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Facial Plastic And Reconstructive Surgery Specialist

Baltimore, Lutherville, Maryland 410. 502 .2145
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African American rhinoplasty  African rhinoplasty   Ethnic rhinoplasty  Revision rhinoplasty           

Nose reshaping in people of African descent requires a unique set of skills and understanding of the African American patient. Because of his background, Dr. Boahene has a specialized interest in rhinoplasty in Africans, African Americans, Carribean and individuals of African descent. The aesthetic standards, techniques and measurements commonly used in Caucasian patients, when applied to the ethnic nose, often results in an unnatural, over-operated and a very unhappy patient.
 

 

 

Ethnic Cosmetic Surgery rising; Washington Times.

 

Christi Tyson, 32, of Silver Spring is typical of the trend. A corporate nutritionist who interned at Hopkins, she came to Dr. Boahene in May for rhinoplasty - a nose job - that cost $6,000. She first got opinions from two other minority surgeons, paying $100 for each consultation.

"What they wanted to give me didn't fit me. I felt rushed," she says.

An otherwise self-confident person, she unabashedly admits she grew up "with some sort of complex" about her nose because "it seemed a more distinct feature that I didn't like." Neither her mother nor her father had a similar feature.

She brought Dr. Boahene a photo of a high school classmate, actress Kerry Washington, to use as a model. Dr. Boahene made before and after pictures on a computer screen to suggest what would be best for her.

"I wanted to look natural, but not in an extreme way," she says.

 

 

Click to read full article

http://www.washingtontimes.com/news/2008/sep/10/ethnic-cosmetic-surgeries-rising/

 

FAQs in African American and Ethnic Rhinoplasty

Here are answers to some frequently asked questions concerning African American Rhinoplasty:
  • What are some common reasons African Americans seek nasal surgery?

    • wide nostrils

    • wide nasal tips

    • flat noses

    • lack of tip definition

    • breathing problems

  • What is unique about the African American nose and nasal surgery?

    • maintaining the African ethnic feature is of utmost importance

    • an unnatural look is poorly tolerated

    • short nasal bones requires special handling

    • skin type prone to scarring

    • standard rhinoplasty measurements used for Caucasians are not applicable

    • thicker skin and delicate cartilages require special handling

    • diverse facial features among African Americans require an individualized approach

  •  What techniques do you use for the African American rhinoplasty?

    • Reshaping the nostril without external scars
    • Narrowing the tip without external scars
    • Improving breathing while reshaping the nose
    • Use of patients own tissue in the majority of cases
    • Building up the nasal bridge with cartilage ( nasal, ear or rib cartilage)
    • Narrowing broad nose with micro-osteotomies using minimally invasive technique

 

  •   Do you use the Open or Closed approach in your rhinoplasty procedures? I use both approaches as needed. The open (external) vs. closed (endonasal) approaches are two methods of exposing the nasal cartilages and bones. The main difference is the placement of an incision across the columella. I use microsurgical techniques to close this incision so it rarely becomes an issue. The approach I select however depends largely on my ability to visualize details of the cartilage framework that needs to be contoured. In some cases, the endonasal approach allows excellent visualization whiles in other, seeing more through the open approach allows me to more precisely contour the nasal framework. In the end, meticulous technique blurs the distinction between the two approaches. We have also mastered an approach we call "the open endonasal" approach which is a blend of the two classic open and closed approaches. In the open endonasal approach, all the incisions used for an external approach are used except the columella incision. Thus, while there is no external columella scar, we have the exposure seen in the traditional external approach. I now use the open endonasal approach in over 90% of my rhinoplasties. My goal is always to use the least intrusive approach to achieve the aesthetic changes desired. When I suspect a patient may be prone to poor scarring, I use the endonasal (closed) approach. 

 

  •   Do you debulk the nasal skin and make major changes in your rhinoplasty procedures? Yes. Rhinoplasty is one of the few cosmetic procedures that the surgeon has to make changes factoring in refinements that will occur long after the surgery is completed. Anticipating the changes that the skin will undergo becomes very important. The thicker the nasal skin, the more structural support is needed. I often will debulk thick skin down to a level that preserves the skin's blood supply that is necessary for nourishment. I use cartilage grafts to provide adequate support and shape to the skin. The skin then adapts to the underlying recontoured cartilages  to achieve the desired aesthetic shape. Major changes made during rhinoplasty will only lead to a nice natural result when it blends well with the other facial features like the lips, cheeks, forehead, brow and chin.

