Latino Nose

The Problem

The term “mestizo” means mixed. In Colombia, although the term initially meant the mixture of European and Native Indian blood, today, mestizos are considered a mixture of European (White), native Indian, and Black African descent people. In the medical literature, the term “mestizo” is used interchangeably with Latino or Hispanic and generally refers to patients coming from any of the countries of Latin America.

Classification of “mixed race” patients becomes very difficult because there are no clear racial features and today it is easier to try and group them according to their anatomical characteristics. With this in mind, most Colombian mestizo patients are individuals with “mesorrhine” nasal characteristics. These are noses with relatively weak underlying bony and cartilaginous framework. Dorsum can be wide with small humps or pseudohumps. Tips tend to have poor projection and rotation, ala that have a tendency to flare, and the overlying skin–soft-tissue envelope tends to be thick.

The Background

A structural approach is used by the author in mestizo patients. The philosophy of this approach is: limited or no tissue excision, preservation and reinforcement of support structures of the nose, use of structural grafts to reinforce and/or increase strength of the existing structures, nasal tip remodeling techniques using sutures and grafts.

To help plan surgery in a proper and efficient manner, the nose is divided into anatomic thirds:

• Upper third: the bony nasal dorsum

• Middle third: the cartilaginous dorsum (upper lateral cartilages)

• Lower third: the nasal tip (pedestal/alar cartilages/nasal base)

The upper and middle third of the nose are usually dealt with (including osteotomies) before final tip procedures are done. Surgical solutions can be multiple and are usually defined depending on the problem that needs solving.