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Indian/Pakistani Rhinoplasty Virginia

  1. The diagnosis and rhinoplasty techniques of Indian or Pakistani Rhinoplasty are very similar to Persian or Middle Eastern Rhinoplasty. There are great variations in skin thickness and cartilage strength so that broad generalizations should not be made. However, a very common scenario is an Indian or Pakistani patient with very thick skin and very weak cartilages. Occasionally acne scars overlying the nasal tip will make the skin even less pliable.

Very nice improvements and results can be achieved and with the aid of computer imaging the Rhinoplasty surgeon can demonstrate these aesthetic improvements to the Rhinoplasty patient.

The two most important issues to consider and discuss with the Indian or Pakistani patient are:

  1. Expectations
  2. Degree of Cosmetic Change

These two issues are the opposite ends of the same computer imaging spectrum.

Lets discuss “expectations” first. Often an Indian male patient, with very heavy and bulbous nasal tip, as a result of thick skin, and old acne scars on the nasal tip, in addition to very broad and weak nasal tip cartilages, will come in for Rhinoplasty consultation. Many of these Indian male patients have a tough time accepting the limitations of just how narrow the nose can be made and how much additional definition can be achieved safely. When realistic computer imaging is done showing the potential cosmetic improvements after a Rhinoplasty, the patient’s expectations must be revised or adjusted. Otherwise, the patient may be unhappy after the Rhinoplasty and it’s always best to avoid undergoing Rhinoplasty in these situations until the realities and limitations of Rhinoplasty have thoroughly been understood. If the patient likes the significant improvements shown on the computer screen then almost always, he or she will be a happy post Rhinoplasty patient. Adjustment of expectations usually refers to the realization that perhaps the individual’s nose cannot undergo the extreme change that he or she had envisioned in his/her own mind for many years.

The second issue with many Indian and Pakistani patients is “the degree of cosmetic change.” Indian or Pakistani patients struggling with how much cosmetic change they desire is usually the opposite problem of “adjustment of expectations.” Basically many, but not all, Indian or Pakistani female patients struggle with the degree of cosmetic change acceptable to them and their families. There is an internal fear that the nose will change too much, and while they may clearly see on the computer imaging screen that the changes result in a very natural and cosmetically appealing nose, the internal fear that the nose may get too small or too defined exists within them and must be thoroughly addressed before any surgery. I have seen female Indian patients with very large dorsal humps or very droopy tips or very bulbous tips who I end up seeing over a span of many months for multiple consultations until they are completely at ease with their Rhinoplasty goals and our collaborative surgical road map. Despite this, occasionally after the nose job they continue to struggle with their pre-op decision by wishing they had actually asked for a smaller and more defined nose. Initially though, many times, they ask for their hump not to be completely removed and to simply make a larger hump into a smaller hump. I have seen Indian female patients who did not want to correct their droopy nasal tip even though they were shown a very natural looking nose on the computer imaging – a nose that was by no means up turned nor over rotated but since for so many years they had been used to visualizing themselves with the longer, ptotic (droopy) tip, adjusting to a new look proved to take time and be complicated. Under no circumstance should a patient be offered or undergo a Rhinoplasty until they are completely satisfied with the computer imaging – as a depiction of the surgical goals and road map. Again, this does not apply to all female Indian or Pakistani patients but after many years and seeing hundreds of patients every year, certain conclusions and generalizations can be drawn and these are simply “pearls” to take note.

So in summary, the actual Rhinoplasty in an Indian or Pakistani patient is not that different from that of a Middle Eastern or Mediterranean patient, but the pre operative dialogue as far as expectations and degree of change is often unique and must be thoroughly addressed.