Multiracial Rhinoplasty Workup

  • Author: Manoj T Abraham, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Mar 2, 2012
 

Laboratory Studies

Perform routine preoperative laboratory studies as indicated.

Next

Imaging Studies

As with all facial plastic surgery, preoperative and postoperative photographic documentation is essential.

Computer modeling of projected outcome may help ground patient expectation.

A well-performed history and physical examination obviates the need for radiologic imaging studies (eg, CT, MRI) in patients who do not have other concomitant rhinologic disease (eg, sinusitis).

Previous
Next

Diagnostic Procedures

The following procedures may be useful in selected patients with nasal obstruction:

  • Rhinomanometry provides objective measurement of nasal airway resistance.
  • Acoustic rhinomanometry allows accurate determination of the cross-sectional area of the nasal cavity.
Previous
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Manoj T Abraham, MD, FACS  Clinical Assistant Professor, Division of Facial Plastic & Reconstructive Surgery, New York Medical College, New York Eye & Ear Infirmary; Private Practice, Facial Plastic, Reconstructive & Laser Surgery PLLC

Manoj T Abraham, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Association of Physicians of Indian Origin, American College of Surgeons, American Medical Association, American Rhinologic Society, American Society for Cell Biology, California Medical Association, International Society of Hair Restoration Surgery, Medical Society of the State of New York, New York Academy of Medicine, New York County Medical Society, Sigma Xi, and Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Thomas Romo III, MD, FACS  Director, Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Lenox Hill Hospital; Director, Facial Plastic and Reconstructive Surgery, Manhattan Eye, Ear and Throat Hospital

Thomas Romo III, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and American Rhinologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Paul S Nassif, MD, FACS  Consulting Surgeon, Facial Plastic and Reconstructive Surgery, Spalding Drive Cosmetic Surgery and Dermatology

Paul S Nassif, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and California Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Dean Toriumi, MD  Associate Professor, Department of Otolaryngology, University of Illinois Medical Center

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Medvoy Ownership interest Management position; Cerescan Imaging Consulting; Headwatersmb Consulting fee Consulting; Venturequest Royalty Consulting

References

  1. Yellin SA. Aesthetics for the next millennium. Facial Plast Surg. Oct 1997;13(4):231-9. [Medline].

  2. Schultz AH. Relation of the external nose to the bony nose and nasal cartilages in whites and negroes. Am J Phys Anthropol. 1913;1:329.

  3. Matory WE Jr, Falces E. Non-Caucasian rhinoplasty: a 16-year experience. Plast Reconstr Surg. Feb 1986;77(2):239-52. [Medline].

  4. Stucker FJ. Non-Caucasian rhinoplasty. Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol. Jul-Aug 1976;82(4):ORL 417-22. [Medline].

  5. Ofodile FA, James EA. Anatomy of alar cartilages in blacks. Plast Reconstr Surg. Sep 1997;100(3):699-703. [Medline].

  6. Baker HL, Krause CJ. Update on the negroid nose: an anatomic and anthropometric analysis. In: Ward PH, Berman WE, eds. Plastic and Reconstructive Surgery of the Head and Neck. St Louis, Mo: Mosby-Year Book; 1984:1.

  7. Wang D, Qian G, Zhang M, et al. Differences in horizontal, neoclassical facial canons in Chinese (Han) and North American Caucasian populations. Aesthetic Plast Surg. Jul-Aug 1997;21(4):265-9. [Medline].

  8. Martin JG. Racial ethnocentrism and judgement of beauty. J Soc Psychol. 1964;63:59.

  9. Falces E, Wesser D, Gorney M. Cosmetic surgery of the non-caucasian nose. Plast Reconstr Surg. Apr 1970;45(4):317-25. [Medline].

  10. Snyder GB. Rhinoplasty in the Negro. Plast Reconstr Surg. Jun 1971;47(6):572-5. [Medline].

  11. Pitanguy I. The negroid nose. In: Conley J, Dickinson J, eds. First International Symposium on Plastic and Reconstructive Surgery of the Face and Neck. New York, NY: Grune & Stratton Inc; 1972:147-52.

  12. Canbay EI, Bhatia SN. A comparison of nasal resistance in white Caucasians and blacks. Am J Rhinol. Jan-Feb 1997;11(1):73-5. [Medline].

