In recent years, the number of African American patients seeking rhinoplasty, or nose surgery, has increased dramatically. Today, more patients of African ethnicity are interested in the potential refinements of a rhinoplasty procedure while wanting to maintain their distinct ethnic features. Dr. Bared’s main objective in rhinoplasty is to provide natural results while achieving the patient’s aesthetic goals.
After spending years working with patients of different ethnicities, Dr. Bared has cultivated a deep understanding of how to address nasal concerns while preserving the patient’s unique heritage. Regardless of the patient’s race, Dr. Bared tailors each rhinoplasty to perfectly blend with the patient’s overall facial features and align with their specific cosmetic objectives.
The African American Nose: Features and Characteristics
As the central feature of the face, the nose is often the first thing others notice about a person. For many, their nose is also part of their cultural identity and a common feature shared across generations. Although nose shape and size vary widely from person to person, individuals of African descent tend to display noses that are wider and broader compared to other ethnic groups. Generally, African and African American noses also feature enlarged or flared nostrils, rounded tips, and a small, flat nasal bridge.
An African American rhinoplasty, or African American nose job, is a plastic surgery procedure that addresses cosmetic or functional nasal concerns, like a wide bridge or flared nostrils, while respecting the patient’s heritage. As with the traditional or Caucasic rhinoplasty, the aim of the African American is to improve specific areas of the nose to achieve a natural, harmonious appearance that complements other facial features.
Goals and Challenges Of An African American Rhinoplasty
Dr. Bared’s primary objective in African American rhinoplasty is to create naturally appearing refinements to the nose while preserving the patient’s ethnic traits. While each case is specific to the patient, there are specific maneuvers that need to be employed in all cases for a successful African American rhinoplasty procedure.
The most important of these maneuvers is tip support. If the tip cartilages remain weakened after surgery, the tip of the nose will droop in time. To avoid this, Dr. Bared utilizes grafts from the patient’s body to provide support. Most of the time, grafts are harvested from the septum, which is the cartilage that divides either side of the nose. However, in cases where the septal cartilage is too small, additional cartilage is taken from the ear from an incision concealed behind the outer ear.
Grafts, in general, are used to provide shape while, at the same time, supporting the nasal structure. Grafts ensure that the results you see are present for a very long time, as the nose structure will be adequately supported. And since they are from your own body, studies have shown that they decrease the risk of complications from infections more prevalently seen when implants are used in the nose.
While tip support is uniform in all African American rhinoplasty cases, other maneuvers may be used in each specific case, including bridge and width refinements. For one, improvements to the tip are usually balanced with refinements to the width of the bridge to achieve a harmonious balance.
Then, the width of the bridge is usually narrowed by means of osteotomies (bone reshaping), where the nasal bones are reset into a more narrow width. In African American rhinoplasty, osteotomies need to be performed at a lower level, given that the African American nose typically has shorter nasal bones.
Finally, to balance the refinements made to the tip and bridge on the frontal view, the width of the base may need narrowing and alar (nostril) bases reduced. Alar base reduction can be a complex maneuver that can be fraught with risks if not performed correctly by a specialist.
Dr. Bared understands how precise a surgeon needs to be when performing alar base reductions to prevent noticeable scarring as well as an overly narrowed and unnatural appearance.
Additionally, if the alar base reduction is performed too aggressively, the nostrils lose their natural rounded appearance and take on more of a triangular shape.
When performing alar base reductions, Dr. Bared uses a small measuring device called a caliper. This device measures the changes made to the size of the nostrils to the millimeter, allowing him to make exact calculations of how much to remove. The placements of the incisions for an alar base reduction are also of utmost importance. Dr. Bared carefully places these incisions in areas of the nostrils where they would be best camouflaged.
