Dott. Armando Boccieri
ANALYSIS OF THE PATIENT: EVERY CASES IS UNIQUE

The purpose of the initial analysis is to identify the ethnic group to which the patient belongs or is most closely related.

The Mediterranean nose
The Mediterranean nose, and its Italian version in particular, possesses specific characteristics that can be exaggerated in some cases and to lead to a situation of authentic nasal deformity. The most frequent of these are a protruding, dorsal hump, drooping tip, acute nasolabial angle, and thick, oily skin. The surgical approach must not only identify all the defects of the nose but also be capable of modification in harmony with the aesthetic canons of the ethnic group in question. To this end, it is advisable to adopt prudent, gradual criteria in selecting the most appropriate techniques to correct the various flaws while seeking to preserve the structures involved as much as possible.

Naso mediterraneo Marcello Mastroianni and Sofia Loren, legends of cinema exemplifying the Italian canons of beauty, both display an absolutely straight nasal profile in this photo.


The Anglo-Saxon nose
The Anglo-Saxon nose is often slightly convex with a markedly projected and rotated tip and very thin skin. The aesthetic canon of reference in this case comprises delicate features, and a slightly upturned nose with a slender tip can also blend in well with the face.

Naso anglosassone The beautiful face of Grace Kelly epitomizes the canons of Anglo-Saxon beauty with a narrow nose, slightly concave dorsum and upturned nose.


The Middle-Eastern nose.

The defects often present in the Mediterranean nose are still more are accentuated in the Middle Eastern. In particular, the nostrils are somewhat large and the tip has a marked tendency to droop. Surgical techniques devised in order to obtain both considerable rotation of the tip and narrowing frequently prove appropriate for such patients.

Naso medio-orientale The Middle Eastern nose of Omar Sharif juxtaposed with the Anglo-Saxon nose of Peter O’Toole in the film Lawrence of Arabia. The nose of one could never go with the face of the other.


The Greek nose
The Greek nose presents a straight profile at only a slight angle to the forehead. When the angle is particularly small, it is possible to execute an osseous reshaping of the nasal root so as create divergence from the line of the forehead in profile.

Naso greco

The splendid Greek actress Irene Papas displays the typical Greek profile with a perfectly straight nasal dorsum and a nasofrontal angle that is open but in any case appreciable in profile.

Naso africano

Nelson Mandela presents the typical characteristics of the African nose: wide nostrils, bulbous tip and thick skin.


The African nose
The nasal pyramid of this ethnic group tends to be large with a bulbous tip, wide base and thick skin. The surgical techniques applied in such cases are basically designed to reduce the thickness of the tip and reshape the base of the nasal wings so as to obtain projection of the tip and reduce the width of the nostrils.


The Oriental nose
Patients from the Far East often present the defect of excessive concavity of the nasal dorsum with an excessively open nasofrontal angle. While correction of this situation entails the use of grafts on the dorsum, it is advisable not to exaggerate, as excessive “westernization” may create an unnatural nasal profile that clashes with the rest of the face.

In conclusion, identification of the ethnic group to which the patient belongs or is closest is essential in order to carry out a correction of nasal flaws in harmony with the rest of the face. These general considerations also make it clear that a concave nasal dorsum is less acceptable in the Mediterranean group than the Anglo-Saxon and that the application of some surgical techniques devised by Anglo-Saxon schools to Mediterranean patients can produce a completely unnatural result.