Rhinoplasty for middle eastern noses

Rod J. Rohrich, Ashkan Ghavami

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

BACKGROUND: Rhinoplasty remains one of the most challenging operations, as exemplified in the Middle Eastern patient. The ill-defined, droopy tip, wide and high dorsum, and thick skin envelope mandate meticulous attention to preoperative evaluation and efficacious yet safe surgical maneuvers. The authors provide a systematic approach to evaluation and improvement of surgical outcomes in this patient population. METHODS: A retrospective, 3-year review identified patients of Middle Eastern heritage who underwent primary rhinoplasty and those who did not but had nasal photographs. Photographs and operative records (when applicable) were reviewed. Specific nasal characteristics, component-directed surgical techniques, and aesthetic outcomes were delineated. RESULTS: The Middle Eastern nose has a combination of specific nasal traits, with some variability, including thick/sebaceous skin (excess fibrofatty tissue), high/wide dorsum with cartilaginous and bony humps, ill-defined nasal tip, weak/thin lateral crura relative to the skin envelope, nostril-tip imbalance, acute nasolabial and columellar-labial angles, and a droopy/hyperdynamic nasal tip. An aggressive yet nondestructive surgical approach to address the nasal imbalance often requires soft-tissue debulking, significant cartilaginous framework modification (with augmentation/ strengthening), tip refinement/rotation/projection, low osteotomies, and depressor septi nasi muscle treatment. The most common postoperative defects were related to soft-tissue scarring, thickened skin envelope, dorsum irregularities, and prolonged edema in the supratip/tip region. CONCLUSIONS: It is critical to improve the strength of the cartilaginous framework with respect to the thick, noncontractile skin/soft-tissue envelope, particularly when moderate to large dorsal reduction is required. A multitude of surgical maneuvers are often necessary to address all the salient characteristics of the Middle Eastern nose and to produce the desired aesthetic result.

Original languageEnglish (US)
Pages (from-to)1343-1354
Number of pages12
JournalPlastic and Reconstructive Surgery
Volume123
Issue number4
DOIs
StatePublished - Apr 2009

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Rhinoplasty
Nose
Skin
Esthetics
Osteotomy
Lip
Cicatrix
Edema
Muscles

ASJC Scopus subject areas

  • Surgery

Cite this

Rhinoplasty for middle eastern noses. / Rohrich, Rod J.; Ghavami, Ashkan.

In: Plastic and Reconstructive Surgery, Vol. 123, No. 4, 04.2009, p. 1343-1354.

Research output: Contribution to journalArticle

Rohrich, Rod J. ; Ghavami, Ashkan. / Rhinoplasty for middle eastern noses. In: Plastic and Reconstructive Surgery. 2009 ; Vol. 123, No. 4. pp. 1343-1354.
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