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Nose Procedures:

African American Rhinoplasty

RAfrican American Rhynoplasty

Toronto Rhinoplasty Surgeon – Otolaryngologist Head and Neck Surgeon

Toronto Rhinoplasty Specialist

Generally speaking there are differences between noses of African American patients than Caucasian patients. While Caucasian patients may wish to reduce the overall size of the nose with “reduction rhinoplasty surgery”, African American patients are often hoping to enhance there nose with “augmentation rhinoplasty”. Augmentation rhinoplasty may involve narrowing the nasal tip, reducing nostril size and in some cases lengthening the nose and raising the nasal bridge. Patients of African American background usually are not looking to make their nose Caucasian but rather improve their nasal proportions and enhance their overall appearance. As with all rhinoplasty patients it is important for the patient and surgeon to share a common and realistic goal. It is also crucial that the surgeon have experience dealing with African American noses as the techniques for this procedure are different than those used in Caucasian rhinoplasty surgery.

What is Different about an African-American Nose?

Generally, African American noses have thicker nasal skin, and weaker nasal tip cartilage. This intrinsic anatomy results in a flatter and wider appearing nasal tip and wider horizontally oriented nostrils. Other common features include short and low nasal bones resulting in a wider and flatter nasal bridge.

African American Rhinoplasty Techniques

There are a number of rhinoplasty techniques available to the rhinoplasty surgeons when dealing with the African American nose. The common procedures include cartilage grafting to strengthen and support the nasal tip. Nasal tip cartilage grafting strengthens the nasal tip like elevating a tent with a post. Cartilage grafts can be taken from the nasal septum, ear cartilage, and in some cases rib cartilage. In some situations synthetic implants such as medpore, are recommended to reconstruct the nasal tip. Often the nose looks better by raising the nasal bridge. This gives a better proportioned and often narrower appearing nose. Again cartilage grafting from the nose, rib cage, and ear can be used to raise the nasal bridge. In certain situations gortex a synthetic medical grade surgical implant can achieve dramatic enhancement of the nasal bridge.

Watch a procedure video of Dr. Solomon performing Rhinoplasty on an African American woman to enhance the look.

Realistic Expectations

The Goal of surgery is to create a natural and beautiful African American nose, not a Caucasian nose. Patients are counseled as to what is a realistic goal for their rhinoplasty surgery outcome.

Dr Solomon and African American Noses.

Dr Solomon is one of Canada’s most experienced rhinoplasty surgeons. He has performed well over 1000 rhinoplasty procedures. He treats patients of all backgrounds and has extensive experience treating patients of African American descent.

To see before and after photos of African American patients please visit our office.

You can also view some examples at http://www.rhinoplasty.ca/photogallery/non-caucasian-rhinoplasty/

Click here to view Non-Caucasian Rhinoplasty before and after photos. click here to: http://www.solomonfacialplastic.com/photo-gallery/photo-gallery-detail

Click here to view Toronto Star interview on Ethnic Rhinoplasty click here to: http://www.solomonfacialplastic.com/press-room/pressroom-category

Reconstructive Rhinoplasty

Noses that have sustained trauma, prior nasal surgery, or have a congenital deformity may require nasal Reconstruction.

Nasal reconstructive surgery generally requires rebuilding damages nasal structure with cartilage grafts from a patient’s nose, ear or rib. In certain situations fibrous tissue known as fascia which is taken from a small incision in the scalp is utilized as a soft graft to reshape the nasal tip or fill in imperfections along the nasal bridge. Dr.Solomon prefers using a patient’s own natural tissue, but in some reconstructive or augmentation Rhinoplasty procedures the use of implant material such as Gore-Tex or Medpore may be a good option. Cartilage from the ear is good for the nasal tip reshaping and reconstruction, but it often lacks strength and support needed for certain reconstructive Rhinoplasties, Revision Rhinoplasties and augmentation rhinoplasty procedures. Ear cartilage grafting is performed through a small incision in front of the bowl of the ear or from an incision from the back of the ear. The scar typically heals nicely and is generally not noticeable. Ear cartilage grafting does not typically change the shape of the ear. Rib cartilage is the most ideal source for cartilage if multiple, sturdy or large grafts are required. Grafting cartilage has its downside: harvesting a rib for a cartilage graft can cause chest wall discomfort for a number of weeks.

Cartilage from the ear is good for the nasal tip reshaping and reconstruction, but it often lacks strength and support needed for certain reconstructive Rhinoplasties, Revision Rhinoplasties and augmentation rhinoplasty procedures. Ear cartilage grafting is performed through a small incision in front of the bowl of the ear or from an incision from the back of the ear. The scar typically heals nicely and is generally not noticeable. Ear cartilage grafting does not typically change the shape of the ear. Rib cartilage is the most ideal source for cartilage if multiple, sturdy or large grafts are required. Grafting cartilage has its downside: harvesting a rib for a cartilage graft can cause chest wall discomfort for a number of weeks.

Patient’s may be unwilling to accept a chest incision; and the graft may potentially shrink or bend with time. Typically Dr Solomon performs rib graft incisions just below the breast so as they heal they are not noticeable. However in certain cases where a large portion of rib including boney rib and cartilaginous rib are needed the incision may be lower down on the chest wall. Over the years the use of rib cartilage, has become recognized as a reliable, safe choice for cartilage grafting in complex reconstructive, augmentation and revision rhinoplasty procedures.

Some patients choose to use surgical grade implant material because of limited natural tissue or an unwillingness to remove cartilage from their ear or rib. Synthetic implants especially gortex can in some cases be ideal for nasal augmentation. Synthetic implant material does carry a small potential risk of rejection or infection quoted as between one to three in a hundred or “one to three percent”.. These risks will be discussed with you by Dr. Solomon if you are a candidate for its use. The two commonly used implant materials for reconstructive or augmentation rhinoplasty procedures are Gortex and Medpore. These materials are very different. Gortex has been used for many years for vascular surgery and has a high safety record. It comes in one to two millimeter sheets and can be sutured and cut to specific shapes to achieve extremely natural cosmetic results. Gortex is a soft material and should be used for nasal bridge augmentation and not be used in the nasal tip. Medpore is a firmer substance which has been used in craniofacial surgery for many years. It is ideal for providing strength and support to the nasal tip. In Dr Solomons opinion it must be covered by cartilage to ensure that it is not in direct contact with the patients skin. When used appropriately these surgical grade materials can be extremely useful in rhinoplasty surgery. Dr Solomon often uses these materials in Asian, and African American augmentation Rhinoplasty procedures. To see examples of non Caucasian rhinoplasty surgery see
http://www.solomonfacialplastic.com/photo-gallery/photo-gallery-detail.php?catid=38

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