Three-Tiered Approach Optimizes Rhinoplasty Results Among African Americans

African American patients report a high degree of satisfaction with three-tiered open structure rhinoplasty, which includes dorsal augmentation, tip refinement, and alar base narrowing, while maintaining ethnic characteristics, according to an article in the July/August issue of the Archives of Facial and Plastic Surgery. Dr. Oleh Slupchynskyj and Marzena Gieniusz analyzed questionnaires completed by 65 African American patients who had undergone rhinoplasty at their private practice, the Aesthetic Facial Surgery Center of New York and New Jersey in New York City. Dorsal augmentation was achieved using the custom-carved Silastic SLUPImplant.

Twenty-one male and 54 female patients, 14 to 58 years old, completed questionnaires addressing self-esteem, preservation of ethnic characteristics, degree of facial harmony, and overall satisfaction. Responses were scored on a 5-point Likert scale where a score of 1 indicates not at all and 5 indicates very much/to the highest degree.

"Patients reported a significant degree of preservation of ethnic characteristics (mean, 2.3), high self-esteem (mean, 4.3), and very high satisfaction (mean, 4.6) and facial harmony (mean, 4.3) postoperatively (p < 0.001 for all)," Dr. Slupchynskyj and Gieniusz report.

There were two major complications: infection requiring implant removal in one case and hypertrophic scarring in the right alar horizontal incision, which was treated with triamcinolone and composite grafting. The overall complication rate was 2.7%.

The authors attribute the high satisfaction rate to the attainment of facial harmony and the preservation of ethnic characteristics, leading in turn to high self-esteem.

"In our opinion," they write, "computer imaging is an indispensable tool in assuring realistic expectations, and more important, providing a better understanding of possible results, which leads to high patient satisfaction postoperatively."

Arch Facial Plast Surg 2008;10:232-236.

Reviewed by Ramaz Mitaishvili, MD

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