 

  •  I have considered having rhinoplasty for a while but have been afraid of getting the over-operated look. I do not want to lose my ethnic features. Can that be achieved? A nice rhinoplasty result is not harsh and does not call attention to the  nose, but rather directs the admirers focus to your eyes. Thus, a natural looking rhinoplasty should blend seamlessly with the rest of your facial features. We achieve such results by concentrating on contour changes but reshaping what you have creating highlights and shadow points that are photogenic. Nice rhinoplasties that are ethnic sensitive are better accepted than those that are harsh and surgical in appearrance. The answer is yes.

 

  • I have a big nose and thick skin. What can be done to achieve a major difference and a nicer nose? The shape and size of a nose is determined by the framework (nasal bones and cartilages) and the soft tissue that drapes over it (skin, fat, muscle).  A thick skin overwhelms the framework preventing any definition to shine through. We address both the soft tissue and the framework to recreate a more proportionate nose that has definition. We recommend in selected cases, treating the nasal skin with creams that improve the nasal skin texture before and after the rhinoplasty. We judiciously thin the skin where necessary to achieve more definition. We focus on building up the frame work with strong cartilage grafts to both support the heavy skin and to achieve favorable definition.The skin then drapes over the new frame work and over time reveal a more defined nose.

 

  • How much does rhinoplasty cost in your practice. The cost of rhinoplasty varies from patient to patient and includes the technical fees, operating room cost and the fees for an anesthesiologist. These costs depend in part on the complexity of the case which determines the time required to make all the changes needed to achieve the results that you will value. We apply any consultation fee towards you final cost and provide follow-up care for up to one year. We provide an estimate of all anticipate fees prior to surgery.

 

  • What should I expect during a rhinoplasty consultation?

Dr. Boahene trained at premiere medical institutions and with expert plastic surgeons around the world. He brings this international perspective to his patients. Knowing that different patients have different features, he approaches each patient with an individualized touch. "I take a personal interest in listening to and educating my patients so that we can formulate a plan that produces a natural looking result". Patients are advised to come to their consultations with as much information as they can. Pictures of potential final results are helpful in directing conversation during the consultation. Your nose will be examined to determine your unique anatomic features that may need correction or refinement to ensure long term stable results. Photographs will be taken and then morphed with a computer program so that you can have an idea of the final results. International patients and others who live afar may start the consultation process on-line. To facilitate an on-line consultation, take digital photographs of the face focusing on the nose. The pictures are most helpful when taken against a bold colored background. Digital photographs for rhinoplasty should include a front, profile ( side) and base ( looking into the nostrils) views.

 

 

Contact Dr. Boahene About African American Rhinoplasty.
                           
                           
A consultation with Dr. Boahene will include:
  1. Personal consultation with Dr. Boahene
  2. Digital photographs and analysis
  3. Computer imaging to preview results
  4. Complimentary skin care consultation

 

For a consult call us at :410 502 2145  or 410 527 1197 

 

 Email us with a your rhinoplasty questions, interests or set up a consultation: info.drboahene@gmail.com









       

 

Before and After Photos African American Rhinoplasty


1.  Before After BeforeAfter
   

Ethnic rhinoplasty to build up a low nasal bridge in this African female using contoured rib cartilage.  The broad nasal tip and nostrils were refined to achieve an overall balanced look.The mid nose was narrowed with microosteotomies. Rib cartilage was harvested through a 1.5cm incision hidden in a crease. We use a composite rib bone and cartilage contoured in a 3-dimensional fashion based on the individual's native nose allowing the graft to conform to the bridge, blend well and stay straight without warping.

  
  BeforeAfter 
  

 Nasal tip refinement African American rhinoplasty.The nasal base width is appropriate but the alar margin and nostrils are flared. Using cartilage grafts and cartilage reshaping techniques, the tip is refined without any visible external scars. Notice the natural un-operated look. 

2. BeforeAfter (3months)After (6months)
   

 Rhinoplasty in an African American model. Beauty models are photographed numerous times a week with

the best of professional equipment which highlights even minor blemishes. Models are therefore particularly

 sensitive to cosmetic surgery result that are not photogenic. They demand results that are natural, scarless and

elegant even under the harsh scrutiny of flash lights and the general public. This model had elegant facial features but

 wanted a finesse rhinoplasty that will highlight her facial features without the operated look. Major changes were done

 here to reshape an extremely flat nose to one that is appropriately projected and photogenic. No implants were used in this case.

