Natural rhinoplasty results are in vogue these days, and for all the right reasons.  In an increasingly global world, patients are taking great pride in their heritage and celebrating cultural and ethnic diversity.  When they seek rhinoplasty, they are looking to preserve features that help create their personal or cultural identity.  Gone are the days of the outdated concept of “ethnic rhinoplasty”.    

I have seen many cases of this phenomenon and am encouraged by it. I have spoken to patients who wish to preserve a hump on the bridge of the nose, but straighten the nose to look and breathe better.  I have also seen patients who wish to narrow the nose, but in a subtle way that does not alter their identity rather than trying to obtain some social media celebrity’s nose.  These requests require a different set of techniques and a greater aesthetic sensibility on the part of the surgeon, who may be used to doing a more “cookie cutter” type of nose.  Most importantly, it means that the surgeon must listen carefully to the patient, do a thorough examination and work with the patient using photography and computer imaging to obtain a clear sense of the aesthetic goals.  Otherwise, the surgeon will simply not know that the patient desires this type of cultural preservation rhinoplasty, and this will inevitably lead to bad rhinoplasty results. 

It is important for the surgeon to understand the anatomical differences between noses of different races or ethnicities.  There are major differences in the amount and quality of septal cartilage, tip cartilages, and nasal soft tissues, all of which require the surgeon to be familiar with different techniques.  For example, in Asian rhinoplasty, augmentation of the nasal bridge with rib cartilage is a frequently requested change, while dorsal bridge reduction or hump reduction is one of the most common changes requested in Caucasian rhinoplasty.