  13. Burres SA. Acoustic rhinometry of the oriental nose. Am J Rhinol. Sep-Oct 1999;13(5):407-10. [Medline].

  14. McKinney PW, Mossie RD, Bailey MH. Calibrated alar base excision: a 20-year experience. Aesthetic Plast Surg. May 1988;12(2):71-5. [Medline].

  15. Romo T, Shapiro AL. Aesthetic reconstruction of the platyrrhine nose. Arch Otolaryngol Head Neck Surg. Aug 1992;118(8):837-41. [Medline].

  16. Toriumi DM. Autogenous grafts are worth the extra time. Arch Otolaryngol Head Neck Surg. Apr 2000;126(4):562-4. [Medline].

  17. Deva AK, Merten S, Chang L. Silicone in nasal augmentation rhinoplasty: a decade of clinical experience. Plast Reconstr Surg. Sep 1998;102(4):1230-7. [Medline].

  18. Romo T 3rd, Sclafani AP, Sabini P. Use of porous high-density polyethylene in revision rhinoplasty and in the platyrrhine nose. Aesthetic Plast Surg. May-Jun 1998;22(3):211-21. [Medline].

  19. Aung SC, Foo CL, Lee ST. Three dimensional laser scan assessment of the Oriental nose with a new classification of Oriental nasal types. Br J Plast Surg. Mar 2000;53(2):109-16. [Medline].

  20. Daniel RK. Hispanic rhinoplasty in the United States, with emphasis on the Mexican American nose. Plast Reconstr Surg. Jul 2003;112(1):244-56; discussion 257-8. [Medline].

  21. Fanous N, Yoskovitch A. Premaxillary augmentation: adjunct to rhinoplasty. Plast Reconstr Surg. Sep 2000;106(3):707-12. [Medline].

  22. Han SK, Woo HS, Kim WK. Extended incision in open-approach rhinoplasty for asians. Plast Reconstr Surg. May 2002;109(6):2087-96. [Medline].

  23. Hubbard TJ. Bridge narrowing in ethnic noses. Ann Plast Surg. Mar 1998;40(3):214-8. [Medline].

  24. Kontis TC, Papel ID. Rhinoplasty on the African-American nose. Aesthetic Plast Surg. 2002;26 Suppl 1:12:[Full Text].

  25. Larrabee WF Jr, Nishioka GL. Surgery of the non-Caucasian nose. In: Bailey BJ, Tardy ME Jr, eds. Head & Neck Surgery-Otolaryngology. New York, NY: Lippincott Raven; 1998:2648-55.

  26. Leach J. Aesthetics and the Hispanic rhinoplasty. Laryngoscope. Nov 2002;112(11):1903-16. [Medline].

  27. Leong SC, White PS. A comparison of aesthetic proportions between the Oriental and Caucasian nose. Clin Otolaryngol Allied Sci. Dec 2004;29(6):672-6. [Medline].

  28. Milgrim LM, Lawson W, Cohen AF. Anthropometric analysis of the female Latino nose. Revised aesthetic concepts and their surgical implications. Arch Otolaryngol Head Neck Surg. Oct 1996;122(10):1079-86. [Medline].

  29. Neu BR. Segmental bone and cartilage reconstruction of major nasal dorsal defects. Plast Reconstr Surg. Jul 2000;106(1):160-70. [Medline].

  30. Ofodile FA. Nasal bones and pyriform apertures in blacks. Ann Plast Surg. Jan 1994;32(1):21-6. [Medline].

  31. Ofodile FA, Bokhari F. The African-American nose: Part II. Ann Plast Surg. Feb 1995;34(2):123-9. [Medline].

  32. Ofodile FA, Bokhari FJ, Ellis C. The black American nose. Ann Plast Surg. Sep 1993;31(3):209-18; discussion 218-9. [Medline].

  33. Ortiz Monasterio F, Michelena J. The use of augmentation rhinoplasty techniques for the correction of the non-caucasian nose. Clin Plast Surg. Jan 1988;15(1):57-72. [Medline].

