The anatomy of a black nose tends to have a flatter (lower) bridge, flaring wider nostrils, a soft flat tip with lack of definition, thick fatty skin and a deeper angle between nose and forehead. The nasal cartilages tend to be weak as compared to the stiffness of the nasal bones. That being said, Dr. Conrad wants to emphasize that there is significant variability.
The same technique of narrowing the nostril bas applies to all noses, regardless of the ethnic origin. The same limitations also apply. They depend on the thickness of the nostril wall, which in African American noses, is usually considerable. Special attention must always be given to the placement of the incisions in order to minimize scarring.
The extent and character of the surgical alteration is planned with the patient’s participation, and attention is paid to the patient’s aesthetic preferences.
Silicone rubber implants, still widely used in many countries, and also to some extent in North America, is not recommended by Dr. Conrad. They have a very high rate of extrusion – even many years after the insertion.
Dr. Conrad’s choice is microporous material, which has been successfully applied in vascular surgery over the last 30 years. Dr. Conrad has published widely on this technique in professional literature. Under certain circumstances, Dr. Conrad prefers to use the patient’s own rib or ear cartilage.
Surgical access, whether the open or closed rhinoplasty methods, is not dictated by ethnicity. It depends on the patients anatomy, the presence of scarring from previous surgery, and a surgeons experience. Every rhinoplasty surgeon must be skilled in both surgical approaches which should be used according to patient’s need and not according to the surgeon’s preference.Back