Indo-Aryan Nose

The Problem

The elements of beauty are universal and generally involve harmony, balance, regularity, and poise. The tenets of rhinoplasty that provide a basis for any surgical plan remain the same, regardless of the ethnic origin of the patient. The nose is the center stage of the face, that can appear larger, wider, thicker, longer, or higher than what is considered an accepted norm, and it must be in harmony with the face, or type of face, so that it is considered attractive in a theoretical sense. The so-called standards of beauty, which have been imprinted into our society by the mass media and film personalities, are generally of the “Northern European” type. These noses have been portrayed as being straight with a narrow nasal bridge; a well-defined and projecting nasal tip; alar refinement; and a nasolabial angle of about 90 degrees. Those that belong to ethnic minorities may feel set apart under the pressure of these standards and some of them may even feel at a disadvantage because of their “nonstandard appearance.” The cosmetic objective of the person who desires to blend in, and look like the majority, is radically different from the objectives of persons who wish to have a more attractive nose without losing its ethnic character.

The “Indo-Aryan nose” is a type of nose found in people living in Northern India, characterized by a blend of features that genetically originate from the Aryan race. This is not a typical White nose, but has many features such as greater height and a prominent dome of the nose, which have been passed down from European races.

The two most common issues that one must deal with is in the first scenario when a patient’s rhinoplastic change may make them lose their ethnicity, resulting in loss of identity. In the second scenario, the patient wants to change or eliminate ethnic features, which may be impossible due to anatomical and tissue limitations. These cases need to be well recognized and carefully managed to avoid serious patient disappointment and dissatisfaction. One of the major problems caused by skin thickness and darker skin is the increased visibility of external rhinoplasty incisions.

The Background

In the mid-19th century the theory of “Aryanism” was developed, which held that Europeans (Aryans) were an innately superior branch of humanity, responsible for most of its greatest achievements. Aryanism was derived from the idea that the original speakers of the Indo-European languages constituted a distinctive race or subrace of the larger White race. These original Aryans could be identified by their blond hair and other Nordic features, such as dolichocephaly (long skull). The argument was given extra impetus by the French anthropologist de Lapouge in his book, L’Aryen , in which he argued that the “dolichocephalic-blond” peoples were natural leaders, destined to rule over more brachycephalic (short-skulled) peoples. In the 1850s, Max Müller introduced the notion of two Aryan races, a western and an eastern one, who migrated from the Caucasus into Europe and India respectively. By the 1880s, his ideas had been “hijacked” by racist ethnologists. For example, as an exponent of race science, colonial administrator Herbert Hope Risley (1851–1911) used the ratio of the width of a nose to its height to divide Indian people into Aryan and Dravidian races, as well as seven castes.

The classification of noses into leptorrhines (narrow), platyrrhines (broad), and mesorrhines (somewhere in between), along with calculating the nasal index or comparison of cephalometric findings may be interesting if one is engaged in anthropometric studies.

The Indications

The following factors have to be taken into consideration when assessing the nose:

• 1.

  Thick skin envelope: prevents achieving the refinement and definition as compared to a White nose. A pad of subcutaneous tissue is usually present, which, when removed, may cause excessive subcutaneous scarring.

• 2.

  Significant dorsal hump, which may be bony and cartilaginous.

• 3.

  Long nasal bones that are also very thick and cause a disproportionately long nose as compared to the tip projection.

• 4.

  Visible deviated septum.

• 5.

  Droopy nasal tip with possible alar flaring.

• 6.

  Wound healing: Since the skin type usually is Type III, IV, or V, more scarring and fibrosis is associated, which may cause notching, pinching, retractions, and even deviation.

The Patient

A thorough preoperative analysis including careful history taking, understanding the goals of the patient, and diagnosis of the nasal deformity are essential to create the nose of one’s choice. It is important to understand the patient’s desires before surgery and inappropriate to assume that all ethnic and racial groups would want a “standard” nose. It is also important not to impose any aesthetic ideals, perceptions, or expectations on the patient, as there might be conflicts with patient desires that will only become apparent after surgery.