Ethnic rhinoplasty candidates have anatomical features such as a flat or flatter appearance instead of a significant elevation on the nasal dorsum, wide nasal wings, thick skin and weak cartilage structure. Surgical techniques are used to correct such anatomical differences in ethnic rhinoplasty surgery. The basic approach often consists of steps such as raising the nasal dorsum, narrowing the nasal wings and increasing the projection of the nasal tip.

What is Ethnic Rhinoplasty?

Ethnic rhinoplasty, unlike classic rhinoplasty, describes a specialized rhinoplasty surgery that prioritizes the nasal anatomy and needs of patients with certain ethnic origins (especially African and Asian). The main purpose is; to offer special solutions to nasal problems frequently encountered in these people, while also ensuring that the surgical results are appropriate for the face shape and ethnic origin.

Basic Objectives of Ethnic Rhinoplasty

• Elevating the Nasal Dorsum: A flat or flat nasal dorsum can cause an undesirable appearance in terms of both the facial profile and nasal aesthetics. For this reason, the nasal dorsum is elevated with extra cartilage.
• Narrowing the Nose Wings:Wide nose wings and nostrils are one of the most common problems to be corrected in ethnic rhinoplasty. The goal here is to bring the nostrils and wings to a width more compatible with the rest of the face without disrupting the naturalness.
• Emphasizing the Nose Tip: Wide and weak nasal tip cartilages make the nose tip look insufficiently high and wide (boxy type). To correct this, thinning and strengthening the nasal tip cartilages and, if necessary, placing a cartilage graft on them can give the tip of the nose a more pointed and distinct appearance.
• Obtaining a Non-Exaggerated and Natural Result: Ethnic rhinoplasty is not just a “reduction” or “change” surgery. At the same time, the goal is to have a nose shape that is proportionate to the other facial features and looks natural. Raising the nasal bridge too much can create lines that are incompatible with the face; therefore, it is important to make moderate interventions.

Who is it Suitable For?

Although ethnic rhinoplasty is an approach that deals with the typical nasal problems of patients of African or Asian origin, it is not limited to being applied only to people from these geographies. Anyone with similar nasal features (e.g., wide wings, low back, thick skin) may also be a candidate for this type of surgery.

How Does It Differ From Classical Rhinoplasty Surgery

Ethnic rhinoplasty, although it contains the basic principles of rhinoplasty, differs significantly from classic rhinoplasty due to the special anatomical requirements of the nasal structure. These differences occur in technical details, surgical planning, and postoperative results.

Emphasizing the Nasal Dorsum (Augmentation) Approach

• Classic Rhinoplasty: In most patients, the primary focus is correcting the arched nasal dorsum or removing excess bone and cartilage.
• Ethnic Rhinoplasty: Since ethnic rhinoplasty patients often have a low nasal dorsum, cartilage grafts are used to raise the ridge (augmentation) instead of removing excess bone or cartilage. This procedure forms the main axis of the surgery.

Narrowing of Wide Nose Wings

• Classic Rhinoplasty: Minimal adjustments to the nostrils, slight narrowing or procedures such as thinning the tip of the nose may be possible. However, serious alar narrowing (alar base reduction) is less commonly required.
• Ethnic Rhinoplasty: Wide nostrils become one of the most critical stages of the surgery. Here, shaping the nostrils, cutting and narrowing excessively wide areas and creating a symmetrical alar line are important.

Strengthening of Thick Skin and Weak Nasal Tip Cartilages

• Classic Rhinoplasty: Surgery may be less complex in patients with medium-thick skin and a hard cartilage structure. Shaping procedures allow the desired contours to be reflected more easily from the outside.
• Ethnic Rhinoplasty: Thick skin makes it difficult to obtain a visibly thin nose tip after surgery. In addition, due to the weak cartilage structure, it may be necessary to use additional grafts to shape the tip and back of the nose.

Excessive Graft Need

• Classic Rhinoplasty: There may not be a need for a lot of cartilage grafts; mostly the septum cartilage inside the nose is sufficient.
• Ethnic Rhinoplasty: Additional graft sources may be needed to elevate the nose dorsum and tip, strengthen the nasal cartilages and support the general structure. Rib cartilage is frequently used. Rib cartilage is preferred because it provides sufficient material to provide the desired volume. can be used. In addition, cadaver cartilage is also used.

How is it done?

Although ethnic rhinoplasty has some similar steps to classical rhinoplasty, the techniques and intervention levels applied differ.

Preoperative Preparation

Detailed Assessment and Consultation

• Understanding expectations: In the preoperative interview, how much the nasal dorsum will be raised, how much the nasal wings will be narrowed and how much projection the tip of the nose will gain are discussed.
• Physical examination: The shape of the nose is evaluated in detail. The width of the nostrils, the current height of the nasal dorsum and the thickness of the skin are examined.

