Ethnic Considerations in Rhinoplasty: A Meta-Analysis of Outcomes and Complications in Caucasian Versus Non-Caucasian Patients.

INTRODUCTION

This meta-analysis evaluates the impact of ethnicity-conscious rhinoplasty on patient satisfaction and complication rates. Traditional rhinoplasty techniques often overlook ethnic anatomical differences, leading to suboptimal aesthetic outcomes and higher revision rates. In contrast, individualised approaches aim to optimise both form and function by tailoring procedures to specific anatomical and cultural contexts.

METHODS

A systematic search of PubMed, PROSPERO, DynaMed, EMBASE, and the Cochrane Library was conducted in April 2025. Seventeen comparative clinical studies (2003-2023) were included in a PRISMA-compliant meta-analysis (PROSPERO ID: CRD420251045319). Primary outcomes were patient-reported satisfaction, complication rates, and revision frequency. Secondary analyses assessed effectiveness of specific surgical techniques across major ethnic groups: Hispanic/Mestizo, African-American, Middle Eastern, Indian-American, Asian, and Caucasian. Statistical analyses used RevMan 5.4 with random-effects modelling and I for heterogeneity. Study quality was evaluated using the Newcastle-Ottawa scale and AHRQ criteria.

RESULTS

Ethnicity-conscious rhinoplasty was associated with significantly greater patient satisfaction (SMD = 0.68 [95% CI 0.63-0.73]; p < 0.001). The highest satisfaction was observed in multi-ethnic (SMD = 0.76), African-American (0.71), and Middle Eastern (0.63) groups. Indian (0.58) and Asian (0.55) patients also showed favourable outcomes, while Caucasian patients had the lowest satisfaction (0.21). Tailored approaches resulted in lower complication (8.7%) and revision (5.3%) rates compared to conventional methods (17.4% and 12.1%). Heterogeneity was minimal (I = 0%), with no evidence of publication bias.

CONCLUSION

Ethnicity-conscious rhinoplasty enhances patient satisfaction and safety across diverse populations. These findings support the need for culturally and anatomically informed surgical planning in modern aesthetic practice.

LEVEL OF EVIDENCE II

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