Before and After: Nose Re-Shaping

Ethnic Nose Surgery / Rhinoplasty in London

Written by Dr Julian De Silva

Ethnic rhinoplasty is the terminology given to patients who are not caucasian who require specialist rhinoplasty techniques to achieve a natural result. If you’re looking for the best ethnic rhinoplasty in London, you’ll know that it is a surgery of finesse and detail, even a 1mm change can be seen.

Dr De Silva believes that nose reshaping requires special techniques for improving definition and shape and keeping a natural appearance. Whether you are from an Asian, Middle Eastern, Afro-Caribbean, or any other background, ethnic rhinoplasty is tailored to your individual facial features.

What To Expect From Ethnic Rhinoplasty?

As the name suggests, ethnic rhinoplasty refers to a style of nose job that is designed to preserve the ethnic nasal characteristics of a patient and requires a different set of techniques and skills for each patient.

There is no “one size fits all” approach with ethnic nose surgery, as what looks beautiful and natural for one ethnicity may look less attractive to another.

When performing an ethnic nose surgery in London, Dr De Silva works to make the corrections you would like without taking away any of the ethnic identifiers that link you to your cultural background. His extensive experience means that he is extremely familiar with each ethnic group’s unique features.

Ethnic Rhinoplasty, female photo model

What Are The Challenges Of Ethnic Rhinoplasty?

Every ethnicity is marked by a unique nose structure. Typically, people from varying ethnic backgrounds have different nasal arches, skin thickness around the nose and nostril sizes.

During your initial consultation, your surgeon will do a full examination of your nose, taking note of the adjustments you would like to make, and creating a plan of action that meets your requirements. Your surgeon will take special care to preserve your ethnic features as part of your surgical plan.

In ethnic nose surgery, the skin is often thicker and there may be a fat pad at the tip of the nose, this may require refinement and graft material to give more tip definition. For markedly thick ethnic skin advanced techniques are required to give more definition to the bridge of the nose often utilising sculpted graft material. To achieve these results, your surgeon will change the shape of the bone and cartilage.

Some issues that often arise in a London ethnic rhinoplasty with those of Latino, Middle-Eastern, Asian and African-American descent include:

  • Thicker nasal skin
  • Increased swelling after the procedure and longer recovery time
  • Many ethnic groups have less flexible, and thicker cartilage
  • Additional fat under skin & reducing tip definition
  • Lower bridge and shorter nose
  • Wider nose and nostril/ alar flare
  • Darker skin tones can be more prone to scarring after surgery

What Are The Risks?

As with most nose surgeries, all patients have a degree of swelling and bruising that resolves over a period of weeks, 80-90% of the swelling resolves over the first six weeks although the final result is not apparent until at least twelve to eightenn months.

Risks that are relatively uncommon include asymmetries, tip definition, delayed healing, numbness, infection and scarring. The majority of these risks are avoidable with technical expertise and skill. Revision rates for nose surgery are around 8%, although the risks can be resolved, revision rhinoplasty is more challenging than primary rhinoplasty as a consequence of previous surgery and scarring.

Dr De Silva Is An Advocate For Patient Safety

Patient safety is of key importance for all facial plastic surgery. The intricate anatomy of the nose requires precision and care. Dr De Silva is a keen advocate of patient safety and has championed the need for patient safety on Sky news.

Kim Kardashian’s nose before and after rhinoplasty, front view

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More About Nose Surgery

Afro-Caribbean Rhinoplasty FAQ

Afro-Caribbean ethnicity is characterised by thicker ethnic skin, a wider lower nasal bridge with a wider tip and flared nostrils which can make the nose appear short.

  • Why Have Rhinoplasty?

    Common reasons for undergoing an Afro-Caribbean nose job are to have a narrower more defined nasal bridge, tip refinement and narrowing of the nostrils.

  • How Can the Tip of My Afro-Caribbean Nose Be Refined?

