Treatment protocol for "Mestizo nose" with open rhinoplasty

de la Peña-Salcedo JA, Soto-Miranda MA, Lopez-Salguero JF.

What this paper says

In 879 primary open rhinoplasties on Mestizo noses, a fixed operative sequence gave an estimated 54.75% improvement in nasal aesthetics, a 5% revision rate and complication rates each under 1.5%.

Overview

The Mestizo nose, common in Hispanic patients, has a weak cartilage frame under thick skin, so techniques designed for Caucasian noses often fall short. The authors, working in Mexico, built an operative sequence and an algorithm for the different Mestizo nose types and tested it across a large primary rhinoplasty series.

Sections of note

879 primary rhinoplasties; 92.37% women, 7.62% men; ages 15 to 63, mean 39.
An algorithm for the different types of Mestizo nose is presented, with ten complete cases illustrated.
Reported improvement in nasal aesthetics of about 54.75%; the abstract does not state how this was measured.
Complications: postoperative bleeding 1.37%, pain 0.57%, septal hematoma 0.23%, unaesthetic scars 0.34%, cartilage extrusion 0.11%.
Revision rate 5%.
Not every step is needed in every case.

What it means for a patient

Patients of Hispanic or mixed ancestry may need support grafts and thick-skin management rather than the reduction used on other noses.
In this large series, serious complications were rare and 1 in 20 patients had a revision.
Single group, no comparison, and the aesthetic improvement figure lacks a stated method; follow-up length is not given.

Why this paper matters

Ethnic rhinoplasty literature was thin in 2011 and this is one of the largest Mestizo series published. It gives a structured, reproducible plan for surgeons treating a growing patient group. Independent outcome measures and long-term results remain unreported.

Terms

Mestizo nose: a nose of mixed European and Indigenous American heritage, typically with a low bridge, weak tip cartilage and thick skin.
Open rhinoplasty: approach through a small cut across the columella, lifting the skin to expose the framework.
Primary rhinoplasty: a first-time nose operation.
Septal hematoma: a blood collection inside the septal lining after surgery.
Cartilage extrusion: a graft working its way out through the skin or lining.
Algorithm: a step-by-step decision plan for choosing which maneuvers to use.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“The aim of this study was to develop an operative sequence to guide plastic surgeons on how to handle the challenges of "Mestizo nose" during rhinoplasty. This type of nose has characteristics quite different from the Caucasian nose. Rhinoplasties on Mestizo nose represent a surgical challenge because of the…”

Excerpt; the full abstract is on PubMed.