Recognizing racial heterogeneity in the Latino nose

Oct 09, 2019, 9:42am

Study examines racial heterogeneity of the Latino nose and the nuances of preserving ethnic characteristics in rhinoplasty procedures.

As demand for rhinoplasty in the Latino community grows, so too does demand for avoiding the imitation of neoclassical ideals and instead preserving desired ethnic characteristics. That’s according to authors of a recent study in the Journal of American Society of Plastic Surgeons.

Study authors Justin L. Perez M.D., Raja Mohan M.D., and Rod J. Rohrich M.D., believe the generalization of an archetypical Latino nose based on geographic location is fundamentally flawed. 

In this study, authors examined and compared nasal consultations of 60 Latino patients in a five-year retrospective review. Patients were identified based on surname and documented clinical history.

Investigators reviewed photographs and operative records of patients who underwent primary rhinoplasty and those who did not but had documented nasal photographs. Also documented were specific aesthetic nasal characteristics, individualized surgical techniques and aesthetic results.

Tip projection was assessed by measuring a line from the alar-cheek junction to the nasal tip, and Fitzpatrick skin type, skin thickness, fatty quality of soft-tissue envelope, dorsum/radix position and contour were evaluated. 

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Investigators documented patients’ nasal characteristics as either frequent (> 50%) or infrequent (< 20%) and found the Latino nose can be characterized by some traits but with notable variability. 

“The Latino nose has some characteristic nasal traits, including thick soft-tissue envelope, bulbous and underrotated tips, fatty hanging alae with propensity for anterior notching, weak underlying cartilaginous structures, and a propensity for alar flare worsened by depressor septi hyperatcitivity,” write the authors. 


However, authors also point out the broad spectrum of heritage that makes up this population - from Native American, Spanish and Portuguese to African and Arabic - creates anatomical variability that makes it critical for the surgeon to clarify aesthetic goals with Latino patients. 

The study also identifies gender preferences and differences, and specific anatomical considerations. Authors offer this word of caution:

“Surgeons should be careful about assuming a patient’s race by means of skin color or surname; it is not uncommon for Latino patients to possess blond or red hair or light eyes,” they write. “It is important to ask a patient’s ethnicity and document it in the medical record as a part of one’s nasofacial workup to understand their expectations and aesthetic goals.”

Considering the interweaving and far-reaching heritage of Latino people, this heterogeneity creates nasal features that range from those consistent with European, Caucasian features to others more closely represented in African or Arabic communities, and authors suggest the recognition and respect of diverse features in the Latino community is the key to executing aesthetic goals and avoiding racial divergence. 


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References:

Perez JL, Mohan R, Rohrich RJ. Recognizing Racial Heterogeneity in the Latino Nose: Aesthetic Concepts for an Individualized Approach. Plast Reconstr Surg. 2019;144(4):857-867.