In 2020, more than 1.7 million African-Americans reportedly received cosmetic surgery procedures. That’s also the year that nose reshaping reigned supreme as the top cosmetic surgical procedure across all race groups, ahead of facelifts, liposuction, and breast augmentation.
For decades, rhinoplasty (popularly known as a nose job) remained a taboo topic in the Black American community, an anathema used to ridicule and shame celebrities whose new noses seemed glaringly unnatural or “chopped,” a scarlet offense against Black pride and power. Yet, advancements both in cosmetic surgery and popular culture have gradually transformed this norm.
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The rise in social video platforms like YouTube and TikTok fostered a space for users to vlog every, single moment of their rhinoplasty journeys, from the initial doctor consultation to the cast removal and healing process. Many medical schools, residency programs, and other professional educational outlets have also since incorporated ethnic rhinoplasty—nose jobs for people of color that preserve their heritage—into their teachings. More and more doctors of all racial backgrounds offer this option to achieve the best outcome for Black patients’ while maintaining the unique characteristics of their race.
“Historically in my field, ethnic rhinoplasty procedures were conceptually thought of as how to make a Black nose more Caucasian,” said Dr. Deepak Dugar, founder of Beverly Hills Rhinoplasty Center in California and author of “Be-YOU-tiful: Flip the Script and Celebrate Your True Beauty.”
Though he’s been performing plastic surgeries for over a decade, Dr. Dugar made the uncommon decision seven years ago to dedicate his entire surgical practice exclusively to “closed” scarless rhinoplasty procedures. (A “closed” procedure involves incisions inside the nostril, as opposed to “open” rhinoplasty, which requires an incision at the base of the nose and can sometimes create scarring.) “The new concept of ethnic rhinoplasty doesn’t cater to the ideals of westernized Caucasian beauty, but instead celebrates the natural heritage of a beautiful Black female, male, or person,” said Dr. Dugar.
While nose jobs have become noticeably less taboo in the Black community, what hasn’t seen much progress is the wealth of rhinoplasty information as the procedure uniquely and specifically relates Black patients. A quick Google search of “rhinoplasty for Black people” will bring up a host of surgeon websites and before and after photos, but less than a handful of articles. So we spoke with Dr. Dugar to learn more about this nuanced procedure and provide a non-judgmental, informed starting place.
ESSENCE: When it comes to rhinoplasty procedures, how are Black noses* unique?
(Note: By “Black nose,” we’re referring to the nose of a person of African descent.)
Dr. Dugar: Throughout our education as surgeons, the only differences that were talked about with Black noses were that they typically have thicker skin and sometimes have weaker cartilage. So surgeons were taught techniques to debulk and de-thicken the skin and strengthen the cartilage to create a more Caucasian appearance, because, historically, most surgeons designed the ideal anatomical concept of a nose based on a Caucasian nose, in terms of the frontal angle and the tip.
Those are things you do have to consider during surgery, but I don’t think it necessarily constitutes recreating every nose into a standardized paradigm created by Western Caucasian culture. There was never a discussion of how do we celebrate and just enhance the beauty of a Black nose instead of trying to make it into a white nose. Recently, there’s been a much larger push in the Black community to have a more natural result that looks and feels even postoperatively like an African American or a Black nose, especially given the history of bad nose jobs among many Black celebrities over the past 30 years.
“Of the hundreds of Black clients I’ve worked with, their biggest concern was not wanting to look [overdone].”
Is there a common concern or question that your Black patients have ahead of the surgery?
Of the hundreds of Black clients I’ve worked with, their biggest concern was not wanting to look [overdone]. They just want a very natural look. I’ve found that in Black and Indian communities, plastic surgery is very stigmatized. So the thought process might be that if anyone finds out you’ve gotten your nose done, then they might automatically assume everything about you is fake. You must have gotten your breast done, your butt, everything.
So in those communities, there’s this sense of shame and secrecy in getting a nose job, and that trickles into what they want and don’t want done to their nose. They don’t want an overly done nose job because then that will obviously “out” them. Whereas in the Caucasian community, it’s historically been one of those things that’s just accepted, that you get a nose job in high school or in college, like a rite of passage.
There’s a chapter in your book about social media, which makes sense. Year after year, we learn more about the potential impact of these technologies and social media culture on one’s self-perception, and how that bleeds into the world of cosmetic procedures. So what are your thoughts on patients coming to you and saying, “I want my nose to look like this person’s”? Does that happen often and how do you typically respond?
It happens all the time. I like when patients show photos of their inspo and desires. But nowadays more and more people are coming in with photos of influencers instead of classical celebrities. I think we feel more similar to an influencer than we do a celebrity because of their relatability.
What I do with that information is based on their anatomy and realism. So if they’re showing me a ridiculously different looking person, then it also gives me insight that this is an unrealistic patient with unrealistic goals. So I like seeing photos and it gives me inspiration on whether they’re being realistic or not. But at the same time, I let every patient know, you can’t have XYZ nose or XYZ face. It’s not like Humpty Dumpty where you can just rebuild the face however you want. It’s about making your nose match your anatomy and your natural characteristics.
“Before you even have your initial consultation, do your research on the different types of rhinoplasty and there are different types of rhinoplasty surgeons.”
Can you breakdown how you conceptualize the best fit for a patient?
The face itself is a sum of its parts or its features, a whole. A lot of people, doctors included, are so hyper focused on making a perfect nose that doesn’t exist. You could have all the definitions of a “perfect” nose anatomically, meaning it has the exact angles, dimensions, smoothness, and tightness [as determined by conventional standards.] But if you zoom out, it might look fake.
No one looks at your individual features. They look at your face as a whole. You don’t look at a flower and only see one petal. We all behold the beauty of the flower in its entirety. It’s the same thing with faces. So hyper-focusing on making a “perfect” nose is a very dangerous pursuit with no real added benefit at the end of it.
What’s your top advice for Black people who are considering a cosmetic rhinoplasty procedure?
Before you even have your initial consultation, do your research on the different types of rhinoplasty and there are different types of rhinoplasty surgeons. A lot of people think a nose job is a nose job, as if there’s only one type and it’s a singular procedure, and that’s just not true. There are open and there are closed rhinoplasties. There are aggressive and there are conservative and all different combinations of those types as well.
A lot of people go to a local surgeon, get the surgeon’s opinion, and—because the surgeon has a medical degree—takes everything the surgeon is sayin at face value, without questioning whether the surgeon is the best fit for them. The problem is that the surgeon may not have a wide enough understanding of all the rhinoplasty options available. Let’s say if you’re in Louisville, Kentucky and you’re seeing a plastic surgeon who only does noses a certain way and there’s not a large rhinoplasty community around. You might be tricked into assuming that surgeon’s options are the only choice you have and that’s just not true.