Rhinoplasty continues to be the most challenging and versatile cosmetic surgery today. Ethnic considerations play a large role in choosing surgical techniques for reshaping the nose during rhinoplasty. The anatomy of the nose varies to a considerable degree depending on the ethnic heritage of the patient. The size and width of nasal bones, the strength and height of cartilages, and the thickness of skin vary predictably in accordance to race and ethnic heritage.

I agree with a recent scientific article which lists the common nasal features of Middle Eastern patients who sought rhinoplasty. These traits include: thick/sebaceous skin, high wide dorsum with cartilaginous and bony humps, ill-defines nasal tip, weak and thin lower lateral cartilages, and droopy nasal tip. The article concluded that often, aggressive but non-destructive techniques are necessary to achieve stable functional results in this group of patients with thick, non-contractile skin. Maneuvers such as cartilage grafts to the tip, columellar struts, release of muscles that depress the tip, and increasing the tip projection are often necessary in this category of patients. An open approach to the nose may be necessary to achieve these goals, and patients can expect a prolonged period of swelling in the nose.

I believe that Middle Eastern rhinoplasty requires an understanding of clinical and anatomic features specific to this ethnic group of patients. The surgeon and the patient should have a thorough discussion of the expected outcome of surgery, which may be aided through the use of computer imaging programs.