Rhinoplasty is an operation that is requested across all races and cultures. Each race to a large degree has inherent features that make it distinct from a traditional Caucasian nose. The Middle Eastern nose is no exception . While the concept of Middle Eastern is a cultural blend of many people that have become intertwined over thousands of years, it does possesses some consistent characteristics that can be altered by rhinoplasty surgery.
In the April 2009 issue of Plastic and Reconstructive Surgery, a paper was published that detailed out the Middle Eastern nose and a sound rhinoplastic approach to it. The most common Middle Eastern nasal characteristics include wide nasal bones, a high dorsum and an overprojecting radix, a downward oriented nasal tip that is wide and bulbous, and nostrils that may be flared. This nasal framework is covered by thick oily skin that has some excess fat at the tip.
Open rhinoplasty can make good cosmetic improvement in the external shape of the Middle Eastern nose but it is critically important to not ‘westernize’ its look. The surgical approach has been described as defatting the tip skin, moderate bone and cartilage hump reduction (but not overly so), low nasal bone narrowing lifting the nasal tip but no greater than a 90 degree nasolabial angle, narrowing the nasal tip at the same time, and possibly narrowing the nostrils if they are too wide. While this is an overall aggressive approach, the two maneuvers of hump reduction and tip elevation, and how they are done, are key to not giving the Middle Eastern nose an operated look.
Because of the thick nasal skin, prolonged swelling after surgery may take some time to settle down. This is particularly true in the tip of the nose. Prolonged swelling and the formation of scar tissue in the tip may require secondary revisional surgery to get the most refined result.
Dr. Barry Eppley
Indianapolis, Indiana