Shifting Goals in Aesthetic Rhinoplasty: Eurocentric Ideals, Ethnic Background, and Cultural Identity.

[BACKGROUND] Westernization of nasal features has long been presented as an essential framework for enhanced beauty. Whether surgery is meant to align one's appearance to Western ideals, or whether it should be considered a means of improvement within one's own culture and ethnicity, deserves serious consideration.

[METHODS] A systematic literature search of PubMed, Embase, and Web of Science databases was conducted to identify reports on aesthetic preferences for ethnic nasal shape as they apply to aesthetic rhinoplasty.

[RESULTS] Identified reports confirmed that there is no universal ideal nasal morphology across cultures and ethnic groups. However, cognitive investigation of aesthetic preferences of non-White patients is very limited, and most reports provided a low level of evidence.

[CONCLUSIONS] Variations in nasal features are morphological adaptive transformations pressured by evolution and natural selection. Their perception as positive beauty cues is also determined by evolution. Nasal profile preferences of various ethnic patients and the objectives of "ethnic rhinoplasty" are still poorly appreciated. Rather than being intended to correct existing features that deviate from the White "norm," for creating a racially congruent and aesthetically pleasing outcome, aesthetic rhinoplasty is better perceived as an improvement fitting within the specific cultural and ethnic background of each patient and within the context of mate preferences and cognitive averageness.