There are no visible external scars. Notice the progressive changes occurring over 6 months with more refinement

expected even up to a year. There is proportionate tip and nasal bridge definition and symmetric nostrils after reduction

without external scars. The result preserves her ethnic features.

3.  Before After Before After 
    

 Early post operative result after rhinoplasty in an African American female. Results showing natural changes,

nice nasal higlights and shawdows which are essential for refining the nose without an obvious operated look.

Nasal tip defining points are highlighted; brow - tip aesthetic lines  are naturally created here. The nostrils and nasal base

 have been reshaped without visible scars. The rhinoplasty procedure was perform without an external columella incision.

Rhinoplasty patients often ask how much down time to expect. These photos are included here to show the typical appearance

one week after surgery.This individual was able to returned to work after one week after her rhinoplasty.

 

4.      Before After   BeforeAfter    
    

 African American female interested in conservative correction of her 

flat nasal bridge and flap bulbous nasal tip. The flat bridge was correced with

careful perforated osteotomies of the nasal bone to prevent destabilization

of her extremely short nasal bones. Septal cartilage graft placed on the 

bridge provided additional definition without over-projection ( raised) profile.

The thick nasal tip skin was delicately thinned to achieve additional definition.

Subtle changes can enhance the overall appearance of the nose while preserving

ethnic sensitive features. 
 

 
 

 

5. Before After  
   

Ethnic rhinoplasty is black female from Europe. Results

after 2 months showing well defined bridge, tip definition and

an overall slender refined nose that fits her facial features. No

implants were used in this rhinoplasty. There are no visible

external scars. This is the classic result of  the Dr. Boahene

ethnic sensitive natural rhinoplasty technique. Additonal lip

reduction and buccal fat reductionbalances the overall contoured

look.

 

 

6.      BeforeAfter Before After 
    
    

 Tip rhinoplasty in African american female . She had an extremely think nasal skin, very wide nasal lip. The combination of a wide tip and thick skin can pose a challenge. It is not uncommon to find this combination addressed with excessive tip cartilage grafts and implants which results in hard, stiff noses that is overly projected ("stuck up" ), pinched and unnatural. Here, signature cartilage contouring techniques and skin debulking was used to refine the nasal tip. Photos shown were taken one week after surgery. Inspite of the post-surgical swelling, the width of the nasal tip has already been reduced by ~ 30% ( compare blue lines). As the swelling resolves, further definition becomes apparent. Notice also that the nostrils that were visible on front view and now less visible. Techniques were also used to prevent the nasal base from widening when she smiles resulting in a more photogenic nose.

 

7. Before                          After                  
  

Rhinoplasty in African American male to reduce dorsal hump and straighten the crooked nose. The bulbous nasal tip was

refined for better balance.

 

8.    BeforeAfter 
  

 African rhinoplasty, finesse changes,excellent profile  and

delicate tip achieved with revision rhinolasty after two previous 

nose jobs

 

9.    BeforeAfter BeforeAfter    
    

Ethnic rhinoplasty in an African male with crooked nose, think nasal

skin, flared nostrils and wide nasal base. Rhinoplasty showing correction

of the crooked nose. Finesse tip rhinoplasty retaining masculine features,

no pinching, correction of nostril flare and reduction of wide nasal base.

Overall, a natural looking, non-surgical appearing result.Rhinoplasty

performed with the hybrid open endonasal approach,

resulting in no visible scars. Result at 4 months.

 

 

 

10. BeforeAfter Before After Before After 
      

Revision rhinoplasty in an  African female. One week result already showing changes in her nasal profile, a smaller nose that is more proportionate with the rest of her face, corrected alar flare and smaller nostrils.Further refinement is expected as the swelling improves. This is the typical extent of bruising 7 days after revision rhinoplasty surgery.

 

11. Before After Before After Before After 
      
 Ethnic sensitive rhinoplasty. This African American female was interested in reducing her nostril size and flare, narrowing and defining her nasal tip and correctiing the widening of her nose whenever she smiled (a common complain). Rhinoplasty with an open technique  with tip refinement, correction of alar flare, nostril reduction, appropriate base narrowing and correction of nasal base widening when smiling. Early result showing minimal buising. Extensive tip work including narrowing of the base of the alar rim and debulking on the tip skin. Swelling over the nasal tip fluctuates during the healing period but over time improves. Judicious use of steroid injection over the nasal tip facilitates the healing process. Notice how the nose does not widen when she smiles. Also notice the absence of obvious scars.

