Ethnic Makeovers

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reese Hayes wanted a new nose. She thought hers made her look "like a character in an old Italian movie." But she didn't want one that was "pointy" or that would make her "look white." So when the 36-year-old African-American software engineer started shopping for a plastic surgeon to do her rhinoplasty, or nose job, she chose from a growing number of doctors who specialize in changing the look of minority patients without erasing their ethnic identity.

The number of nonwhite Americans opting for cosmetic surgery quadrupled between 1997 and 2002, to more than 1 million a year, according to the American Society of Plastic Surgeons. Nonwhites present a special challenge for plastic surgeons, who for years were taught to give every face that came to them Anglo-Saxon eyelids and a classic Greek or Roman nose. Today plastic-surgery journals are filled with articles about rhinoplasty for African Americans and Hispanics and blepharoplasty (eye lifts) for Asians.

This is a tricky business. The articles explore ways to straighten or subtly change the width of an African-American patient's nose while still allowing for a slight flaring of the nostrils. They explain how Asian eyes, which tend to lift slightly higher in the corner than do Caucasian eyes, often look tired or old beyond their years when that corner drops down with time. These patients want to look younger, but they aren't interested in having their ethnicity erased with a standard eye lift.

If you're considering cosmetic surgery, it's important to know why you are doing it and what you can realistically expect to achieve. Trying to change your racial identity through surgery can lead to unfortunate results. But if your goal is to make the features you were born with work better together, there are cosmetic surgeons who can help. To find one who specializes in your ethnic group, you can contact the American Society of Plastic Surgeons or visit its website at www.plasticsurgery.org.

Dr. Gupta is a neurosurgeon and CNN medical correspondent