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Ethnic Considerations in Plastic Surgery

Natural Faces of Beauty Staff Report

Ethnic Considerations in Plastic Surgery Plastic and cosmetic surgeons everywhere have noticed that visits from ethnic and racial minorities have increased exponentially in the last several years. For instance, the number of Asian-Americans receiving an aesthetic overhaul has increased fourfold in just the last two years. Since 2000, U.S. Hispanics have increased their trips to plastic surgeons by 49 percent.

In 2004, ethnic and racial minorities accounted for about 20 percent of the estimated 11.9 million cosmetic surgeries in America. In fact, one of the top continuing ten trends in plastic surgery, according to the American Society for Aesthetic Plastic Surgery, is ever more procedures for minorities. Experts say it's because medicine has become more sensitive to ethnic backgrounds so most surgeons realize there is not a single standard of beauty. Instead, the objective of plastic or cosmetic rejuvenations is to look one's best - while retaining unique ethnic features.

And while all patients are basically the same inside, the actual skin that covers us bears some medical and anatomical differences to which plastic and cosmetic surgeons must pay heed.

Moreover, because the strong summer sun is now upon us - and will do damage to skin that plastic surgeons must later treat - the American Academy of Dermatology has divided the hues and colors of skin, from bone white to darkest ebony, into six types. Skin types also affect the way a person ages - which is one of the primary reasons we visit plastic and cosmetic surgeons in the first place.

But, cautions, Min-Wei Christine Lee, M.D., a dermatologic surgeon and director of the East Bay Laser and Skin Care Center in Walnut Creek, California, any one racial group can have people who range from type I to VI skin.

"That means that treatments within any ethnic group can run the gauntlet of all six skin types," Dr. Lee says. "An Asian person may have a skin type that must be treated like Black skin. Or, perhaps a patient with an Anglo background must be treated like a person from a Mediterranean area because he is one-quarter Native American."

Thus, the chart below is a very broad generalization of skin types. Any dermatologic, cosmetic or plastic surgeon has more refined tests to precisely nail down actual proper skin type and the most appropriate treatment.

I. Redhead, blonde Irish, Scots, Welsh Always burns easily. Very sun sensitive. Early aging. Thin skin crinkles earlier in life. Deep wrinkles often difficult to remove; bruising is more obvious than in more deeply pigmented skin types. Facelifts, rhinoplasties, blepharoplasty (eyelid surgery,) liposuction and breast augmentation
II. Blonde Northern Europe Burns easily. Also early. But scars are narrow and nearly invisible. Same as above. Same as above.
III. Fair Mid to Northern Europe; some Mediterranean lands. Sometimes burns. Tans to light brown. Average skin. Sooner. Same as above. Same as above.
IV. Olive skin Mediterranean lands, Asia, India. Minimally. Always tans to moderate brown Later. Asians have thicker skin and fine wrinkling typically does not occur. Asians tend to have more fat in the upper eyelids. Many Asians get blepharoplasty to create an eyelid crease. Low nasal bridge often corrected; breast augmentations are common.
V. Dark Middle East, some Hispanics, some African-Americans and Asians; Native Americans. Rarely burns. Skin cancers are rare. Later still, due to somewhat thicker skin. Hispanic skin tends to sag as it ages. Prone to scarring and uneven skin tones. Oily skin and hyperpigmentation can be a problem for type V skin. Some razor bumps. Liposuction; breast augmentations for Hispanics; Middle Eastern patients often opt for rhinoplasty.
VI. Darkest Africa Seldom burns. Sun-insensitive skin. Post-opt swelling is minimal. Latest aging of all skin types. Skin cancers rare Easy formation of keloids, a hard, wide type of scar that is often treated for life. Many razor bumps. Many African-Americans opt for nose reshaping, breast reduction and liposuction.

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