aRTiCLE | RHInOplasTy |
Religious implications and sensitivities with regard to
rhinoplasty must be respected in the Middle East, especially with Muslim patients. Many Muslim patients believe that aesthetic surgery of the face, and rhinoplasty in particular, is against their religious beliefs. It is therefore vital not to produce too radical a change in appearance and identity, but only to reduce exaggerated features, such as a dorsal hump, hooked tip, or excessively long nose. preoperative counselling is vital to provide the patient
with enough information regarding the procedure and its possible complications. The patient’s expectations, as well as psychological status, should be carefully gauged during this period. always strive to fulfill the patient’s criteria, not your own. Interpret and respect each patient’s wishes carefully. It is also important to give the patient an idea about the average period of convalescence, and when packs and casts will be removed. The final results of rhinoplasty should not be judged until a few months have passed postoperatively. The authors found the open approach to be
unnecessary for the patients in this study. as many patients in this series had thick, pigmented skin, complications such as a visible scar and keloid formation were thus avoided. Technically, a tailored approach for each patient should be used to avoid excessive rigidity. The final aim should be a satisfied patient, and not necessarily a beautiful nose. This makes ethnic rhinoplasty a true challenge that requires analytical capabilities, logic, manual skill and artistic sensitivity from the plastic surgeon6
. The goal and the ultimate
challenge of rhinoplasty on arabic patients is to achieve balanced aesthetic refinement, while avoiding surgical Westernisation7
.
The authors’ findings with regard to the surgical techniques correspond to those of Daniel8
, who stated
the following critical techniques: ■ Reduce the specific component of the dorsal deformity ■ Use a balanced approach of augmentation and reduction ■ as reduction increases, the need for spreader grafts increases ■ achieve tip shape with structural support and not excision.
48 ❚ October 2011 |
prime-journal.com References
1. Rohrich RJ, Bolden K. Ethnic rhinoplasty. Clin Plast Surg 2010; 37(2): 353–70
2. Boccieri A. The surgical approach to the Mediterranean nose. Facial Plast Surg 2010; 26(2): 119–30
3. Leong SC, Eccles R. Race and ethnicity in nasal plastic surgery: a need for science. Facial Plast Surg 2010; 26(2): 63–8
4. Noback ML, Harvati K, Spoor F.
Climate-related variation of the human nasal cavity. Am J Phys Anthropol 2011; 145(4): 599–14
5. Weiner JS. Nose shape and climate. Am J Phys Anthropol 1954; 12(4): 615–8
6. Palma P, Bignami M, Delù G, De Bernardi F, Castelnuovo P. Rhinoplasty for the Mediterranean nose. Facial Plast Surg 2003; 19(3): 279–94
7. Azizzadeh B, Mashkevich G.
Middle Eastern rhinoplasty. Facial Plast Surg Clin North Am 2010; 18(1): 201–6
8. Daniel RK. Middle Eastern rhinoplasty: anatomy, aesthetics, and surgical planning. Facial Plast Surg 2010; 26(2): 110–8 May
9. Huizing E, de Groot J. Functional Reconstructive Nasal Surgery. 2003, George Thieme Verlag: Stuttgart, Germany
Figure 5 Pre- (A and B) and postoperative (C and D) images demonstrating correction of a dorsal hump
Conclusions The nasal surgeon should be aware of the limits of surgery. If a person’s nose is considered ‘normal’ with regard to their ethnic origin, gender, and age, changing its features may run counter to medical ethics. Occasionally, the shape of the nose may be a perceived problem by the patient and not an actual problem. In such cases, reassurance and occasionally, psychological counselling, may be a better alternative to surgery. surgery has its complications and it is the surgeon’s responsibility to carefully explain outcomes to the patient and to correct unrealistic expectations. Rushing in to surgery is not advisable in these cases. The primary objective of nasal surgery must be to restore function. The goal of functional improvement must always be given priority over that of enhancing beauty9
. a final point is the authors’ strong support of close if a person’s
nose is considered ‘normal’ with regard to their ethnic origin, gender, and age, changing its features may run counter to medical ethics.
cooperation between the plastic and Ear, nose and Throat (EnT) surgeons during septorhinoplasty. This is especially important in patients who also complain of intranasal symptoms. Therefore, both aesthetic and functional problems can be tackled in a single anaesthetic administration. This reduces risk to the patient, as well as to the costs of surgery, and the combined expertise will result in the best possible outcome for the patient.
Declaration of interest none
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