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, and its Italian version in particular, possesses specific characteristics that can be exaggerated in some cases and lead to a situation of authentic nasal deformity. The most frequent of these characteristics 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 alter it in harmony with the aesthetic canons of the ethnic group in question. To this end, it is advisable to adopt careful and gradual criteria in selecting the most appropriate techniques to correct the various flaws, while seeking to preserve the structures as much as possible.
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 harmoniously with the face.
The Middle-Eastern nose
The defects often present in the Mediterranean nose are still more accentuated in the Middle Eastern nose. In particular, the nostrils are somewhat large and the tip has a marked tendency to drop. Surgical techniques devised in order to obtain both considerable rotation of the tip and narrowing have been frequently proven appropriate for such patients.
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.
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 an excessive concavity of the nasal dorsum with an excessively open naso-frontal angle. While the 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 will clash with the rest of the face.
In conclusion:
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.
