Transcription
In case you have the attention span of a goldfish, in this video we’re going to be going into a lot of detail on nose shape aesthetics and surgical changes for African, Hispanic, East Asian, Middle Eastern, South Asian, and Caucasian noses for both men and women. If you’ve seen our previous video on how climate influences your nose shape, then you’re likely aware that people of different ethnicities and geographical regions have different nose shapes. Part of this shape is a longstanding adaptation to the local climate to maximize airflow while minimizing irritation.
But with the world being more globalized now than ever before, heterogeneous societies like the United States and the United Kingdom are made up of demographic minorities of African, Hispanic, South Asian, and East Asian, among others. It’s important to recognize the growing shift in cosmetic surgery demographics as improved economic factors allow minorities to have greater access to expensive, but purely cosmetic surgeries. Rhinoplasty, aka the reshaping of the nose, is the most common of these surgeries. And so, while in the past surgeons have applied a more one-size-fits-all nose shape, white-washing the features into a typically Caucasian shape with greater nasal prominence, a narrower base, and upturned tip, this has led to decreasing patient satisfaction over the years.
Just look at Michael Jackson’s nose. With Michael being born to African descent, his facial features show phenotypic expressions of African features, especially the midfacial width, the facial-width-height ratio, the scleral show, and most notably the very wide chin. Changing his skin color to a pasty white (be it for vitiligo or other) doesn’t change his African features. Shortening his naturally wide nasal base to a sharp, upturned point seen only in people from the coldest of climates doesn’t change his dentofacial dimensions. A lot of this insecurity came from the shape of his nose, as he had revealed in many later interviews, and this insecurity is not uncommon in the African-American population who naturally have wide nasal bases and high fibrofatty tissue as a climatic adaptation to dry air.
The issue isn’t in getting your nasal shape changed to be more comfortable in your body, but rather how your surgeon designs your rhinoplastic changes to suit your ethnic features. In Michael’s case, his surgery was when he was 21 to repair a broken nose, and the idea of nose shape planning by ethnicity was not big at the time. When you have a face as naturally wide as Michael’s, having a thin and dainty nose greatly harms proportion and harmony. The problem is that a lot of what you find beautiful is based on social acceptance. Many rhinoplastic patients do want a more Westernized nose because they live in the Anglosphere as a minority. Much of the neoclassical proportions that surgeons are taught were based on Renaissance understandings of beauty which only suit a select few people, even among Europeans who these standards were developed in mind for. From Farkas’ revision of these canons, they were not well suited for the African face and nose.
Nowadays, surgeons and well QOVES Studio use anthropometric studies based on the target ethnicity itself, e.g., Middle Eastern values for a Middle Eastern subject, but these are the averages for an average-looking population. The most attractive Middle Eastern face, for example, would have features and values that surpass the average nasolabial angle, or nasofacial value, which is what makes them above average in looks. So for many surgeons, a lot of it is guesswork and experience. If your surgeon doesn’t have a large portfolio of people who look similar to you, then you’re at a risk of getting a nose that doesn’t harmonize well with your ethnic features. Apart from cost, medical tourism, especially for rhinoplasties, is popular because ethnic surgeons who share the same ethnicity as you and operate on people of your ethnicity in your ethnic region will have far more experience than someone who doesn’t.
From Patel Et al’s paper, here is a good example of a good nose-job. East Asians typically have a very flat nasal bridge, which is one of the features that Anthropologist Doug Jones mentioned as making their faces appear very neotenous or child-like. The surgeon here has augmented the nasal bridge and has developed a smooth, consistent line through the dorsum, reducing the sharpness of the supra-tip break and supra-tip lobule. The nasal base appears to be left untouched, which is fine because it’s proportionally situated in-between her medial canthus, and so if it ain’t broke, don’t fix it. Cobo’s 2017 paper actually devised a way to categorize the flatness of East Asian noses compared to the sharpness of Northern European ones.