 

12. Before AfterBefore  AfterBefore After 
      
 Revision rhinoplasty in African American female showing improved profile, defined nasal bridge, delicate tip work, natural appearing result correcting multiple deformites from her previous rhinoplasty.  Early post operative results after her revision rhinoplasty are shown. In revision rhinoplasty, it is important to be specific about the aesthetic goals, identify any functional problems such as breathing difficulties and address both at the same time. Specialized nasal base suture techniques were use to prevent widening of nostrils when she smiles.

 

13.  BeforeAfter  BeforeAfter 
    

Male rhinoplasty with correction of crooked nose, hooked nose, nasal hump droopy

tip and retracted nsotrils.

 

14.  BeforeAfter Before After Before After 
      
 

Finesse ethnic rhinoplasty in an African American female.Her droopy tip with hanging columella

is corrected. Her tip is slightly projected and rotated up. Her nose is narrowed to fit her face . Note the corrected  alar flare and wide nostrils without any visible external scars. Dr. Boahene uses a special technique of cartilage grafting to reshape the nostrils that yields a natural result. Results at10 months are shown here.

 

15. BeforeAfter  
   

Ethnic rhinoplasty in an African American professional  female.She was interested in refining her nose without the sharp, harsh surgical appearance . Notice the correction of the droopy tip and improvement in her nasal profile. Results are ethnic sensitive and natural appearing. A well defined tip was acheived inspite of her thick nasal skin.

 

16. BeforeAfter Before After 
    

Tip rhinoplasty in a female with wide nostrils and droopy tip. Finesse changes to

correct droopy tip , reshape and reduce the nostrils were performed.

 

17. BeforeAfter 
  

 One week result after revision rhinoplasty in a female who had undergone

 two previous rhinoplasties. Note the correction of the rounded nasal tip.

Inspite of post-operative swelling,the new tip reveals better definition. The

 previous short nose appearance is corrected. Revision rhinoplasties are

challenging because the surgeon has to accurately identify the alterations made

during the previous surgery and correct them. In this case, an extensive amount

of scar was removed from the tip and shapeless tip cartilages were replaced. Note

the correction of the visible alar scars from the previous nostril reduction. Poor

 scarring ouside the alar is a common complain among patients.As

such, I prefer to reshape nostrils and reduce them without external alar scars.

 

 18.      Before After
  

Rhinoplasty in an African American female with low nasal bridge and short

nasal bones. Notice the defined nasal bridge after rhinoplasty utilizing

the patients own nasal cartilage without any implant. Results after 2 years shows

stable cartilage grafts, no resorption, a  less bulbous tip and an overall

natural result that fits her face better.

19.  BeforeAfter Before  After
    
    

Ethinic rhiniplasty. Afican American rhinoplasty in a female with flat nose, bulbous tip, no nasal bridge and poor nasal definition. Her nose widens when she smiles. Commonly, a nasal implant such as silastic, Medpor or Gortex implants will be recommended by most surgeons. We refined her nose without any implants. Her nasal bridge was defined  by repositioing her own nasal bones, and augmenting it further with cartilage harvested from within her nasal septum. We straighten her nasal septum to improve her breathing as well. The patients own tissues  blend well with the rest of their nose  compared to implants. The mid- portion of the broad flat nose was narrowed with micro-osteotomies.

 

How narrow should a nose be? In order to refine a nose to blend with the rest of the face, I take in to consideration several features such as one's brow position, cheek height, facial width, eye position etc. Overly narrowing the nose makes the eyes look too far apart.  A broad nose  can overwhelm the face. Notice the reshaped nostrils and narrowed nasal base. No external incision was utilized in making these changes. The patient particularly disliked the fact that her nose widened whenever she smiles. This  is a  common complain. This was addressed with special nasal base techniques. These rhinoplasty photos were taken  3 months following her surgery. Further nasal tip refinement is expected.

20. BeforeAfter 
 

Rhinoplasty in an African American male .His nose was reshaped to correct wide nostrils, project the droopy nasal tip

and augment  his flat nasal bridge.

