During the past 5 years, Persian Rhinoplasty has gone from 5% to almost 50% of Dr. Daniel’s practice. This change was due to three factors: surgical commitment, natural results, and patient referral for Persian Rhinoplasty in Newport Beach, CA. It has been said that the largest Persian community outside of Tehran is in Southern California. Also, there is probably no other nationality that is as focused on the nose or as knowledgeable about rhinoplasty surgery as Persians. In 2005, Dr. Daniel began to study Middle Eastern rhinoplasty in depth and ultimately published 3 articles and 2 book chapters on this subject. With greater insight into the subject, it became obvious that the Persian nose is distinctly different from the Arabic nose both anatomically and aesthetically. In 2010, Dr. Daniel was the invited Visiting Professor to lecture in Tehran and give multiple presentations. His keynote lecture was on “Persian Rhinoplasty in Southern California.” During his trip to Iran, Dr. Daniel took the opportunity to visit Persepolis, Shiraz, and Isfahan as well as the major museums in Tehran to benefit his patients in giving Rhinoplasty in newport Beach.
From talking with Persian patients, it has become obvious that the current generation want a “natural nose” without any sign of surgery. In contrast to surgeons who think a natural nose means a strong bridge, a wider base, and a minimally defined tip, Middle Eastern patients want the natural nose to have “no sign of surgery”’ – no scooped bridge, no pinched tip, no upwardly rotated tip, no visible nostrils. How much change do they want? In discussing their goals, Dr. Daniel gives the patient a mirror and lets them tell him what 3 things they want fixed which is usually the bump on profile, more tip definition, and an overall smaller nose. The patient is also asked to bring photos of noses that they like, especially tips that they like. Patients also look through Dr. Daniel’s books of before and after photographs to understand their options. Once the specific goals are defined, the degree of change can usually be classified into one of four groups: natural, naturally cute, naturally cute, or maximum cute. However, no matter how great the change, the result must be natural – that the patient can go to any party and nobody can tell that she has had a nose job, only that it is a very attractive nose.
In order to achieve superior results, it was important for Dr. Daniel to understand how a generation of patients ended up with the “surgical look” which was popular in the 70s and 80s. The answer was a classic error in judgement. Since the worst cases had thick skin and no definition in their tip, surgeons removed as much cartilage as possible to shrink the nose. However, the skin had nothing to contract around resulting in the pinched rotated tip and collapsed nostrils that were characteristic of that era. Dr. Daniel then studied 100 Middle Eastern Patients, predominantly Persians, and realized that their skin thickness was exactly the opposite of what was expected. The findings indicated that 60% of Persians had normal skin thickness, 15% had thin skin, and only 25 % could be considered thick. Thus, aggressive excision and division of cartilages should not be done in the majority of Persian patients and should be reserved for only the 5-10% with very thick skin. Thus, new operative techniques for suturing the tip cartilage were devised as was the use of soft integrated tip grafts.With these progressive techniques, Dr. Daniel was able to achieve the refined naturally cute tips that his patients wanted. Thus over the last 7 years, patients who are happy with their naturally cute noses have told their family members, cousins, and friends which has led to a dramatic increase in the number of Persian patients in the practice. Newport Beach and Dr. Daniel have certainly become the specialized center for Persian and Middle Eastern rhinoplasty. Dr. Daniel’s teachings and techniques are widely used in Iran, Turkey, Egypt, UAE, and other Middle Eastern Countries for Persian rhinoplasty.