Platyrrhine noses are more common in those with African descent or South East Asians with small nasal bones, a low radix, wide dorsum, reduced tip support, decreased forward projection, lower nasolabial angles (i.e., the nose is more downward facing), and most characteristically, a wide nasal base. Leptorrhine noses are more commonly seen in Caucasian patients and Patel et al consider them to be the anatomical opposites of the Platyrrhine with a high radix, well-developed bones, narrower dorsum, and a well-defined and projected tip. They also seem to naturally have some degree of rotation to them which some may consider unsightly as a deviated septum. Mesorrhine noses are seen in Hispanic populations with features in between the Platy and Leptorrhine shapes. The tip is not as projected and the nasolabial angle is more acute, meaning that the nose is more downturned with an intermediate amount of soft tissue thickness. According to Cobo, the noses of the world belong to some combination of these three categories. Instead of assigning people by race or ethnicity, it may just be easier for surgeons to classify them by their nasal characteristics.
African American Noses Let’s start off with the African American Nose. Baker Et al’s in 1984 found that most African-Americans did not want their noses to be transformed into resembling Caucasian nose shapes, and the most common reasons for wanting a rhinoplasty were that they believed their noses to be too broad or wide. As a result, Rohrich and Muzaffar’s study on African patients had defined 5 goals for ethnicity-specific rhinoplasty: * Maintaining nasofacial proportions * Ensuring a narrower and straighter dorsum * Enhancing tip projection and definition * Controlling alar flaring * Narrowing interalar distance (shorter nasal base)
One of these challenges is improving tip projection, which is typically flat due to African noses having more fibrofatty tissue than Caucasian noses. However, Rohrich’s study, among others, has shown that underneath this fatty tissue, the structure of the African nose is actually quite similar to the Caucasian nose in terms of structural integrity, cartilage strength, and cartilage distances. But while the noses may have similarities, African dentofacial features are very different, with a higher percentage of Africans developing bimaxillary protrusion. This gives the chin a retruded look as the upper jaw, or the maxilla, protrudes forwards and makes the nose appear even flatter. We’ve covered this in depth in this video going over the statistics of how often it occurs and how it affects aesthetics using Michael B. Jordan in this celebrity analysis. What Patel et al’s paper suggests is that in these cases, chin augmentation may yield greater aesthetic gains rather than fiddling around with the nasal projection. This is because we evaluate the face as a whole, especially in the side profile, and so if the chin is heavily retruded or there is some dentofacial anomaly, then that will draw our attention away from the nose.
Another concern that African patients have is that their nose is too wide, flaring their nostrils to noticeably large sizes. Flared nostrils are often corrected because they’re less common and thus more unusual and noticeable, but the width of the African nasal base is quite normal and in similar proportions to noses of other ethnicities. African faces are wider and so the nasal features are also stretched out further too. Most nose shapes follow a 1:1 ratio between nasal width and intercanthal width, but Porter and colleagues suggest a ratio of 1:1.25 to 1.3 for African faces as their nasal bases are wider. At QOVES, we still recommend the 1:1 ratio because Porter’s study takes the average of a sample population of average-looking people. Attractive African models and celebrities have slightly smaller nasal widths than the average at 1:1 ratios and so an alar resection may be needed.
Hispanic Noses This refers to Spanish-speaking people of Mestizo or Latin origins, and this group has seen a lot of diversity from European and Indigenous descendants. The Mestizo literally means a mixture of races, and Roxana Cobo 2010 indicates that they share features from European, African, and Indian noses. Similar to the African nose, they have a thicker soft tissue envelope, with wider but shorter nasal bones with a less projected but rotated tip. They also have a wider nasal base but not as wide as African noses. Hispanic faces in general have sharper malar eminences (cheekbones), with a more acute nasolabial angle (downturned nose), the base is typically wider than the intercanthal width, and greater midface protrusion with a weaker lower third. This last dentofacial feature of midface protrusion emphasizes the aquiline shape of the nose more greatly, which some love and others absolutely hate as making their face appear bird-like. Hispanic noses also have a slight to moderate dorsal hump, or the hump could just be due to the plunging curvature of the nose and not an actual bony bump like with other nose types; regardless, most get rhinoplastic surgery to straighten the nose. Of the Hispanic noses, there are 3 groups, and as you can see the Hispanic features are a mix and not noticeably distinct. Carribeans - Noses similar to Africans. Central American - Noses similar to Caucasians. South American - Noses similar to Caucasians. For a lot of anthropological studies, researchers often use African, East Asian, and Caucasian features because the rest of the world falls into a mix of these 3 diverse morphologies. As the major concern for Hispanic noses is regarding the dorsal hump, a good surgeon should be able to identify whether there really is a hump to flatten or if it is due to the nose lacking forward protrusion and instead plunging downwards.