    Commonly the Afro-Caribbean nose tip can lack definition and can be relatively wide or even bulbous. The appearance of a nasal tip is partly characterised by the shape of the underlying cartilages, ethnic fat beneath the skin and relatively thick skin.

    Often open rhinoplasty is the preferred technique for increasing tip definition as it enables the skin to be thinned and more accurate definition to be achieved in the tip of the nose with the sculpting of the underlying cartilages and the use of specialised graft tissue to give more definition. There are limitations in the degree of definition achievable in the tip of the Afro-Caribbean nose as there is a limit to how much cartilage and skin can be shaped through the thicker ethnic skin. Every surgery is unique and requires customisation for the individual. To improve definition and give a more defined nasal bridge and tip, Dr De Silva often uses additional graft material (this is not required in caucasian nose jobs), this graft materials is able to give a more defined nose and result.

  • Will I Have Visible Scarring?

    Dr De Silva uses innervational techniques to reduce scarring for patients. The key to normal healing of scars is a surgical technique, choice of non-dissolving stitches and avoiding sun exposure in the healing period, as ultraviolet light may cause darkening of the skin.

    Although dissolvable stitches are quicker for surgeons, in some patients these may increase scarring, for this reason, Dr De Silva does not utilise these stitches. In patients who have a marked propensity for scars, he uses additional non-scarring agents to improve healing after surgery. Key is the positioning of the scars with meticulous technique to minimise scars.

  • Longer recovery after surgery?

    Often patients with afro-caribbean ethnicity have more swelling after surgery, Dr De Silva often uses anti-inflammatory medicines after surgery to aid resolution of swelling and speed up healing. In ethnic rhinoplasty this medicine can also reduce scar tissue and improve definition and the result, and is often required between 1 to 3 times to give the best results.

Asian Rhinoplasty FAQ

Asian noses are often characterised by a relatively low nasal bridge which makes the nose appear relatively small and thicker skin which can result in the tip of the nose being bulbous and lacking definition.

  • How Can the Tip of My Nose Be Refined?

    In Asian noses, commonly the tip can lack definition and can be relatively wide or even bulbous. Often open rhinoplasty is a preferred technique for increasing tip definition as it offers an improved result as this enables the skin to be thinned and more accurate definition to be achieved in the tip of the nose with the sculpting of the underlying cartilages and the use of graft tissue to give more definition.

  • Do I Need Graft Tissue?

    Dr De Silva frequently completes revision Asian nose surgery for patients who have undergone nose surgery elsewhere to improve the definition of the nasal bridge. His first choice for graft material is your own cartilage from your nasal septum or cartilage from your ear, sometimes your own cartilage may be insufficient in length, the nasal bridge and other material may be required. Silicone is one option, however often this can move with time and need to be revised. Dr De Silva’s focus is on a natural augmentation of the nasal bridge in Asian nose surgery to ensure that the result looks like your nose, just more elegant and refined. There is a an artistic aspect to asian rhinoplasty as the degree of augmentation has to be in proportion to your facial characteristics.

  • Do I Need To Have Nostril Reduction?

    The need to narrow nostrils with surgery requires complete customisation for the individual. The position of the eyes in your face can give a good indication of facial proportions and the need for nostril reduction. Wide nostrils are reduced with alar narrowing techniques. Nostril narrowing is one of the more challenging aspects of the procedure, as complete symmetry cannot be achieved in the nostrils as they are a complex 3-dimensional dome, a natural shape.

    Dr De Silva hides the incision of nostril reduction by making an incision in the natural curvature under the nose. He is frequently asked to correct the scars from patients who have undergone surgery elsewhere which are best avoided by making hidden incisions in the first place.

  • Longer recovery after Asian Rhinoplasty surgery?

    Often patients with Asian ethnicity have more swelling after surgery which is a reflection of thicker skin. Dr De Silva often uses anti-inflammatory medicines after surgery to aid resolution of swelling and speed up healing.

