The Non-Caucasian Nose

Extract

Dr. Peck: The first patient is a 25-year-old woman, seeking primary rhinoplasty, who complains of a wide nose and no tip projection (Figure 1). Dr. Guzman, how would you approach treating this patient?

Dr. Guzman: This woman typifies African-American patients undergoing rhinoplasty. She has a low radix, decreased nasal length, foreshortened tip, acute columella-tip angle, and wide alar base. I would certainly use the open approach for a nose like this one.

But her skin is very thick, so there are limitations to what can be achieved as far as shape or definition. The nose will need some dorsal grafting; for this, I would use septum, if possible. A tip graft would enhance projection. I would use a columella strut to reinforce the entire area, followed by an onlay graft. I routinely trim the lower lateral cartilage.

Dr. Peck: What about infracture for this patient?

Dr. Guzman: No, not on this patient.