Middle Eastern Rhinoplasty: Balancing Form, Function, and Ethnic Harmony

Rahimian H, Sajjadian A.

PubMed 40855021 Publisher (DOI)Free full text (PMC)

What this paper says

A review of 100 consecutive Middle Eastern primary rhinoplasty patients found dorsal humps in 91%, septal deviation in 85%, bulbous tips in 81% and drooping tips in 78%, and outlines surgical strategies suited to this anatomy.

Overview

Sajjadian's practice reviewed 100 consecutive primary rhinoplasty cases in patients of self-identified Middle Eastern heritage with at least one year of follow-up, documenting the anatomical features found, the techniques used and the outcomes at about one year. The paper is descriptive; it does not report outcome scores.

Sections of note

100 patients: 28 men, 72 women.
Feature prevalence: thick or moderately thick skin 53%, dorsal hump 91%, wide nasal bones 47%, drooping tip 78%, septal deviation 85%, alar flaring 38%, bulbous tip 81%, nostril asymmetry 76%.
The soft-tissue envelope is described as fibrofatty, with a distinct bony-cartilaginous framework.
Emphasis on culturally sensitive communication to align expectations.
Level of Evidence V.

What it means for a patient

Middle Eastern noses tend to share a cluster of features, so most patients in this series needed hump reduction, tip support and septal work together.
Thick skin limits how much tip definition is achievable and should be discussed before surgery.
The paper describes approach and anatomy, not measured results.

Why this paper matters

It gives prevalence figures for anatomical features in a large consecutive Middle Eastern series, useful for planning and counselling. Limits: single surgeon, descriptive, no outcome metrics.

Terms

Dorsal hump: a bump on the bridge made of bone and cartilage.
Alar flaring: outward curve of the nostril walls.
Bulbous tip: a rounded, poorly defined tip, often from thick skin and wide cartilages.
Fibrofatty soft-tissue envelope: thick skin with dense fat and fibrous tissue beneath.
Septal deviation: a bent septum, causing obstruction or a crooked nose.

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

Abstract

Introduction: Middle Eastern rhinoplasty presents unique challenges that require a comprehensive understanding of the unique anatomical distinctions that set it apart from Western Caucasian ideals. Achieving natural, harmonious results necessitates an approach that integrates detailed analysis, technical precision, and an appreciation for cultural and aesthetic preferences.

Methods: A retrospective chart review was conducted on 100 consecutive primary rhinoplasty cases performed by the senior author (A.S.) involving patients of Middle Eastern descent who had at least one year of postoperative follow-up. Inclusion criteria were based on self-identified Middle Eastern heritage as documented through demographic forms, chart notes, and name recognition. Operative reports and standardized photographs were reviewed to evaluate nasal anatomy, surgical goals, techniques, and outcomes assessed at approximately one year postoperatively.

Results: Among the 100 patients analyzed, 28 were male and 72 were female. Preoperative assessments revealed a consistent set of nasal features commonly observed in this population. The most prevalent included thick and moderately thick nasal skin (53%), prominent dorsal humps (91%), wide nasal bones (47%), drooping nasal tip (78%), septal deviation (85%), alar flaring (38%), bulbous nasal tip (81%), and nostril asymmetries (76%). These anatomical patterns often presented both aesthetic and functional challenges, informing tailored surgical strategies.

Discussion: The fibrofatty soft tissue envelope and distinct bony-cartilaginous framework of the Middle Eastern nose present specific operative challenges. Optimal outcomes are achieved through a combination of precise, technique-driven modifications tailored to common anatomic features in this population. Equally important is culturally sensitive, patient-centered communication to align expectations, acknowledge aesthetic preferences, and define realistic goals.

Conclusion: Middle Eastern rhinoplasty requires a deep and comprehensive understanding of ethnic anatomy and aesthetic goals. Tailored surgical techniques that preserve identity while addressing structural and cosmetic concerns are essential to achieving balanced, natural, and functional results.

Level Of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).