Or perhaps the patient’s complaint is that her nostrils flare when she smiles, making her nose look even wider. “Facial plastic surgeons should learn how to correct that feature,” he said.
Explore This IssueAugust 2013
“I like patients to tell me specifically what they like and or dislike about their nose. At first thought, most patients say they like nothing about their nose, but with proving they actually see things differently. This is key,” Dr. Boahene said. For instance, a patient may say he likes the hump on his nose because it’s a family feature. He may want it preserved or only slighty modified. “Let them talk,” he said. “Then I can tell them what I achieve, or what’s not reasonable.”
“I do think there’s a general awareness that it’s not one size fits all,” said Jennifer Parker Porter, MD, FACS, director of Chevy Chase Facial Plastic Surgery in Maryland, who added that minority patients seek her out because she is African American. Like many facial plastic surgeons, Dr. Porter uses imaging technology and photos of previous patients to discuss with her patients what can be accomplished. “There are differing ideals of the African American nose, but you want to have an ideal more fitting for you.”
An otolaryngologist, Dr. Porter started out in reconstructive surgery but now practices mostly cosmetic procedures. “It’s a little bit of tweaking,” she said of her methods. “Typically, I’m doing slightly different things in ethnic patients,” she said. “You have to take into account the thickness of the skin and the differing bone structure. With experience, you develop techniques that work for you and give the result you want.”
Jeffrey Epstein, MD, FACS, founder and director of the Foundation for Hair Restoration and Plastic Surgery, with offices in Miami and New York City, has been in practice for 20 years and has witnessed the increase in Hispanic, African American and Asian patients. He said there are some features that no one likes—a wide bridge, a crooked nose, droopy eyelids—and that there are ways to reduce these features while maintaining ethnic appearance.
“As a doctor, I can show patients what’s possible,” Dr. Epstein said. “Then the patient can tell me: I like this. Not that.” He also warned, “Don’t make assumptions based on standards of beauty.” As an example, he said, if a young Asian woman with an underprojected chin comes in for a consult, don’t automatically suggest a chin implant.