Last February, The New York Times released an article about ethnic diversity in plastic surgery in New York City. The article described the plastic surgery procedures that different ethnic groups, such as Hispanics, African Americans, and Asians, were more likely to undergo to help preserve their cultural identities. With that article in mind, I’d like to offer my perspective as a plastic surgeon about the role of cultural differences in plastic surgery. In Atlanta, I see a variety of ethnicities seeking plastic surgery, and while preserving cultural identity is important, it’s also important for a plastic surgeon to understand the complications that can arise with different skin types.
Going beyond color, skin type differs from ethnicity to ethnicity. According to the Cosmetic Dermatology for Skin of Color, the stratum corneum of black skin has more cell layers and elevated lipid content compared to white skin even though the overall thickness is similar, meaning darker skin is more compact. Patients with darker complexions, especially African American patients, have more melanin in their skin than patients with lighter complexions. Because there is more melanin present with darker skin tones, there is an increased risk of pigmentation changes with any incisions or trauma to the skin, including surgery.
Rhinoplasty (nose surgery) is more complex among diverse ethnicities due to differences in cartilage texture and should be performed by plastic surgeons with ethnic plastic surgery experience. Cartilage is flexible, connective tissue found in many parts of the body such as the nose, ears, rib cage, in many joints and between bones. A black patient’s cartilage is typically softer and less prominent than that of a white patient. Continue reading