Rhinoplasty Considerations in the Ethnic Patient Using a Case-Based Approach: The Patient of African Descent

Overview

The article is a case based teaching piece rather than a study. Two cases are presented to illustrate approaches to rhinoplasty in patients of African descent. The two differ in both the problem addressed and the surgical route taken.

Sections of note

• Case based article presenting two patients; the abstract reports no outcomes, no complication rates and no follow up.
• The first case involved a contour irregularity on the bridge.
• That case also involved a poorly defined and drooping tip with a widened nostril base.
• It was addressed through an open approach.
• The second case focused on improving nasal tip definition.
• It was addressed through an endonasal approach, meaning all incisions were inside the nose.

What it means for a patient

• The approach chosen depended on how much needed changing, with the more extensive case done open.
• An open approach gives direct view at the cost of a small scar between the nostrils.
• Two cases illustrate technique; they provide no evidence about how often such approaches succeed.
• No results are reported for either case in the abstract.

Why this paper matters

Rhinoplasty proportions and techniques developed around one set of nasal anatomies, and applying them without adaptation produces poor results in others. Case based teaching articles like this one document those adaptations. They carry no outcome data.

Terms

• Open approach: surgery through an incision across the columella, lifting the nasal skin.
• Endonasal approach: surgery through incisions inside the nose only.
• Amorphous tip: a nasal tip without clear definition or shape.
• Ptotic tip: a nasal tip that droops downward.
• Alar base: the bottom of the nostril wings where they meet the face.
• Dorsal contour irregularity: an uneven surface along the bridge of the nose.