  34. Palma P, Bignami M, Delu G, et al. Rhinoplasty for the Mediterranean nose. Facial Plast Surg. Aug 2003;19(3):279-94. [Medline].

  35. Porter JP, Olson KL. Analysis of the African American female nose. Plast Reconstr Surg. Feb 2003;111(2):620-6; discussion 627-8. [Medline].

  36. Porter JP, Olson KL. Anthropometric facial analysis of the African American woman. Arch Facial Plast Surg. Jul-Sep 2001;3(3):191-7. [Medline].

  37. Porter JP, Tardy ME Jr, Cheng J. The contoured auricular projection graft for nasal tip projection. Arch Facial Plast Surg. Oct-Dec 1999;1(4):312-5. [Medline].

  38. Rohrich RJ. Rhinoplasty in the black patient. In: Daniel RK, ed. Rhinoplasty. Boston, Mass: Little Brown; 1993:659-76.

  39. Rohrich RJ, Muzaffar AR. Rhinoplasty in the African-American patient. Plast Reconstr Surg. Mar 2003;111(3):1322-39; discussion 1340-1. [Medline].

  40. Romo T 3rd, Abraham MT. The ethnic nose. Facial Plast Surg. Aug 2003;19(3):269-78. [Medline].

  41. Romo T 3rd, McLaughlin LA, Levine JM, et al. Nasal implants: autogenous, semisynthetic, and synthetic. Facial Plast Surg Clin North Am. May 2002;10(2):155-66. [Medline].

  42. Romo T 3rd, Sclafani AP, Jacono AA. Nasal reconstruction using porous polyethylene implants. Facial Plast Surg. 2000;16(1):55-61. [Medline].

  43. Sheen JH. Aesthetic rhinoplasty. St. Louis: Mosby; 1978:210-29.

  44. Sim RS, Smith JD, Chan AS. Comparison of the aesthetic facial proportions of southern Chinese and white women. Arch Facial Plast Surg. Apr-Jun 2000;2(2):113-20. [Medline].

  45. Song C, Mackay DR, Chait LA, et al. Use of costal cartilage cantilever grafts in negroid rhinoplasties. Ann Plast Surg. Sep 1991;27(3):201-9. [Medline].

  46. Stucker FJ. Non-caucasian rhinoplasty and adjunctive reduction cheiloplasty. Otolaryngol Clin North Am. Nov 1987;20(4):877-94. [Medline].

  47. Stucker FJ, Lian T, Sanders K. African American rhinoplasty. Facial Plast Surg Clin North Am. Feb 2005;13(1):65-72. [Medline].

  48. Uhm KI, Hwang SH, Choi BG. Cleft lip nose correction with onlay calvarial bone graft and suture suspension in Oriental patients. Plast Reconstr Surg. Feb 2000;105(2):499-503. [Medline].

  49. Wang TD. Non-Caucasian rhinoplasty. Facial Plast Surg. Aug 2003;19(3):247-56. [Medline].

  50. Yotsuyanagi T, Yamashita K, Urushidate S, et al. Nasal reconstruction based on aesthetic subunits in Orientals. Plast Reconstr Surg. Jul 2000;106(1):36-44; discussion 45-6. [Medline].

 
Previous
Next
 
Lateral view (a) - Characteristics of the platyrrhine multiracial nose (on the left) compared with the Caucasian nose (on the right) include reduced bony and cartilaginous dorsal support and lack of tip projection and definition. Base view (b) - The platyrrhine multiracial nose often has wide flared nasal alae, poor tip support, and a thick, subcutaneous, fibrofatty pad, resulting in blunted tip definition. The ideal equilateral triangle appearance of the nose on base view is not achieved.
Postoperative augmented platyrrhine multiracial nose, achieved by using techniques described in this article. Lateral view (a) - Dorsal augmentation with tiered cartilage and fibrofatty graft, columella strut, tiered shield tip graft, dome binding stitch, and premaxillary augmentation graft. Base view (b) - Secured columella strut, shield tip graft, premaxillary augmentation graft, and alar base reduction.
Preoperative (left) and postoperative (right) views of the African American multiracial nose. Rhinoplasty was performed as described in this article.
Preoperative (left) and postoperative (right) views of the Asian mesorrhine nose. Rhinoplasty was performed as described in this article.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.