Although the same basic principles and surgical techniques are applicable to multiple different ethnicities, there are some specific issues that differ when operating on Asian, Eastern European, Hispanic, Middle Eastern, and African American noses.
In general, these ethnicities have a different anatomy than Caucasian noses and thus require different surgical considerations.
For starters, most of these ethnicities mentioned have thick skin envelopes. This creates a situation in which it is much more difficult to achieve fine definition and much more challenging to perform a reductive rhinoplasty.
When too much bone or cartilage is removed from a nose with thick skin in an attempt to make the nose too small, the result is an amorphous, ill-defined nose. This result can often look reasonable from the side view, but will never look good from the front or angled view.
The solution to this dilemma is to be cautious with reduction and focus more on cartilage addition.
Appropriate cartilage grafting, carefully placed and secured, will add structural support as well as fill out the skin envelope in order to create definition. It frequently holds true that when the proportions and relationships throughout the nasal contour are optimized, the nose will take on a much more pleasing cosmetic appearance regardless of overall size.
In addition, many of the ethnicities mentioned above have thin, weak cartilage. This too can only be addressed with meticulous cartilage grafting to strengthen and support the framework of the nose. Lastly, the concept of ethnic rhinoplasty raises the issue of whether the patient would like to retain elements of his or her ethnicity in the nasal contour or abandon them for a completely different look. This requires clear communication and photo analysis during the pre-operative appointments.