Middle Eastern Rhinoplasty FAQ

Middle Eastern noses are often characterised by a relatively high nasal bridge which makes the nose appear relatively large and thicker skin which can result in the tip of the nose being bulbous and lacking definition.

  • How Do Dr De Silva’s Techniques Differ for Middle Eastern Patients?

    He often utilises specialist techniques in surgery to build a more elegant and refined dorsal bridge, this results in the appearance of the nose becoming narrower and more refined. London is regarded as a center for World Class medical care, and many Middle East patients fly to London for rhinoplasty. Dr De Silva has customised his treatments of Middle East patients dependent on their specific needs. Although closed approach can be suitable for some patients, Middle East patients with thicker skin, asymmetry may need an open approach to give the best results.

  • Longer recovery after Middle East nose job?

    Often patients with Middle East ethnicity have thicker skin which can result in more swelling after surgery. Dr De Silva often uses anti-inflammatory medicines after surgery to aid resolution of swelling and speed up healing. This medicine reduces swelling and scar tissue to improve definition and the final result.

    Dr De Silva uses specialised Rhinoplasty techniques to improve both the bridge of the nose, the definition in the tip of the nose and to enhance recovery time with the use of anti-swelling medication. By the use of these techniques, they offer a patient a natural-looking result with more definition and refinement and faster healing time.

  • What Type of Anaesthesia is Used?

    Sedative anaesthesia, also known as “twilight anaesthesia,” is a combination of local and sedative medications. At the centre, we have developed our own specialised form of twilight anaesthesia, based on practices in the USA.

    This sophisticated sedation uses tiny amounts of four to five sedation medications that cumulatively give a relaxing and safe experience to avoid the risks and side effects of general anaesthesia.

    A much shorter recovery period than general anaesthesia, with most patients able to leave 30 to 60 minutes following the procedure. These are the most advanced sedation techniques available, and the optimal option for patients considering ethnic nose surgery.

  • What is the Cost of Rhinoplasty in London?

    Rhinoplasty cost varies significantly. On average, it ranges from £5,000 to £15,000 depending on the facility, location, surgeon, technique and recovery care in London. Dr De Silva believes that cost should not be the main factor when searching for a surgeon who specialises in ethnic nose surgery as you ideally want to work with the best rhinoplasty surgeon in London. Ethini rhinoplasty can take 1 hour or it can take 4 hours, Dr De Silva believes in taking the time to measure accurately, complete surgery with precision, with the aim of improving each detail of your nose only once.

Revision Surgery

Ethnic rhinoplasty is regarded as a challenging aspect of nose reshaping as the degree of detail is fine and aspects such as skin thickness limit definition. Over 30% of all Dr De Silva’s patients have undergone previous surgery and are termed revision procedures. Although more challenging than primary surgery often with his advanced techniques the overall appearance of the nose can be improved.

Can Ethnic Nose Surgery Be Combined with Other Procedures?

Dr De Silva frequently combines surgery with other facial procedures including:

  • Blepharoplasty
  • Facelift (deep plane, natural facelift) & Neck lift surgery
  • Lower eyelid surgery for puffiness (eye bags)
  • Chin augmentation and facial balance
  • Regenerative medicine
  • Volume enhancement with fat transfer.

How to Choose the Right Surgeon for Your Ethnic Rhinoplasty

If you’re thinking of undergoing ethnic rhinoplasty, it’s essential that you choose a facial plastic surgeon dedicated to retaining the general nasal characteristics of your individual ethnicity. At London Facial Plastic Surgery, Dr De Silva uses computer modeling to give you a full overview of what your face will look like after surgery when combining your preferences with his recommendations.

Dr De Silva will work with you, adjusting the imaging until you are satisfied with the results in order to provide you with the results you desire. To find out more about his rhinoplasty techniques or to book an initial consultation, contact our office today!

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