Surgery

Anesthesia and Beginning of Surgery

• The surgery is performed under general anesthesia.  
• The duration of the surgery may vary between 1-3 hours depending on the scope of the procedures to be performed.

Surgical Technique: Open or Closed?

• Open Rhinoplasty: A small incision is made on the columella between the nostrils. The nasal skin is lifted through this incision, providing a wide field of view of the bone and cartilage structure. In the case of ethnic rhinoplasty, the open technique is generally preferred so that procedures such as raising the nasal dorsum and narrowing the wings can be performed in detail.
• Closed Rhinoplasty: All incisions are made from the inside of the nose, leaving no external scar. However, extra small incisions may be required for procedures such as wide wing narrowing. The closed technique can be used in more limited interventions.

Cartilage Harvesting and Graft Placement

• Septal Cartilage: If there is sufficient cartilage in the nasal septum and the patient's nose will not be significantly elevated, only the septal cartilage can be used.
• Ear Cartilage: In cases where there is not sufficient septal cartilage, cartilage can be taken from behind the ear. Ear cartilage is especially preferred for shaping the tip of the nose; it is flexible and suitable for shaping.
• Rib Cartilage: If the nasal dorsum needs to be significantly elevated, rib cartilage is one of the most abundant and durable sources. The surgeon takes the cartilage with a small incision in the chest area and prepares grafts of appropriate sizes for the nasal dorsum.
• Cadaver Cartilage: Can be used as an alternative to rib cartilage. These are cartilages that have been taken under suitable conditions and made acellular. It may cause additional cost increase.

Nasal Dorsum Shaping

• Cartilage grafts prepared to bring the low or flat nasal dorsum to the desired height are placed on the nasal dorsum.
• The grafts are fixed so that they do not slip and remain fixed after the surgery. In some cases, special suture techniques ensure that the graft fits the nasal dorsum perfectly.

Alar Base Reduction

• If the wide nasal wings open too far outward from the face, the surgeon removes a small V or W shaped tissue from the base of the nasal wings and the edges of the nostrils.
• The incisions are then sutured and the nostrils take on a narrower, more oval shape. During this procedure, both sides of the base of the nose are precisely adjusted to maintain symmetry.

Nose Tip Shaping (Tip Plasty)

• Extra cartilage support can be placed to increase the projection of the nasal tip cartilages (alar cartilages). In this way, the tip of the nose comes forward at an angle appropriate to the face.
• It can sometimes be difficult to shape the tip of the nose to a thin shape in thick-skinned noses.

Post-Operative Recovery Process

First Days and Hospital Stay

• A 1-night hospital stay is required following the surgery. The patient's post-anesthesia pain level, bleeding and swelling are checked at this stage.
• It is normal to see swelling and bruising around the nose, especially under the eyes. These symptoms usually decrease significantly within 7-10 days.

Removal of the Splint

• The splint and splints are usually removed 5-7 days after surgery. The nose will still be swollen during this period. Edema lasts longer, especially in patients with thick skin.

Return to Daily Life

• Return to work or school: Most patients can return to social life approximately 7-10 days after surgery. However, it should be noted that mild swelling and tenderness on the nose will continue.
• Sports and exercise: It is recommended to avoid heavy exercise for the first 4 weeks. Activities that may increase blood pressure may cause bleeding or prolonged edema.

Long-Term Shape Adjustment

• It may take up to 1 year for the final results to appear in noses with thick skin after ethnic rhinoplasty. It takes time for the graft to adapt to the tissue and for the skin to adapt to the new shape.
• The recommended massage and care techniques are important during this process. For example, patients with thick skin can help the edema to go down more quickly by lightly massaging the tip of the nose.

Possible Complications and Reasons for Revision

Bleeding

Especially in those with severe septum deviation, there is a low risk of bleeding in the postoperative period. In such a case, necessary interventions are performed.

Asymmetry or Graft Displacement

The placed graft may shift slightly during healing or there may be tissue absorption. This may sometimes require revision surgery.

Insufficient Dorsal Height

If the patient thinks that the nasal dorsum has risen less than desired after surgery, a repeat intervention may be needed for additional correction.

Excessively Narrowed Wings

Excessive narrowing by the surgeon may adversely affect the nostrils and respiratory tract. Therefore, the basic principle of surgery is “narrowing in dose”.

Additional Procedures That Can Be Considered Together with Ethnic Rhinoplasty

It may be possible to maximize the benefit you will get from surgical procedures with combined surgeries. Correcting more than one deformity at a time may yield better results. You can customize your surgery with Dr. Celal Alioğlu's other treatment options.