For centuries, Black people have been conditioned to believe that our features are somehow less desirable. Whether it be our full lips or wider noses, influences of European standards have permeated through every ethnicity, skewing expectations of beauty. It's why often times, rhinoplasty for Black noses leaves patients nearly unrecognizable and appearing somewhat artificial. It serves as further proof of the need for knowledgable plastic surgeons, well-versed in the history of Black noses, who are not married to the idea of compromising the integrity of the face. Doctors like that exist, but they're not all-too common.
The history of Black people having more pronounced noses — nostrils in particular — is something that dates back hundreds of years. According to a 2013 study published in The Anatomical Record, the larger size of the nose was due to climate adaptation for breathing. In colder climates, it's beneficial to have a narrower nose, hence why those of European descent generally boast leaner bridges. For Black people, however, descending from the tropical climates of Africa, larger nostrils aided in adjusting to sinus volumes. That centuries-old impact stands true even today, and is why rhinoplasties for Black noses must be approached completely different than that of other ethnicities.
"With all of my patients I ask what their motivation for getting rhinoplasty is," Dr. Jennifer Parker Porter, MD, FACS, a Washington, DC plastic surgeon at Chevy Chase Face says. "The goal, especially for Black people, should not be to completely change the face. It's to accentuate the features that already exist."
It's after setting these expectations that Dr. Porter says she approaches the procedure with a heightened level of meticulousness. "In particular for Black people or people of color, I always observe the skin thickness," she says, explaining that, customarily, Black people have thicker skin in the nose area which can make achieving drastic definition more difficult. "While it's hard to generalize, rarely is Black skin thin," she says. "I would say we're anywhere from medium to thick, but like so many other things with Black people, there's such variety and nothing is exactly the same."
But it's not just the skin that sets Black noses apart. "You have to understand the difference in structure," she says. "There's a lot of differences also between Black and Caucasian noses when we think about what's under the skin." For context, when she speaks on structure she's referring to bone lengths, specifically. "Some people have very short bones," she says. "These can be difficult to maneuver in the operating room as they are harder to manipulate. Whereas long bones are great because you can break them and move them exactly where you want."
Dr. Porter insists that these differences however, are not properly taught in training which can ultimately result in a lack of education for surgeons. "When I first started this journey we learned how to operate on mainly Caucasian patients," she says. "So it's had to be in actual practice that I learned to develop different techniques to address whatever it is my Black patients are concerned with while maintaining the integrity of the face. I did some research a long time ago, just looking at the different types of [Black] noses, and came to realize that some people have very low bridges with no hump at all or some have a large hump. There's such variety in Black noses."
Through her research she also discovered more profound reasons for the unique bone structures of Black noses. "Some people have a hump with more Native American influence in their nose, which results in a droopier tip, while others may have a very large tip and wide nostril," she says. That variety is why Dr. Porter doesn't provide patients with a one-size-fits-all experience, and doesn't suggest that other Black people seeking rhinoplasties accept that either. "The goal is to get my clients to a good place where they can still recognize themselves," she says. "It's more about making nice changes that are going to make it better, but not make them look like a totally different person."
To do so, understanding proportions and the face of the patient is important. "People want a difference, but they also want to look natural," she says. "You don't simply want to go into your procedure with the mindset of 'I just want my nose pointy or pinched.' You want it to look like a nose you could have been born with. That said, the idea is to have a nose with soft curves without anything too angular." A common mistake made with many "botched" nose jobs on Black people comes from a focus solely based on the tip. "Often times doctors think the solution is to pinch it in order to get that defined tip appearance, but it ends up looking awkward, unnatural, and completely skews the face. There are other ways you can get the definition without having that disproportionate, artificial look."
So during consultation, Dr. Porter makes a treatment plan based on that particular client and that client alone. "I focus on making the tip a certain width compared to the nostrils and then compare it to the way the face looks overall," she says. "Secondly, I have to respect the skin. The goal isn't to thin out the skin. Instead, the goal is to make the structure that lies underneath the skin more visible. That's how one ends up with a natural-appearing nose. It's a common mistake made, but most people don't need a lot of definition, so that's not something I even talk much about with my clients. It's just kind of understanding what you have and what the patient wants and determining what's realistic."
Before deciding your plastic surgeon, Dr. Porter suggests doing extensive research on your doctor's history of rhinoplasty on Black noses through photos and patient reviews. "It's really hard for a doctor to talk through actual techniques, so the most-effective way of ensuring the best work is through witnessing first-hand accounts."
And while finding a well-trained, board-certified surgeon is an absolute must, so is continuing to embrace your features in all their glory in the process. Find someone who doesn't see the structure of your nose as a flaw, but instead sees windows of opportunity to further enhance your appearance.