title typically refers to rhinoplasty in African-American, Hispanic, Indian, Middle Eastern and Asian patients. However, defining ethnic groups can be difficult, sometimes impossible, as there are multiracial mixes defined by cultural and geographical factors.

To accommodate the wide anatomical and structural diversity among these patients, several investigators have developed subcategories within each ethnicity. The concern with dividing these ethnicities into multiple subcategories stems from the surgeon tailoring the patient to a predetermined treatment algorithm rather than tailoring an individualized treatment algorithm for each particular patient. While subcategories are helpful, it is critical for the surgeon to master common but variable anatomical features within certain races and cultures. Of course, at the same time, the surgeon must be equipped with appropriate surgical techniques in order to understand various cultural aesthetics and achieve a successful result.

In this article, the term ethnic (albeit a harsh generalization) refers to African-American, Arab, Indian, Hispanic, and Asian patients. These populations also share a few common anatomical features with the effect of geographical and cultural overlap.

Rhinoplasty in Ethnic Patients

Harmony and symmetry are essential elements of beauty and are the main goals of any surgical plan, regardless of the patient’s race or ethnicity. Beauty standards in Western society were heavily influenced by Northern European traits. For example, some authorities defined the aesthetic Caucasian female face as having clear, pale, smooth skin.

At the same time, a medium-sized mouth with long eyelashes, large, widely spaced, prominent cheekbones and gentle lips that are not too thick… A flat, narrow bridge with the aesthetic peculiar to the nose; prominent protruding tip and nasal-lip angle of approximately 90 to 95 degrees in males and 95 to 105 in females.

In strong contrast to this, of course, the African-American nose is often characterized by a broad, low back; Less tip definition, increased dorsal enlargement or shorter nose length; nose-lip angle and low floor… The nose and general appearance of each patient will certainly reflect this multicultural background.

It should be noted, however, that these characteristics can vary considerably from one patient to another, given the background of the African diaspora and the multi-ethnic origins of most African-Americans.

This diversity adds to the complexity of rhinoplasty in the Indian, Hispanic, and Arab communities that share similar characteristics. Given such great variability in these ethnicities, it is inappropriate for the surgeon to use aesthetic standards and techniques commonly used in Caucasian rhinoplasty patients to evaluate the ethnic rhinoplasty patient. Similarly, it would be the surgeon’s fault for an ethnic patient presenting for rhinoplasty to plan their nose to resemble a Caucasian or Northern European nose.

On the contrary, the rhinoplasty surgeon should determine the aesthetic goals of each patient individually. Most of the ethnic patients who applied for rhinoplasty in the past years probably wanted a Caucasian-looking nose, which was perceived as the “accepted beauty standard”. However, ethnic patients who want to have rhinoplasty wish to obtain an attractive nose that preserves its ethnic character.

While all these are at hand, it is the surgeon’s responsibility to determine whether the goals are realistic and the aesthetic goal during the preoperative examination.

Although there are defined standards for the Caucasian female nose, an ideal standard for African-American, Indian, Asian, Hispanic or Arabian rhinoplasty has not yet been established. Some authorities have summarized the objective values and proportions of African American women’s noses using anthropometric measurements, and similarly, other authorities have made anthropometric measurements of Latino women from the Caribbean, Central America and South America.

However, considerable variability persists in these heterogeneous populations. Therefore, general knowledge and understanding of the anatomical features that are more common in patients of different ethnic origins will assist the surgeon in planning surgery. For example, as we mentioned above, the African-American nose can be defined as a short columella (the middle part between the nostrils), wide flat nasal ridge, slightly widened base, smaller nose-lip angle, oval and rounded tip.

Inadequate nasal protrusion, which is approximately 0.5 times the nose length versus 0.67 times the ideal nose length, is common in Caucasians. Considering such general differences is of great importance to the rhinoplasty surgeon planning to reshape the nose in any patient who is African-American, non-Caucasian, or has variable anatomy, and the importance of choosing the right surgeon comes into play in such nuanced situations.

