The Middle Eastern–Mediterranean Nose

The Clinical Problem ( Fig. 18.1 )

The term Middle Eastern commonly refers to people of Turkish, Persian, Arabic, and North African descent. Although a large variety of nasal features can be seen, the population in Turkey usually presents with a mixture of Middle Eastern and Mediterranean nasal morphology.

Synopsis

Middle Eastern–Mediterranean patients possess a varied combination of nasal characteristics :

1.
There is a significant dorsal hump.
2.
A poorly defined nasal tip is present.
3.
The nasal bones are usually thick and long.
4.
Septal deviation is common and is often visible externally.
5.
The nasal length is often disproportionately long relative to the tip projection.
6.
A droopy nasal tip with an acute columellar-labial angle is seen frequently.
7.
The lower lateral crura and medial crura may be long and strong. In these cases, the tip complex is usually displaced caudally, away from the anterior septal angle, which may need significant maneuvers to improve its projection and position. Alar flaring and increased interalar width are also common.
8.
Thick nasal skin, with a highly sebaceous texture, is frequently seen, particularly at the nasal tip, lobule, and alar rims.

Thorough preoperative analysis and diagnosis of the deformities are essential for a successful rhinoplasty. After the diagnosis is determined, the goals of surgery are established, and a treatment plan is formulated according to the deformities that are present.

Surgical Preparation and Technique

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