East Asian Noses East Asian noses are unique and have been broadly classified as mesorrhine, being a mix of flat and sharp features very similarly to Hispanic faces. East Asian noses on average have a wider nasal base than Caucasians with greater nose flaring, but as Rhee 2017 found, the standards are different for attractive Asian faces where the intercanthal distance for attractive Caucasian faces is similar to the interalar distance for attractive East Asian faces. Meaning that your nasal width should sit comfortably in between the inner corner of your eyes, otherwise it throws off harmony and becomes overly salient. One notable differentiator of East Asian noses is that they have a remarkably flat nasal bridge, making the face seem juvenile as children share the same trait. Rhinoplastic surgery for these noses is often about increasing bridge prominence to make the face seem more adult. Aung and Colleagues put these noses into 3 groups: Bulbous Tip, Better Defined Tip, and Defined Tip, with over 80% of Asian noses being in the first 2 categories. East Asian noses also have a gentle contour throughout unlike Caucasian faces which have a defined ridge at the supratip break, and so corrective surgery can either keep this contour or remove it as some may feel that it makes their nose more snout-like than graceful. As we covered in our East Asian beauty standards (yes, I know Lisa is Thai, I’ve explained why she’s there many times), many women especially opt for a narrower nasal base while increasing nasal tip prominence and maintaining the gentle curve that is ethnically seen on attractive Asian faces. This isn’t a mimicry of westernizing their noses but rather a beauty standard that developed independently from the west since the late 1800s.
Middle Eastern Noses From Rohrich et al, Middle Eastern noses have thicker skin than usual, and the healing process can be more unpredictable. The nasal dorsum is characteristically wider, often with a dorsal hump, which is what most opt to get removed in their rhinoplasty. The nasal tip is generally more bulbous, resulting in an underprojected and under-rotated tip with an acute nasolabial angle, i.e., downward-facing nose, and often a plunging nasal tip. This also gives the impression of increased nasal length which is masculinizing, especially on women. The nasal base width is often greater than that seen on Caucasians with greater alar flaring present. Middle Eastern noses also exhibit unusually higher rates of asymmetry with Rohrich and Mohan finding it in 82% of patients. This unusually high rate of asymmetry makes asymmetry correction and dorsal hump reduction the primary goals of Middle Eastern patients. Niechajev’s study characterized the Egyptian nose with wide nostrils, a sharp nasolabial angle, a broad and rounded nasal tip, and wide dorsum. On the other hand, Levantine noses were narrower but more arched with a notable dorsal hump and fine nasal tip. The Turkish nose also had a plunging tip with inadequate projection but with a wider nasal profile and prominent dorsal hump. Assyrian noses were on average larger than the other groups with broad nasal tips but more upturned nasolabial angles. Kurds and Iraqis had similar features but with thicker skin, and the Iranians had more crooked noses but with thinner skin. For many female Middle Eastern patients, the goal is to improve femininity by reducing masculine nasal characteristics such as a large nose or plunging nasal tip, and for men, reducing asymmetries or deviating septums.
South Asian Noses Lastly, South Asian noses. This video is very long, but we have covered South Asian noses multiple times in much more detail here. South Asian noses were similar to Caucasian noses for one half of the population and closer to Middle Eastern noses for the other half. Characteristically, many had a plunging tip and prominent dorsum, but this is very similar to the Middle Eastern features. This rhinoplasty patient has a notable supratip break, like you expect to see on a Caucasian nose with quite a minimal dorsal hump, so in many ways South Asian features are a mix of Caucasian and Middle Eastern. Unlike most Caucasians, however, the nose tip is often more blunt than sharp and pointy, which some opt to get changed like here. I recommend you watch South Asian beauty standards where this has already been covered, and if you’re Caucasian, then watch this video where Caucasian noses were covered in great depth going over all of the nasal angles too.
There you have it. If you want to learn more about your nose, or get an in-depth consultation from our medical team or in-house plastic surgeon on what type of nose you have, your options, Photoshop morphs, and what to look for, then order a QOVES Aesthetics report with 24 pages of anthropometric assessment of your facial features or request an online consultation with one of our Doctors about a specific area of concern.