To achieve consistent aesthetic results in non-“white” rhinoplasty patients, authorities aim to:

1. Nose-face harmony
2. Narrower, flat back
3. Nose tip prominence
4. Normal interalar distance (the width of the tip of the nose that becomes laterally oval)

Using these guidelines and making minor changes appropriate for the patient will provide the rhinoplasty surgeon with consistent results in ethnic rhinoplasty studies.

Afro-American, Indian and Middle Eastern(Arab) Noses – Ethnic Rhinoplasty

The scattering of the African diaspora into Europe, Asia, and the Americas occurred primarily during the Arab and Atlantic slave trade, which was influential in the ninth and fifteenth centuries. This distribution is one of the biggest migrations in human history, and it is also one of the biggest reasons for the merger of many races and ethnicities around the world.

Populations around the world often have African influences. This is probably also the reason for the anatomical similarities between African-Americans, Latinos, Arabs, and people from the West Indies.

These populations have historically been generalized to the term ‘platyrrhine’, referring to the broad nature of the nose, as opposed to ‘leptorrhine’, a term used to describe the white’s narrow nose. While these classifications no longer apply to a single race or ethnicity, these historical origins hint at some of the similar anatomical features found in African American, Indian, Arab, and Hispanic patients.

Anatomical Diversity

The main differences between the Caucasian nose and the noses of these ethnic groups are as follows:

Skin thickness, fibrofatty layer (oval section above the perforations), alar cartilages, alar bases, and bony pyramid.

The skin in these patients is typically thicker, relatively inelastic, particularly at the tip of the nose. At the same time, patients have increased subcutaneous adipose tissue, which causes an unaesthetic nasal tip.

Although the size of the nasal cartilages of these patients is similar to that of Caucasian patients, the space between the cartilages is usually wide and filled with fat.

The bony pyramid is often characterized by a broad nasal base, low nasal ridge, and deepened nasal-forehead angle, especially in African-Americans. However, the flattened nose appearance is caused by the low back bridge rather than the wide nasal base.

As a result, nasal ridge elevation is generally recommended in this scenario as opposed to bone base fractures. Variations more common in Arab and Indian patients include a significant back arch, nasal tip instability, nostril asymmetries, low nasal-lip angle, and protruding nasal tip.

Lower nasal dorsum are less common in Arab patients. However, a wide nasal base and thick oily skin, especially at the tip, are very characteristic.

Typical Middle Eastern Nose: High back, ill-defined nasal tip, and thick soft tissue.

Hispanic Nose – Ethnic Rhinoplasty

The terms Hispanic, Latino, and Mestizo are used interchangeably to describe patients in Spanish-speaking countries. Therefore, there is a wide variety of nasal structures seen among this group. The nose structure in hybrids has common features with European, African and Indian noses. Therefore, generalizations that can be made for the African-American nose are more difficult to make for the Spanish nose.
Ortiz-Monasterio, a pioneer in Hispanic rhinoplasty, identified 5 characteristics as the primary factors that distinguish mestizo noses from Caucasian noses. First, similar to the African-American nose,
Hispanic noses have a thicker, more oily, soft-textured nasal skin. Second, these patients have wider but shorter nasal bones and a relatively small cartilage dome. Third, because of the short medial crura and a weak caudal septum, the tip has less support and appears less protruding and rotated. Fourth, the columella is typically concealed by a shorter membranous septum. Finally, Hispanic patients have wider nostrils.
Additional features, anthropologically termed the ‘mesorrhine’ nose, have been used to describe the Hispanic nose and distinguish it from that of Caucasians.

These include wider faces with prominent temporal and under-eye protrusions, more horizontally oriented nostrils, and a sharper nose-lip angle. There is a prevalence of dorsal hump in the Hispanic population. However, these may be false humps, which are made evident by the lack of tip protrusion or a lower base location. More importantly, nasal tip protrusion may cause a sharper nose-lip angle seen in Hispanic patients and may not actually be drooping in relation to the tip face. For this reason, the nose-lip angle is not an accurate method for nasal tip evaluation for many people. Rotation in the Hispanic patient. Attempts have been made to better describe the great diversity in nasal architecture found in the Hispanic population. In the first anthropometric analysis of Latinx noses compared to Caucasian and African-American noses, authorities identified 3 distinct Hispanic groups by origin: Caribbean, Central American, and South American.

