Ethnic Rhinoplasty

Thick Skinned Ethnic Nose Aesthetics

For more detailed information about rhinoplasty operations with ethnic and thick skin features, and to see before and after images, you can check the link >> Ethnic Rhinoplasty in Istanbul

Different from the classical thin-skinned noses, which are used in the sense of ethnic rhinoplasty, which can vary according to racial characteristics, aesthetic nose surgeries performed for noses with the following features are meant:

- Wide and flat noses

Patients with soft cartilage features, wide and flat nasal tip, flattened and wide nostrils, which are seen in people of Asian and African descent, usually have a rather thick and oily skin structure. It is not easy to obtain a thin and angular nose tip in these patients. As a result of the edema period that may last longer than normal after the operation and the camouflage effect of the skin, which is more than normal due to the oily - thick subcutaneous structure, a rounded appearance may occur at the tip of the nose. In these patients, the cartilage support tissue should be preserved as much as possible. Especially in patients of Asian origin, even in primary rhinoplasty operations for the augmentation of the nasal arch due to the accompanying depressed nasal bone; rib cartilage or fascia may need to be used. In these patients, hump reduction should be done, on the contrary, augmentation of the nasal hump region should be aimed to make the nose appear thinner. In these patients, there may be a significant difference between the simulation result and the long-term postoperative outcome.

- Thick-skinned African origin nose structure

In these patients, it can be understood that there are many comedones on the nasal skin when viewed closely, and that the skin in the supratip and nasal tip region is much thicker than the upper side when checked using the index finger and thumb during the examination. In addition, in some patients of African descent, the nasal bone may be flattened and broad. In these patients, open technique rhinoplasty, bilevel skin dissection and underskin tissue removal may be beneficial in thinning the skin during the operation. Again, it may be necessary to put as much cartilage graft as possible, strengthen the nasal cartilage support, and perform alarplasty with bilateral alar base resection. In thick-skinned rhinoplasty operations, it is important not to leave "dead spaces" under the skin as much as possible, because the production of subcutaneous tissue and the characteristics of thick oily skin are also genetic, and during the healing process in patients, these dead space areas can easily be filled with soft tissue by the body. Link to a nice scientific article about rhinoplasty on the skin >> An Effective Algorithm for Management of Noses with Thick Skin

- Arched and thick-skinned noses

In patients with this type of nose, besides reducing the volume of the nasal bone with hump reduction and bilateral osteotomy; As in other thick-skinned rhinoplasty operations, classical applications such as thinning the nasal skin, increasing the nasal cartilage support with cartilage grafts, and alar base resection can be performed. There is no need for dorsal augmentation of the nose due to the nasal arch. Latino patients and people living in different regions can have this type of nose. Again, many physicians in Turkey have experience in the operations of this type of nose.

Things to Do Before Ethnic Rhinoplasty

Before the ethnic rhinoplasty operation, what should be done by the patients can be summarized as follows: 

"The use of blood thinners should be stopped at least one week before the operation. Apart from these, foods and products such as fish oil pills, garlic, ginko biloba, and cherry should not be consumed, which may have a blood-thinning effect.  It is appropriate not to use these drugs and products after the ethnic rhinoplasty operation.  In addition, you can consult the anesthesiologist or the surgeon who will perform your surgery before the surgery about the medications you use.  Again, it is ideal to stop smoking at least 2 days before the operation, ideally one week before the operation".

