{Aired 08.09.14}

This is a show that will cover the very specific topic of ethnic rhinoplasty – what it is and they types of patients seek this. Maria and Joan address – what the differences are between typical rhinoplasty procedures and ethnic rhinoplasty procedures?   What are the concerns for most patients?  How do you evaluate a patient to maintain a particular look based on racial/ethnic patterns?  What if the look you are asking for does not fit your face?  Were you concerned about losing your ethnic features or have you had a surgery to the nose and appear as if you just had surgery on the most prominent feature on your face? Today’s show will be informative and may change your mind about the subject.

I think over the past 8 months we have discussed so many subjects that cover plastic and reconstructive surgery.  One of the discussions that I felt we should explore is Ethnic Rhinoplasty and by rhinoplasty we are talking about a change to the appearance of the nose – which sits in the center of our face.

Many people associate ethnic rhinoplasty with Michael Jackson and assume that he was trying to change his ethnicity. The common goal of plastic surgery is not to look like someone else or to acquire someone else’s features  – the point of plastic surgery is not to look like you had work done but to enhance what you’ve already have.  Today’s expert guest will

Dr. Anthony Brissett, MD (Baylor College of Medicine)

Joan: Before we go into our topic on ethnic rhinoplasty, tell us how did you get interested in the field of facial plastic surgery?Brissett-Web
Dr. Brissett: The key word is evolution. We always have a story behind our path and my story begins in medicine itself and having great mentors and friends in medical school. They were able to stimulate an interest in a specific interest and that happened to be the head and neck. As I evolved my interest I also evolved in my thought process and creativity. Being able to creativity change things or reconstruct things in the head and neck area really inspired me.

Never Compromise Function for Form

Joan: When we are talking about ethnic rhinoplasty, we know that rhinoplasty is changing the appearance of the nose, what are we really talking about and what groups are particularly interested in rhinoplasty. 
 Dr. Brissett:  In general when we think about rhinoplasty you have to consider both form and function because the nose is a very unique feature. Not only is it for everyone to see its responsible for a significant function – breathing, it is the inlet for filtering air going into our lungs, it is the inlet for smell as well as taste so the combination of form and function is critical. You never want to compromise function for form. Every patient and plastic surgeon should consider. But then we begin to think about how patients may find themselves in terms of appearance in relationship to their race and or culture. There are no standards in the relationship to race and culture however there are various ethnicity that have uniqueness so when we think about ethnic rhinoplasty I think that every person that we see has some unique background or ethnicity however some of the most common paradigms are often times focused and central to what western society felt was a form or identity of  beauty. Now that we embrace more ubiquitous forms of beauty and  more global thoughts of beauty  and universal concepts of beauty we now recognize that patients from unique backgrounds – Asian, Hispanic, African American, Middle Eastern whatever it may be also have features unique to them or features that should be preserved. Every patient to a certain degree is an ethnic rhinoplasty. 


Preserving Ethnicity

Joan: Would you say that patients are wanting to preserve their ethnicity when getting an ethnic rhinoplasty?
Dr. Brissett: Not necessarily, I think  many patients that seek a rhinoplasty often times do want to preserve their ethnicity and some patients don’t necessarily have an ethnicity that they identify with. So that then brings the concept of race and culture because race and culture don’t often times collide and sometimes are not even parallel. I think about race I would say it’s how other people see you, culture is how you see yourself. You have to explore that concept of race and culture before you can explore how they see themselves and how they respond to facial plastic surgery, primarily rhinoplasty. 
(Hear the entire segment here.)

What Questions Will Be Asked During Your Consultation

  1. Where are you from?
  2. Where are your parents from?
  3. What race are you considered?
  4. What culture do you best identify with?
Dr. Brissett: By asking these series of questions you will have a better understanding as to where they may see themselves along that continuum and how to achieve the best result. 


Ethnic Rhinoplasty Expectations

Maria: Have you ever found what the patient wanted was not in line with what they  identify with ethnically or culturally? 
Dr. Brissett: That happens often and it’s important to set expectations and on occasion there are patients that have unrealistic expectations  in terms of what they would like their outcome can be. When we are dealing with patients of ethnic decent often times there are limitations  in terms of what we can achieve with rhinoplasty. Oftentimes when we see patients of Asian, Hispanic or African decent the skin or the soft tissue envelope can be much thicker that what we see in a Caucasian or a European nose and as a result trying to make a nose smaller or refined is limited. For those patients we have to be realistic. 
(Hear the entire segment here

Keloids and Rhinoplasty

Joan: Are patients concerned about scars and keloids that may occur during a rhinoplasty. 
Dr. Brissett: The placement of the scar and the significance of the scar should be a concern of the patient. African Americans, Hispanics and Asians have a 5-15%  increased likelihood to have a hypertrophic scar, a robust scar or a keloid. However in the mid-face it is very uncommon in fact almost unheard of to have a keloid in that area. Even if you have a history of keloiding that is an area that I am confident about in having an appropriate appearing scar. 
  • Keloid – is a growth of extra scar tissue where the skin has healed after an injury. It can be itchy and uncomfortable. 
  • Hypertrophic scar – is a cutaneous condition characterized by deposits of excessive amounts of collagen which gives rise to a raised scar, but not to the degree observed with keloids.


(Hear the entire segment here.) 

Dr. Brissett’s Role in the Medical Community

Dr. Brissett: I have the opportunity to work closely with patients and other surgeons and specialists. What i have found that is a unique place for me in the medical community is to be able to serve as a resource, not just to other patients but to other providers as well. There are a lot of folks that come from other parts of the city, the state, country and world that are Looking for a level of expertise that can be found her in the Medical Center. As a resource we are able to provide a sub specialty best practice philosophy meaning that we know a lot about a very specialized area and if there are patients or physicians that have unique need or interest whether it be cosmetic or reconstructive we can allow them to use us as a resource and an environment that will provide the highest level of care. 

Revision Rhinoplasty

Complications can happen with any kind of surgery that you may have with rhinoplasty the complication is either going to be an impairment in form or function. Dr. Brissett is often a resource in the medical community to repair rhinoplasties. 10%-20% of patients seeking a rhinoplasty will not be satisfied with their surgery. Ensure that you identify a board certification to perform your surgery and do your homework about the procedure prior to the rhinoplasty.

(Hear the entire segment here.)

Evolution of Rhinoplasty

The concept of beauty has changed and is now more accepting of a more global concept of beauty. Western or European noses where considered the prototype for beauty however now we are in an era of racial preservation. The evolution went from a racial transformation to one of racial preservation where the nose is reshaped in a way that does not make the patient feel like an outlier in their community.

(Hear the entire segment here.)


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