Middle Eastern Rhinoplasty

The ethnic appearance of the Middle Eastern nose is defined by several unique visual features, particularly a high radix, wide overprojecting dorsum, and an amorphous hanging nasal tip. These external characteristics reflect distinct structural properties of the osseo-cartilaginous nasal framework and skin–soft tissue envelope in patients of Middle Eastern extraction. The goal, and the ultimate challenge, of rhinoplasty on Middle Eastern patients is to achieve balanced aesthetic refinement, while avoiding surgical westernization. Detailed understanding of the ethnic visual harmony in a Middle Eastern nose greatly assists in preserving native nasal-facial relationships during rhinoplasty on Middle Eastern patients. Esthetic alteration of a Middle Eastern nose follows a different set of goals and principles compared with rhinoplasties on white or other ethnic patients. This article highlights the inherent nasal features of the Middle Eastern nose and reviews pertinent concepts of rhinoplasty on Middle Eastern patients. Essential considerations in the process spanning the consultation and surgery are reviewed. Reliable operative techniques that achieve a successful aesthetic outcome are discussed in detail.

Demographics and scope

In the United States, the estimated size of the Middle Eastern diaspora ranges from 1.2 to 3.5 million people, depending on the census source. Most of this ethnic group (94%) reside in large metropolitan areas, particularly in the cities of Los Angeles, Detroit, and New York.

Patients of Middle Eastern extraction can trace their roots to 1 of the many countries in a vast geographic area of the Middle East. As ethnic and cultural borders of this part of the world have been blurred over the centuries by migration and intermixing of various populations, it is not surprising that people living in the Middle East and neighboring countries (Afghanistan, Pakistan, and India) have many of the nasal characteristics found in the Middle Eastern nose.

Because Middle Eastern extraction implies a wide range of ethnicities and religions, aesthetic needs and desires for rhinoplasty vary subtly between various geographic regions of the Middle East (and, by extension, within the diaspora presently living in the United States). For instance, people living outside the Arabian Peninsula and Gulf regions (Saudi Arabia, Kuwait, Qatar, UAE, Oman, and Iran) desire a greater change with rhinoplasty, in terms of dorsal reduction and tip projection.

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