The noses of the Caribbean population had anthropometric features of African-Americans, while the noses of Central and South America were more similar to those of Caucasians. Later, classification of 3 nose types was proposed: Castilian, Mexican-American and Mestizo.

As a summary of the reported findings, patients of the first archetypal or Castilian profile have a thinner, variable skin thickness than the African-American population. The radix (the area where the nose meets the forehead) is usually in a high-normal position with prominent nasal bones.

Although the tip projection is similar to the Caucasian population, the tip width may appear somewhat broad and there is variation in the width of the base.

Patients in the Mexican American profile also have a variable skin thickness but, unlike the first group, a lower root position.

Although the bony dorsum is not prominent, the diminished tip projection gives the illusion of a large dorsal hump.

Recognition of this is imperative as dorsal reduction may not be appropriate for this group of patients. The rest of the nose shares the same features as the Caucasian nose.

The mestizo snout has features more similar to the Caribbean population. The nasal skin is thicker, while the fibrofatty tissue (oval section above the holes) is thicker. Alar base and dorsum are wider than seen in white patients. The tip of the nose is less protruding and there is loss of definition, these features are similar to the African American population. These classification schemes reinforce an important element of rhinoplasty in the Hispanic patient; Great variability in nasal structure requires an individualized approach to nasal improvement.

Asian Nose – Ethnic Rhinoplasty

The Asian nose is one of the most challenging ethnic rhinoplasty doctors faced by rhinoplasty doctors, primarily due to the lack of thick skin and soft tissue combined with a weak cartilaginous framework. The three goals to be achieved are:

1. To please the patient.
2. To achieve an ethnic, aesthetic and functional result,
3. Achieving a natural look.

Of these goals, patient satisfaction may be the most difficult to achieve because many patients have unrealistic expectations and desire to achieve a white nose. Since the patients do not know the underlying structures of the nose structures, they may want to dream of noses similar to the noses of models or celebrities, even if they are not suitable for their faces.

The most important task of the surgeon is to try to convince the patient that this result is unrealistic, dysfunctional, not aesthetically pleasing and difficult to achieve with his thick skin. However, this can only happen with good communication between the surgeon and the patient.

One of the most common problems in Asian rhinoplasty is the desire to achieve a less convex, Westernized nose tip. Obtaining a prominent nose tip is mostly done by taking the lower cartilages.

Of course, when the reduction of the lower cartilage occurs, this usually causes the following problems: loss of sharpness, inversion, loss of support, nasal congestion, more convex nasal tip and possible long-term nasal tip contour irregularities…

Modern rhinoplasty practices suggest that less is more, and cartilage removal is outdated. Additional nasal support is provided by structural grafting with less cartilage removal.
National and international rhinoplasty symposiums suggest that these techniques may lead to a decrease in Revision rhinoplasty operations.

Ethnic Rhinoplasty Price in Turkey

Turkey ranks 3rd in the world in medical tourism. North American and European citizens going to Turkey for rhinoplasty with peace of mind, thanks to affordable prices, the abundance of competent surgeons and the experiences shared by their patients who have had surgery in Turkey.

All Inclusive Ethnic Rhinoplasty Turkey

– Rhinoplasty
– 6 nights 7 days accommodation in luxury hotels (2 people)
– Airport, clinic and hospital transfers with a V.I.P vehicle
– 12-month patient follow-up

Ethnic Rhinoplasty Turkey All Inclusive Price

As mentioned above, you can get all inclusive health package in Turkey for the price of rhinoplasty in Europe. All inclusive rhinoplasty prices in Turkey range from $3000-$4000. We have said that the price varies depending on the surgery done on the nose of the patients should be carried out. You can find out the exact price with a free online video call find out for yourself.

Source: PubMed