Rhinoplasty in the Hispanic Patient

ABSTRACT

In the United States, rhinoplasty has traditionally been performed in Caucasian patients. Ethnic rhinoplasty is often thought of as a procedure done to reshape the nose of a black or Asian patient. Little attention has been paid to rhinoplasty in Hispanic patients. There has been a large increase in the Hispanic population of the United States, and plastic surgeons will see a concomitant rise in requests for rhinoplasty among this population. In an effort to increase our understanding of Hispanic rhinoplasty, a retrospective review of a senior surgeon's experience was performed. A retrospective chart review was done examining the senior author's (S.S.) rhinoplasty practice over the past 10 years. Hispanic patients presenting for aesthetic and corrective rhinoplasty (cleft patients were excluded) were analyzed. The Hispanic nose was divided into three archetypes. Type I is characterized by a high radix and prominent vault; these noses should be corrected by dorsal reduction and resection of caudal septum. Type II is characterized by a dependent tip with inadequate projection; dorsal augmentation with diced cartilage and tip support with cartilage grafts are important. Osteotomies should generally be avoided in this group. Type III noses are characterized by a broad nasal base with thick skin and a wide tip; rhinoplasty in this group requires correction of the dorsum-base disproportion using several techniques including columellar struts, tip grafts, and dorsal augmentation. Hispanics are projected to become the largest minority population within the next 10 years, and rhinoplasty in this population will become more frequent over time. It behooves plastic surgeons to become familiar with the different archetypes of Hispanic noses and appropriate corrective techniques for each.

Hispanic rhinoplasty - aesthetic and corrective rhinoplasty - archetypes

REFERENCES

• 1 Merriam-Webster Dictionary .Available at: http://meriam-webster.com Accessed May 8, 2009
• 2 United States Census Bureau .Population estimates. Available at: http://www.census.gov Accessed May 8, 2009
• 3 ASPS .2007 National Clearinghouse of Plastic Surgery Statistics. Available at: http://www.plasticsurgery.org/media/statistics/2007 Accessed May 8, 2009
• 4 Daniel R K. Hispanic rhinoplasty in the United States, with emphasis on the Mexican American nose.  Plast Reconstr Surg. 2003;  112 244-256 discussion 257-258
• 5 Ortiz-Monasterio F, Olmedo A. Rhinoplasty on the mestizo nose.  Clin Plast Surg. 1977;  4 89-102
• 6 Ortiz-Monasterio F. Rhinoplasty in the non-Caucasian nose. In: Gruber RP, Peck GC Rhinoplasty: State of the Art. St. Louis, MO; Mosby-Year Book 1993: 171-180
• 7 Ortiz-Monasterio F, Olmedo A. Rhinoplasty in the mestizo nose: secondary rhinoplasty in the thick skinned nose. In: Rees TD, Baker DC, Tabbal N Rhinoplasty: Problems and Controversies. St. Louis, MO; Mosby-Year Book 1988: 372-383
• 8 Erol O O. The Turkish delight: a pliable graft for rhinoplasty.  Plast Reconstr Surg. 2000;  105 2229-2241 discussion 2242-2243
• 9 Gunter J P. The merits of the open approach in rhinoplasty.  Plast Reconstr Surg. 1997;  99 863-867
• 10 Sheen J H. Tip graft: a 20-year retrospective.  Plast Reconstr Surg. 1993;  91 48-63
• 11 Peck Jr G C, Michelson L, Segal J, Peck Sr G C. An 18-year experience with the umbrella graft in rhinoplasty.  Plast Reconstr Surg. 1998;  102 2158-2165 discussion 2166-2168
• 12 Gruber R P, Grover S. The anatomic tip graft for nasal augmentation.  Plast Reconstr Surg. 1999;  103 1744-1753 discussion 1754-1758
• 13 Cobo R. Mestizo rhinoplasty.  Facial Plast Surg. 2003;  19 257-268
• 14 Milgrim L M, Lawson W, Cohen A F. Anthropometric analysis of the female Latino nose. Revised aesthetic concepts and their surgical implications.  Arch Otolaryngol Head Neck Surg. 1996;  122 1079-1086