Ethnic Rhinoplasty (Nose Job)

Why we prefer Closed Approach at Ethnic Rhinoplasty Surgery ?

Dr. Bora Ok, MD. Plastic Surgeon

Why we prefer Closed Approach at Ethnic Rhinoplasty Surgery ?

Closed Rhinoplasty is a complex type of surgery requiring the experience of a highly skilled surgeon. This surgeon will need to employ the full gamut of their technical skills to help with the manipulation of nasal tissues, whilst understanding the balance of patients’ facial features to ensure a natural look. Open and Closed Rhinoplasty refers to two surgical approaches that expose the skeletal framework under the nasal skin. Changes to the shape and contour of the nose will come as a direct result of changes made to the nasal skeletal area.

So what is the difference?

Closed Rhinoplasty surgery – is unique in the way that it’s practised. Corrections and enhancements of the nasal area are made internally, thus avoiding external visible scars. Open Rhinoplasty surgery – is performed by making a cut across the tissue at the bottom of the nose that separates the nostrils. This area is also known as the columella .

What is Ethnic Rhinoplasty?

Ethnic rhinoplasty, or ethnic nose job , is a subdivision of the clinical practice of rhinoplasty. It relates to nose surgery carried out on non-Caucasian or ethnic patients. There are many characteristics that differentiate the nose of an individual of African descent to that of other ethnicities. For example, compared to that of a Caucasian nose, the anatomy of a black person generally feature characteristics such as: ● Larger nostrils ● Thicker skin ● Fat present in the nasal tip ● A low bridge

Do different ethnicities have different skin types?

The short answer...yes. This is why Dr Bora Ok, with over 10 years of experience is able to offer and customize this surgical technique taking into account an individual's ethnic characteristics.

Revolutionary Closed approach in Ethnic Rhinoplasty?

With years of experience, Dr Bora Ok has adapted the classic Closed Rhinoplasty method. Using his revolutionary technique, he is able to perform procedures that are usually undertaken in the Open Rhinoplasty – with the advantage of not having to make an incision to the columella. Procedures such as nasal tip shaping, stitching techniques and cartilage graphs can be performed whilst all the while protecting the columella. By using this method, changes can be made to the tip of the nose and can give excellent results – but it does need to be applied by experts with long-term Closed Rhinoplasty experience. Each patients ethnicity presents its own set of complex challenges. Performing Ethnic Rhinoplasty requires a highly skilled surgeon with the experience to determine the most natural look for each patient. Ethnic Rhinoplasty requires a comprehensive understanding of the nuances of anatomy and the techniques required that make it different from Caucasian Rhinoplasty. Due to Dr Bora Ok’s professional understanding of the anatomical structure of patients from African descent, he is able to tailor surgery using specialist techniques in Closed Rhinoplasty that offers individuals a refined look with much-needed faster healing time. The difference between both surgical procedures may appear small, however, the outcome is paramount to the patient. With the elimination of the columellar incision, the Closed technique enables a shorter operation and less swelling during the healing period. Although the incision of the columella may heal nicely for some patients, this incision can leave a hypertrophic scar which darker skin is prone to. With no cuts made to the columella in Closed Rhinoplasty, this factor is completely eliminated.

Here are some brief pointers as to why Dr Ok uses the Closed approach.

1. In Open Rhinoplasty, with the incision made in the columella, the vessels feeding the nose tip are interrupted reducing the blood flow. This, in turn, can cause more swelling and stiffness during the healing process. (See Figure-1 below). 2. In Open Rhinoplasty, more cartilage grafts and sutures are required to restore nasal stabilization at the end of the operation when the nose is fully released and opened. This may lead to greater stiffness at the tip of the nose, prolonged swelling and also possible reaction to stitches. 3. Defatting may be necessary to provide a more contoured nasal tip, especially for people with thick skin and prominent fat layer under the skin. In Closed Rhinoplasty, it is safer to apply this thinning process because the vessels in the columella are protected. In Open Rhinoplasty, necrosis (tissue death due to failure of the blood supply) is more likely to be seen in the skin of the region as a result of this procedure, especially when aggressive defatting has been performed. 4. The columella is a perfect, unique anatomy and each millimetre of skin has a different thickness along it. With Ethnic Rhinoplasty, the upper and lower part of the incisions can seem to be more prominent. This may cause a notching visage around the incision line. In Closed Rhinoplasty, you will notice that all the features of the unique structure are protected, guaranteeing a smooth columella as an end result. (See Figure-2 below). 5. Bridge Augmentation is one of the important steps during Ethnic Rhinoplasty. Using the Closed Approach, the bridge of the nose can be dissected to a meticulous level. Not too high and not too low is the desired outcome and this helps to place dorsal grafts to the bridge in a precise manner. Also, this kind of approach needs less in the way of stabilization techniques, resulting in less swelling and faster recovery time. Times have changed, the days where the sole objective of Ethnic Rhinoplasty surgery was to simply produce a more Caucasian appearing nose, eliminating all trace of the patient

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