For most of his life, 37-year-old Jabari McPherson was apprehensive about looking at himself in the mirror. He felt his nose was a bit misshapen, too wide for the size of his face. He desired a more proportioned look and started considering the possibility of a rhinoplasty (commonly referred to as a nose job), but he was concerned about how much his appearance would change. He wanted to make sure his African features would still closely resemble those of his children when he became a father.
When African American entrepreneur and social media influencer Jessica Cromartie opened up about her undergoing rhinoplasty to her 150,000 Instagram followers (she explained how she, too, felt the proportions of her nose didn’t complement the rest of her face), she was met with both praise and criticism from her social community. While some applauded her natural-looking nose (they had no idea it had even been altered), others accused her of trying to deny her Blackness. But the latter is exactly why she sought the assistance of a specific plastic surgeon (he was located outside of the country), one who was proficient in how to maintain the ethnic integrity of her nose.
McPherson and Cromartie’s stories are only two of many recent examples of how, for Black people, the approach to a nose job is no longer a one-size-fits-all process based on the aesthetic standards of Caucasians. They are among a growing number of patients of color who are pursuing what plastic surgeons refer to as an ethnic rhinoplasty.
Although nose jobs have been around for decades in the United States, obtaining a satisfying outcome was a typically challenging prospect for people of color. Historically, the best practices were designed around the general facial shapes and features of white people, who make up approximately 74% of patients who undergo the procedure. Plastic surgeons were mainly focused on the aesthetic known as the “American nose”, a cookie-cutter, overdone nose job with a pointed tip which failed to preserve and account for the diverse, varying physical traits of today’s society. However, as patients become more diverse, both they and their doctors have progressively pursued methods that maintain the cultural hallmarks that make each one of them unique.
Preserving a patient’s identity during a rhinoplasty procedure isn’t a novel practice. Dr. Anthony E. Brissett, a Black facial plastic surgeon at Houston Methodist Hospital in Houston, Texas (he is co-author of a 2009 article published in the journal Seminars in Plastic Surgery that digs into the topic), notes that ethnic rhinoplasties have become increasingly common over the past 10 to 15 years. Patients began expressing worry about losing their distinctive physical attributes, something Brisset calls “cultural destruction.”
“We would lose these racial features or unique features of one’s face or nose,” Brisset says in an interview with the Houston Chronicle. “I began about 15 years ago seeing patients coming to me upset – psychologically, physically, emotionally – because they had lost the uniqueness of their appearance.”
Researchers say the increase in ethnic rhinoplasty coincides with the overall rise in plastic surgery procedures in the United States. According to a recent report from the American Society for Plastic Surgeons (ASPS), it states that in 2020, there were 2.3 million plastic surgeries performed, 22% more than the 1.9 million performed in 2000. But while white people still underwent over 70% of the 352,000 rhinoplasties in 2020, their data shows that patients from other ethnic groups have moderately begun to assume a larger share, per ASPS data.
The ASPS also notes that, on average, rhinoplasty costs nearly $4,500 and is not generally covered by insurance.
Dr. Brissett credits the growing popularity to a greater emphasis on celebrating diversity in America as compared to just three or four decades ago. Traditionally, Western beauty standards have been rooted in whiteness, but he says, within the plastic surgery space, those ideals are shifting. Brissett also predicts this shift will continue forward as the American population becomes more racially and ethnically diverse.
“We’re seeing that people are becoming more aware of global influences. And as a result, they are celebrating that uniqueness,” he says.
As ethnic rhinoplasties continue to increase for patients of color specifically, Kofi Boahene, a Johns Hopkins University professor (he is an expert in the field), says it is critical for surgeons to understand how the appearance of someone’s nose will differ according to their ethnicity. Studies in the journal Annals of Plastic Surgery have identified vast differences in the look and shapes of African, Afro-Indian and Afro-Caucasian noses, and every group should serve as a guide for how a nose should look.
“You have to be invested to really understand that culture because you are not just taking care of noses in isolation,” Boahene tells the Chronicle. “You’re not sculpting noses. You’re sculpting lives. You’re sculpting personalities. You’re sculpting the features that people interact with.”
For plastic surgeons like Brisset, this means creating symmetry and harmony in how each part of a patient’s face can relate to one another. He says he does not only consider his patients’ noses during rhinoplasty; he is thinking about every aspect of their faces. If done correctly, an ethnic rhinoplasty should look natural and preserve the patient’s cultural distinctiveness.
“We’re looking more for balance. We’re not trying to be influenced by Western features,” he says. “Once you achieve that, it just creates a more unique aspect of beauty.”