 

21. BeforeAfter 
  
  
  
 

Rhinolasty in an African Ameican male. African American males 

seeking rhinoplasty usually want to maintain strong masculine nose

as well as their ethnic features. In this individual, the nasal hump is

 reduced and the droopy tip corrected. On base view, nostril symmetry

 is maintained. His nasal tip has betterdefinition. His breathing difficulties

 were corrected at the same time. Notice the natural rhinoplasty result.

 

22.. BeforeAfter   Before After 
    
 Three months following ethnic african american rhinoplasty
 23.       BeforeAfter 
  
Rhinoplasty in African American female. Note refinement of nasal tip with debulking and cartilage reshaping and nostril reduction without any visible scars. Reduction rhinoplasty result at 3 months.
 
24. BeforeAfter
 

Ethinc rhinoplasty in this young African American female.

Refining the round and broad nasal tip to achieve a delicate

tip that blends with her full lips and cheeks.

25.  BeforeAfter  BeforeAfter  
    
 Ethnic rhinoplasty defining a flat nose using septal cartilage.

26.    BeforeAfter Before After
   

Reshaping of wide nostrils without visible scars.To reshape the nostrils,special cartilage grafts were placed along the nasal tip to lift the nose and change the orientation of the flared nostrils. Additional reduction of the nostrils was done with hidden incisions.This technique allows us to reshape the wide nostrils with natural looking results.

 

 27.  BeforeAfter  Before After  
    
 Defined nasal bridge with septal cartilage graft.Tip slightly narrowed

 

28.  Before               After  Before                          After   
  

Rhinoplasty in African female correcting flared nostril, broad tip and nasal bridge.

Results at 6 months, no external scars , no implant was used resulting in a natural looking result.

29. BeforeAfter Before After  
    

 Rinoplasty in black female. Notice nice profile change

with a refined smaller tip which is less rounded. Her bridge is now narrower

but fits her face well. The nostrils have been reduced without any externally visible

scars. She was particularly interested in rhinoplasty refinement without loosing her

ethnic features. The result is a natural ethnic sensitive rhinoplasty.

 

  BeforeAfter Before After  Before After  
      
 

 

31 Before After  Before  After  
    

 . 

Ethnic sensitive rhinoplasty in an African American female who was interested  in defining her

 nasal bridge and reducing her bulbous tip. She  stressed her desire for a natural appearance 

 and retention of her ethnic features.Note how her bridge is more defined and slightly narrowed .

Raising the nasal bridge can be done in a subtle manner to achieve a photogenic appearance

without the " over done" and over projected appearance that is not ethnically sensitive. Her nasal

 tip has been refined but sitill maintains the soft curves the is natural and fits her face.

 

32

 BBeforeAfterAfter
   
   

Ethnic rhinoplasty in African american female. Note tip definition, bridge definition and no spreading of the nostrils when

she smiles keeping her nose photogenic. Also note the natural rhinoplasty result, symmetric nostrils and no visible scars.

Her result refines but preserves her ethnic feature . An example of an ethnic sensitive rhinoplasty.

 33

 BeforeAfter Before  After
    
 

Ethnic sensitive rhinoplasty in an African American female who was interested  in defining her

 nasal bridge and reducing her bulbous tip. She  stressed her desire for a natural appearance 

 and retention of her ethnic features.Note how her bridge is more defined and slightly narrowed .

 

34

 Be BeforeforeAfter   Before After  
    
 Early post operative result after rhinoplasty in an UK female. Results showing natural changes,

nice nasal higlights and shawdows which are essential for refining the nose without an obvious operated look.

Nasal tip defining points are highlighted; brow - tip aesthetic lines  are naturally created here. The nostrils and nasal base

 have been reshaped without visible scars. Rhinoplasty patients often ask how much down time to expect. These photos are included here to show the typical appearance one week after surgery.This individual was able to returned to work after one week after her rhinoplasty. Refine continues even up to tow years depending on skin thickness.

35

BeforeAfter  After  

 

 
 

Black female from UK interested in rhinoplasty to  correct

wide nostrils, droopy tip and low bridge nasal that lacked definition.

Early results showing changes in profile, tip and bridge refinement.

No implants were used in this rhinoplasy, Technique includes selective

 debulking of nasal tip skin, perforated osteotomies to reposition

 the wide nasal ones, tip cartilage

 recontouring.and nostril reduction without external alar scars.

 
 
Cover page featuring article by Dr Boahene on rhinoplasty. CLICK to READ FULL ARTICLE
 
Tip rhinoplasty in the African nose by Dr Boahene and colleagues. Click on imade to read full article.