Patient Care After Ethnic Rhinoplasty Operation

Immediately after the ethnic rhinoplasty operation, patients should be hungry and thirsty for the first 4 hours during the recovery period from anesthesia.  In the first 3 days after the operation, there may be bleeding in the form of dripping and leakage from the front of the nose and the nasal region.  Again, it is normal to have an increase in swelling and bruising around the eyes during the first 3-4 days after the operation.  Since the risk of bleeding is high in the first 10 days after the surgery, it is inconvenient to lift a load by bending down.  It is beneficial to apply cold to the face on the day of surgery and for 2 days after the surgery.  For this, it is sufficient to apply ice to the face area for half an hour and take an hour break in 45 minutes.  In case of repeated cold application in this way, facial edema and bruises around the eyes can be reduced.  When the first control is made between 7 and 10 days after the surgery, the silicone Sprint inside the nose and the bandage outside the nose and external splint are removed.  Afterwards, an implant made of medical silicone, called nostril retanier, which provides almost equal healing of the nasal tip, is placed into the nose, and the nose can be bandaged again and aluminum splint can be applied.  Considering the thick and oily skin structure of the patients after the ethnic rhinoplasty operation, it is recommended to pay attention to nutrition.  After the operation, it is appropriate not to consume extremely hot, salty and spicy products for a long time, about 2 months.  Some clinics recommend salt restriction in food for up to 4 months after thick-skinned rhinoplasty.  The recommended foods are Mediterranean-style green salads, eating pineapple and drinking green tea.  There is no harm in swimming in clean seas after 3 weeks after the operation.  It is ideal to be very careful about sunbathing, especially in the first 2 months, because in the heat of the afternoon, when the sun's rays are steep, due to long-term exposure to ultraviolet rays, serious edema and swelling may increase in the nose.  Especially in patients with very thick skin structure, nasal taping at night and pressure with a splint may be recommended.  The use of a Nostril retainer may be required between 2 and 6 months, you can discuss the follow-up and need of this with your doctor.  Generally, 6 weeks after the operation, I ask my patients to send me their nose photos from both sides, anterior and lower.  During this period, I am updating the maintenance recommendations again.

Ethnic Rhinoplasty Surgery Appointment

If you want to make an appointment for ethnic rhinoplasty operation, you can contact my secretary by clicking the contact link on the side. Generally, hospitals do not give operation appointments for longer than one month, and one day before the operation, it is necessary to come for blood tests and anesthesia examination, which must be done before the operation. On the day of the operation, you stay in the hospital for 1 day. Afterwards, it is appropriate to stay in Istanbul for 7 to 9 days. After the control examination, you can travel by plane and return to your country.

Ethnic Rhinoplasty Controversial Topics

I would like to share with you the following controversial issues regarding ethnic rhinoplasty. 

Why Is Ethnic Rhinoplasty More Difficult Than Classic Thin-Skinned Rhinoplasty?

During classical thin-skinned rhinoplasty operations, shaping the cartilage and bones is usually sufficient to achieve the desired result. However, during ethnic and thick-skinned rhinoplasty surgeries, unlike classical rhinoplasty surgeries, the cartilage support tissue should be preserved and the cartilage should not be weakened as much as possible. In addition, depending on the exaggerated camouflage effect of the thick skin, the shape change in the nose obtained after the cartilage shaping performed by the doctor may not be clearly visible and more cartilage grafts than normal may be required. During ethnic and thick-skinned rhinoplasty surgeries, unlike classical thin-skinned nose surgeries; Additional procedures such as augmentation of the dorsum of the nose, reduction of the nostrils, and thinning of the nasal skin may be required. As a difference from classical rhinoplasty surgeries; It is very important not to leave dead spaces under the skin, and in patients with thick oily skin, these spaces can be easily filled with subcutaneous healing tissue.

Why Rhinoplasty Simulation Results Performed Before Ethnic Rhinoplasty Operations Cannot Reflect the Reality?  

After aesthetic operations on thick-skinned ethnic noses, unexpected tissue edema, long recovery time, as well as regeneration and thickening of subcutaneous tissue in varying amounts depending on the patient's healing characteristics may occur.  Some rhinoplasty surgeons do not accept nasal surgeries of patients with very thick skin features.  Because the patient's expectations and the actual surgery result may not overlap and may cause disappointment for the patients after the surgery.  It is currently not possible to shape and permanently thin the sub-serial tissue.  I usually perform two-level subcutaneous dissection and excision of subcutaneous tissue by performing open technique rhinoplasty operations in ethnic and thick-skinned nose surgeries.  In other words, we are trying to thin the patient's nose skin during the surgery, but;  Even if the subcutaneous tissue is excised here;  Since the skin characteristics of the patient are genetic, it can be produced again by the body during the recovery period.  Arnica gel application, oral vitamin tablets containing bromelain and quercetin may be recommended to patients during the recovery period, salt restriction may be made.  Despite all the recommendations, this procedure consists of living tissue changes, apart from the surgical procedures performed by the physician in determining the result;  The healing characteristics of the patient, the care of the patient and genetic cutaneous - subcutaneous characteristics are also effective.  Therefore, it is not possible to predict the result with certainty in advance.

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Dr. Murat Enöz - MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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Address: İncirli Cad., No:41, Kat:4, Dilek Pastanesi Üstü (Dilek Patisserie Building), Posta kodu: 34147, Bakırköy - İstanbul

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E-mail: muratenoz@gmail.com

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Fax: +90 212 542 74 47