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Rhinoplasty - Thick Skin

Dr. Harris will answer all your questions about facial plastic surgery for African-Americans and people with skin of color, including rhinoplasty (nose job), facelift, eyelid surgery (blepharoplasty), lasers, dermal fillers and all other types of facial plastic surgery.

Rhinoplasty - Thick Skin

Postby covgirl33 » Sun Sep 21, 2008 3:32 pm

Hi Dr Harris

Im a black woman whose been thinking about a nose job for years now. Ive always been worried to actually take it to that next step. Im always seeing on forums that black people have thick skin. Im quite a dark skinned woman and apparently the darkness of your skin relates to the thickness of your skin? From what ive read online thick skin is harder to operate on because it doesnt shrink aswell to the structure of the new nose and this can also lead to deformities such as pollybeak. Are these all myths? If not, are there precautions that can prevent these dangers? I want this op but some of the dangers just scare the s*** out of me! lol. Have you experienced anything like this? If Im honest this is what scares me the most about rhinoplasty as it would be my worst nightmare for something to go wrong that extreme. Thanks
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Postby covgirl33 » Mon Sep 22, 2008 11:57 am

Ive also heard about the inverted V, retracted or hanging columella deformities. Are these issues more common in people with thick skin?
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Postby drharris » Thu Sep 25, 2008 5:51 am

Dear covgirl33

I commend you on the accuracy of your research. Patients with skin of color do tend to have thicker skin when compared to their lighter complexioned counterparts. In nasal surgery, the thickness of the skin poses unique challenges with regards to increased risks of scarring and limitations with achieving improved definition. On the flip side, thick skin can also prove to be a huge advantage in situations where one is trying to enhance the shape of the nose with underyling grafts and implants. In African American rhinoplasty, i use cartilage grafts in almost 100% of cases . . .and at times use synthetic implants such as Gortex to help achieve excellent aesthetic results. So, in most cases I'm happy to have a bit of a thicker "skin" blanket to help achieve a natural looking outcome. Experience comes when surgeons understand the limitations of thick skin and are able to use it to their advantage. Patients also have to appreciate the surgical limitations that thick skin presents . . and have realistic expectations of how much "change" is possible.

Rhinoplasty is a wonderful, yet challenging operation with the potential of extremely rewarding results for my patients. Experience does count, particularly with African American rhinoplasty. I'd be happy to review photos with you and see if we can alleviate some of your fears.

Take Care,

Dr Harris
Monte O. Harris, MD
5530 Wisconsin Avenue, Suite 612
Chevy Chase, MD 20815
301.951.9292
http://www.aestheticmodernism.com
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Thankyou!

Postby covgirl33 » Thu Sep 25, 2008 12:41 pm

Thank you Dr Harris - what a wonderful reply. Youve already alleviated some of my worries with that response!!!!!!!

I would like to send you my photos as Im based in Kentucky. Do you have an email address or can i upload them on here for yor viewing? Do you only perform surgery in d.c?

I just had one more question that I seem to have read a lot of debate on. Open v closed technique. Do you favour one? Ive read some surgeons can also perform open surgeries and vice versa. Can you perform both? How many rhinoplastys have you performed on black women or on anyone in your career? LAST question (so sorry!) are grafts and stuff safe long term as once again ive read conflicting information online. Some surgeons seem to always use grafts and some hardly ever use grafts. It seems strange that theres a 50-50% split of surgeons who always use them and surgeons who dont! Im confused!!! I apologise for all the questions but ive researched this op for years and ive read so much stuff online and as im sure other posters will agree its hard to know the valid stuff from the b.s. Thanks
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Postby drharris » Mon Sep 29, 2008 7:16 am

You can send the photos to my practice manager, Monica Gomez (monicagomez@culturaface.com). My practice is based here in DC/Maryland. I have a large number of patients who travel from abroad (primarily Europe/Africa) and throughout the continental United States for my culturally sensitive approach to rhinoplasty. DC is a wonderful place to visit and we can facilitate travel arrangements/accomodations.

Although I perform both (open/closed), I much favor the open rhinoplasty in patients with thick skin. In my hands, it allows for optimal visualization of the underlying anatomy and the ability to precisely place/secure structural graft material when necessary. The incision heals well with meticulous surgical technique. I have not had any issues with scarring.

Rhinoplasty, particularly on women of color, is the most frequent operation I perform. Rhinoplasty should be very individualized . . .i use graft material when it is most appropriate to acheive the ideal aesthetic outcome for that particular patient. I would shun any "cookie cutter" approach where a surgeon always uses or doesn't use graft material. I hope this helps.

Dr Harris
Monte O. Harris, MD
5530 Wisconsin Avenue, Suite 612
Chevy Chase, MD 20815
301.951.9292
http://www.aestheticmodernism.com
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