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.

 

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