Improving Nasal Skin
Another technique employed in African American rhinoplasty, which further helps refine the tip of the nose, is the careful de-fatting of the nasal tip skin. Often, the skin of the tip in African American patients is thicker and presents a secondary fat layer. This layer of fat can be carefully removed to allow the skin to re-drape over the cartilages and allow the refinements made to the cartilages to become more evident. The de-fatting of the nasal tip skin needs to be done very carefully and meticulously to avoid injuring the skin.
Narrowing A Widened Bridge
The nasal bridge may appear wide and flat due to either widened nasal bones or a low bridge. A widened nasal bridge can be narrowed via two approaches. First, if the nasal bones are found to be wide, osteotomies are used to reset the bones into a more narrow position. The second component of narrowing a bridge may be due to the flatness of the bridge. A lower bridge will also give the appearance of a widened bridge.
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Bared’s Approach to Rhinoplasty
Dr. Bared’s approach to rhinoplasty is to, whenever possible, only use the patient’s own cartilage during the procedure. Implants are often used by surgeons during African American Rhinoplasty to augment the dorsum ( bridge) of the nose. Augmentation of the dorsum is utilized to narrow the bridge and create height for a lower bridge.
However, Dr. Bared’s practice is to not use synthetic material to augment the dorsum as these can be prone to infections and even extrusion. Infections and extrusions have been reported to occur even years after surgery. Instead, Dr. Bared will often use ear cartilage and temporalis fascia (removed from a small incision hidden within the hairline). Although this technique augmentation requires more technical skill and surgical time, Dr. Bared feels that it is in the best long-term interest of his patients to avoid the use of artificial implants.
What To Expect During An African American Rhinoplasty Consultation
If you’re considering an African American rhinoplasty, you’ll want to meet with a plastic surgeon beforehand to discuss your goals and concerns and find answers to your questions. During your initial consultation with Dr. Bared, you can expect that he will listen to your concerns and your specific goals regarding your procedure. This appointment is an integral part of the process, where mutual goals and trust need to be established between the patient and the surgeon.
After performing a thorough evaluation of your nose, Dr. Bared uses his aesthetic background to convey what is realistic and how nose surgery can achieve harmony with the rest of your facial features. He considers, amongst other details, the distance between the eyes, the shape of your face, and the existing anatomy of the nose. In addition, he will assess the amount of tip cartilage support, the width of the tip cartilages, the size of the nostrils, the width of the base, and the width of the bridge.
Procedure and Recovery
Rhinoplasty is a highly sophisticated surgery that requires tremendous attention to detail. As such, the intervention typically takes 3-4 hours to complete. Surgery will involve manipulating and resetting bone and nasal cartilage to shape and refine the nose. Before your procedure, Dr. Bared will recommend either an open or closed rhinoplasty, depending on the type of changes that need to occur.
Open rhinoplasty surgery entails making a small incision across the columella (the strip of skin that connects your nostrils) to gain access to the underlying nasal structures. The scar from this incision typically heals exceptionally well and becomes virtually invisible. Closed rhinoplasty involves making incisions inside the nostrils. Dr. Bared performs the majority of his procedures using the open approach.
After rhinoplasty, particularly patients with thicker skin are expected to have more extended periods of swelling. In some cases, Dr. Bared may place small amounts of anti-inflammatory steroid injections into the nose to help with the swelling after surgery. If used, these are usually started one month after the procedure. Swelling in the tip area is the most persistent and can take up to one year to subside completely.
Frequently Asked Questions
An African American rhinoplasty procedure can cost anywhere from $5,000 to $35,000, depending on the extent of the changes needed, your geographical location, and surgery and anesthesia fees.
Yes, rhinoplasty surgery can correct structural problems that cause breathing issues, like septum deviations and alleviating blockages to nasal passages.
Yes. Some patients find that combining rhinoplasty with chin augmentation surgery helps them strike the right balance between the nose and the chin. Nose surgery can also be successfully paired with nonsurgical interventions, like dermal fillers and Botox.
If you live near Miami, FL, Dr. Anthony Bared offers African American rhinoplasty among its services and is conveniently located at 6280 Sunset Dr #506, Miami, FL 33143.