THIRD QUARTER 2007, VOLUME 21, NUMBER 2

Nip and Tuck: Facial plastic surgery among ethnic groups is a growing trend

IN THIS ISSUE

We know you can raise a few eyebrows

Nip and Tuck: Facial plastic surgery among ethnic groups is a growing trend

Ask the Surgeon / Health Tip / What’s New

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Record numbers of African-Americans, Asian-Americans, and Hispanics are lining up for a nip here, a tuck there. Where patients 30 years ago had mixed feelings over changes that might reject their ethnic heritage, now, members of minority groups are realizing that facial plastic surgery can refine features, correct disharmonies, and reduce the signs of aging. There is not one standard of beauty to compare oneself with; instead, the goal is to look our best-transcending cultural and racial boundaries.

The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) surveyed 1,336 of its physician members in 2006 and found a substantial long-term and short-term difference in ethnic groups undergoing facial plastic surgery. Compared to 1999, African Americans who underwent cosmetic surgery has increased by 77 percent, Hispanics increased 56 percent, and Asian Americans increased by 60 percent. Asian Americans demonstrated the largest growth rate since 2005, expanding by 35 percent last year alone.

When compared to the other facial cosmetic procedures offered, the 2006 survey revealed that African Americans were most likely to undergo rhinoplasty, nose surgery, (62 percent) as were Hispanics (53 percent). Asian-Americans were most likely receiving blepharoplasty, eyelid surgery, (44 percent), while Caucasians opted almost equally between blepharoplasty and rhinoplasty (32 percent versus 29 percent).

Rhinoplasty
Rhinoplasty means to reshape the nose. The goal of this procedure is to bring your nose into balance with the rest of your facial features. Many people of Asian and African descent have noses with wider bases and less sharply defined tips. These people, as well as many Hispanics, also have thicker skin on the tip of the nose, giving it a rounded, bulbous appearance. If you are self-conscious or uncomfortable with your nose, talk to your facial plastic surgeon. Since the nose is a prominent feature, rhinoplasty can have a positive affect on the overall harmony of your face.

The procedure begins by either a closed rhinoplasty, where incisions are confined to inside the nose; or open rhinoplasty, where an incision is made across the columella–between the nostrils–in addition to inside the nose. Your physician will assess the bone and cartilage structure of the nose and then begin shaping it. Depending on your needs, this may mean adding to, taking away, or moving various structures to obtain optimal results. Once refinements are made, the tissues are redraped over the new frame and the incisions are closed. A splint is placed on the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose tomaintain stability along the septum (dividing wall of the air passages).

Blepharoplasty
Characteristic of approximately 90 percent of the Asian race, a single eyelid hangs from the brow to the lashes with no eyelid fold. Some Asian patients seek blepharoplasty, or eyelid surgery, to divide the eyelid into two portions, creating a permanent fold. This can provide a more awake look, may ease application of makeup, and can improve one’s upward gaze.

Regardless of race, you may be a candidate for blepharoplasty. Different techniques provide options for reshaping and adjusting the lids for both cosmetic and functional purposes. Cosmetically, you may want to reduce the excess skin in your upper eyelids to create a younger, more wide-eyed appearance. In upper eyelid surgery, your physician will follow the natural lines and creases of the eyelid in order to minimize the appearance of scars. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incision. A variation of this surgery is the double eyelid procedure for patients who seek to add a crease to their upper eyelid.

Blepharoplasty can also be used to correct ptosis, a drooping upper eyelid that is congenital or develops with age. Patients whose field of vision is limited due to ptosis may be able to seek insurance reimbursement since the procedure is medically necessary.

Most people seek lower blepharoplasty to reduce the bags under their eyes. There are two common approaches for lower eyelid surgery. In the first approach, the surgeon makes an incision inconspicuously under the lower lashes and removes skin and fatty tissue. Scarring is hidden in the inherent folds. The second approach, transconjunctival blepharoplasty, involves making incisions from the inside of the lower lid to remove excess fat. This method works best for the patient who has a pocket of fat beneath the lower eyelid with no sagging skin.