Most African American noses have certain common anatomic elements which require a special expertise. These include:
- Thick nasal skin
- Weak nasal cartilages
- Short and low set nasal bones
- Bulbous nasal tip
- Alar flaring and widened nasal base
- Short nasal septum (internal nasal structure) and large nasal turbinates
Given these anatomic variations, many African American patients interested in rhinoplasty are looking to gain the following changes to the nasal shape from surgery:
- Narrow and raise nasal bridge and improve its definition
- Improve definition and decrease width of the nasal tip
- Reduce alar flaring and nasal base
While these goals are not uncommon to rhinoplasty patients of other ethnicities, the specific variations in nasal anatomy in African American patients discussed above commonly dictate a totally different surgical approach to achieve desired results. For example:
- If the nasal bones are really short and shallow, trying to “squeeze” them together may not only fail to improve the definition of the nasal bridge, but sometimes may lead to bridge collapse and saddle deformity. Therefore, the correct approach to this type of nasal dorsum is placement of an onlay graft (cartilage from nasal septum or rib, and sometimes nasal dorsal implant).
- A combination of thick nasal skin and very thin and weak tip cartilages usually does not allow for the improvement of tip definition by a mere reshaping of the native tip cartilages (a common method for the improvement of tip definition in Caucasian patients). Since the cartilages a very weak and flimsy, they simply don’t hold the desired shape when modified by sutures only. Moreover, thick nasal tip skin unfortunately hides most of the refinements. Thus, in order to successfully define the tip, its structure usually needs to get reinforced by additional cartilage grafts (such as tip or shield grafts) and tip skin may need to be slightly thinned out on the undersurface.
- Also, having short nasal septum with short septal cartilages requires a rhinoplasty surgeon to be prepared to look for other sources of cartilage (such as rib or ear cartilage) as septal cartilage may not be sufficient enough.
- Large nasal turbinates may need to be surgically reduced as they may become more swollen as a result of the surgery causing difficulty breathing.
- One should always keep in mind a higher tendency of keloid (thick scar) formation in African American patients, especially when planning for alar base reduction which necessitates additional external incisions.
Taking into consideration all of the above, one should be careful when selecting a rhinoplasty surgeon. It is of paramount importance that a prospective surgeon understands all the intricacies of African American rhinoplasty and has had an extensive experience in ethnic rhinoplasty in order to be able to achieve great results.
Needless to say, many African American patients seek to improve the appearance of their noses without erasing their ethnic heritage and identity. It takes skill and sensitivity to achieve a cosmetic result that beautifies the face while respecting and preserving ethnicity. Dr. Ovchinsky has a very busy ethnic rhinoplasty practice in New Jersey and New York. We would be delighted to see you at a consultation in our office and to have an opportunity to create the nose you have always dreamed of!
What do I need to avoid before surgery?
If you are on “blood thinners,” you will be asked to stop them approximately one week prior to surgery. We also ask that you avoid certain over-the-counter medications. If you are taking some herbal supplements, you should stop those as well as they may contain blood thinning substances. Also, you have to completely quit smoking at least two weeks before surgery.
What about my daily medications before surgery?
You will have a preoperative appointment well in advance of your surgery when we will review all mediations with you. If you are on “blood thinners,” you will be asked to stop them approximately one week prior to surgery. We also ask that you avoid certain over-the-counter medications. You may continue taking most routine medications up until the morning of surgery with a small sip of water.
What happens after surgery?
You will go to the recovery room for a few hours until you are fully recovered from anesthesia. Once you are stable you will be taken home (or to a hotel) by your family member or a friend. You will want to stay relaxed for the first few days. You will need to keep your head elevated when in bed to help with faster resolution of swelling. You should begin to start walking, eating, and using the restroom the day after surgery. Your activity can slowly increase each day but it will take up to 2 weeks before you start to feel like your old self again. You should avoid any strenuous activity for 4 weeks. You will need to take medication prescribed to you by Dr. Ovchinsky, which usually include antibiotics, pain medicine, antibiotic ointment for the incisions, and occasionally anti-nausea medications.
Are there any dietary restrictions following surgery?
No. Patients can eat whatever they want. Advance your diet from liquids (fruit juice, milk shake, etc.) to soft food (pudding, macaroni and cheese, mashed potatoes and gravy, oatmeal, pasta) to solids as tolerated. To prevent dehydration, please drink as much juices and nutritional fluid as possible.
When will my stitches be taken out?
Stitches are normally removed five to six days after your surgery.
How soon will I be able to exercise?
Dr. Ovchinsky recommends that patients do not return to exercise for three weeks after their procedure.
When will I be able to see the results?
You may see the difference right away, and more so once the swelling goes down within the first one to two weeks. As with any surgical procedure, it takes anywhere from 6 to 12 months for the results to become final.
What is special about the way Dr. Ovchinsky does the surgery?
Dr. Ovchinsky tailors his surgical technique to an individual patient rather than using the same “run of the mill” surgery on everybody. The technique he uses causes minimal pain, has natural results, and is long-lasting. The vast majority of patients are quite surprised afterward at how little discomfort they have and how quickly they return to normal activity. Most patients have minimal bruising. Finally, with Dr. Ovchinsky technique and attention to details during skin closure, scars are typically minimal and are often difficult to see once they have fully matured.