SECOND QUARTER 2000, VOLUME 14, NO 2

Ethnic differences and facial plastic surgery

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Trust your face to a specialist

Ethnic differences and facial plastic surgery

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Surgical scar revision can help minimize scars

Skin characteristics and facial structure differ depending on your ethnic background. These differences influence the aging process and the types of facial plastic surgery procedures that will be most effective for you. Your facial plastic surgeon will evaluate these factors, as well as the overall dimensions of your face, when developing a treatment plan for you.

Regardless of your ethnicity, the goal of any facial plastic procedure is to achieve a natural look that brings individual facial features into balance with the whole.

African-Americans
The signs of aging in dark skin typically appear very late, and fine wrinkling may not occur at all. Both the skin and cartilage may be thick and less easily adjusted.

African-Americans may experience either dark or light pigment changes, especially following surface procedures that penetrate deep into the skin, such as skin resurfacing. Lighter-complected skin is more likely to experience pigment changes, and lightening color changes are more common than darkening ones. The pigment changes are generally permanent, so skin resurfacing may not be advisable.

African-Americans are also prone to keloids; enlarged scars that grow beyond the margin of the original wound. These may form after facial plastic surgery procedures. Keloids are usually treated very successfully with steroid medications, either injected into the area or applied on the skin.

Flesh moles, brown or black raised dark spots that usually appear on the cheeks, occur mostly in African-Americans. They are not cancerous, but some patients have them removed for cosmetic reasons.

With fewer signs of aging, facial plastic surgery procedures for those of African heritage are more likely to focus on correcting facial disharmonies and refining features that are out of balance with the rest of the face.

Asian Americans
Signs of aging among those of Asian ancestry usually don’t appear until very late, and fine wrinkling typically does not occur.

Asians are also susceptible to dark or light pigment changes, especially following surface procedures that penetrate deep into the skin, such as skin resurfacing. Lightening color changes are more common than darkening ones, and the pigment changes are usually permanent. More rarely, skin resurfacing can lead to darkened skin tone or uneven skin patches, which may be treated with a bleaching agent.

People of Asian descent sometimes request eye surgery to create a double eyelid. In many instances, the Asian eyelid hangs like a smooth curtain from the brow to the lashes. The double eyelid procedure creates a fold that separates the eyelid into two portions. It gives patients a more energetic and natural look without changing their ethnicity.

Caucasians with dark complexions
The skin of those with Hispanic, Southern Mediterranean and Southern European heritage usually shows signs of aging later, and fine wrinkling over the entire face is less common. Heavier skin tends to resist lifting, and postoperative swelling and bruising tend to last considerable longer. Cartilage tends to droop and is somewhat resistant to change.

With fewer signs of aging, facial plastic surgery procedures for Caucasians with dark complexions are more likely to focus on correcting facial disharmonies and refining features that are out of balance with the rest of the face.

Caucasians with fair skin
Light skin shows signs of aging relatively early, and may develop fine, deep wrinkles that can be difficult to remove entirely. Initial bruising after surgery may be more obvious, but overtime those with light skin may have fewer complications from scarring.

Caucasian skin is thinner, and more easily moved, but it can also make bone and cartilage irregularities more obvious.

Procedures that minimize the signs of aging are the most common among Caucasians with fair skin. Facelifts, upper and lower eyelid surgery, and skin resurfacing procedures such as chemical peels are frequently performed.

Preserving ethnicity in facial plastic surgery
Your ethnicity influences the type of facial plastic surgery procedures that will be most effective for you, but it is not somethin