By: Michael Petrosky, MD

It is a common misconception that laser hair removal is not an option for people with dark hair and dark skin. Although this may have been true in the past, technology has improved in recent years to make the procedure effective for most skin and hair types.

Laser hair removal is straightforward to perform on individuals with light skin and dark hair because the laser energy is absorbed by melanin, the pigment in skin and hair cells. Darker hair has more melanin; lighter skin has less. Treatment becomes more difficult, however, when the amount of melanin in the skin and hair is similar (light skin and blonde hair or darker skin and black hair, for instance).

It used to be a concern for many of my patients with dark skin that laser hair removal in Atlanta wouldn’t achieve significant hair reduction, or even could over-treat the area, leaving white spots on the skin. Modern technology is significantly more advanced and in the hands of a skilled technician, people of all ethnicities can now benefit from the long-term hair removal that can be accomplished with laser technology.

There are two key variables that need to be considered: treatment technology and provider training. If a practice is using older laser hair removal technology, it may not be effective for people with darker skin tones. In addition, even if a practice has a highly advanced laser, treatment effectiveness could be compromised if the provider isn’t properly trained in how the laser can be used to treat a wide range of skin and hair colors.

Bottom line: Laser hair removal can be safe and effective for people with darker skin, but you should do a little extra research to ensure that you are choosing a provider with the right technology and the right experience for your needs.

By: James Romanelli,, MD

If you’re Hispanic or African-American, you might be worried that your skin tone will make your facelift scars very noticeable after healing. I’m happy to tell you that this usually isn’t a problem. It’s true that darker skin sometimes will show scars more easily, but a good surgeon can take steps to help make sure your scars will flatten and fade properly:

• Limiting the approach: Newer techniques in mini face lift on Long Island allow for very nice results with dramatically smaller incisions. The faster healing time and smaller suture areas mean it’s much less likely for you to develop noticeable scarring, no matter what your skin type.
• Choosing more conservative suture placement: For any given facelift technique, a Long Island plastic surgeon has multiple options for where exactly to place the sutures. Sutures behind the hairline and toward the back side of the ear are less noticeable.

The bottom line: If certain factors increase your risk of scarring, this doesn’t mean you can’t get very good results, but you should still be aware of the risks and be direct about asking your plastic surgeon what he or she plans to do to make sure your results look right. Plastic surgery should never be a “one-size-fits-all” process, but in these cases it’s particularly important not to settle for anything less than the “best” approach.

In a previous post, one of my colleagues identified the core concerns for ethnic cosmetic surgery patients. I’d like to build on that groundwork by taking an in-depth look at some of the specifics of ethnic rhinoplasties which, along with other procedures like upper eyelid surgery, constitute the majority of the “ethnic” San Francisco cosmetic surgery procedures I perform.

Why Your Nose Requires a Specific Approach

The front of your nose is made of joined sections of cartilage attached to the bone. The specific arrangement of this cartilage can differ significantly between ethnicities.

• African-American noses are often characterized by minimal alar (nose-tip) cartilage, limiting the distance and angle at which the nose projects from the face. African-American noses also tend to have more soft tissue than the textbook nose.
• Asian noses similarly tend to have less projection, a lower bridge, and a higher ratio of soft tissue. The nostrils also may take on a “flared” appearance.
• Mediterranean noses very often have a thicker buildup of cartilage at the bridge of the nose, creating a hump that, combined with a greater tendency for the nose to dip, gives a bonier, more aquiline profile.

At the same time, nasal appearance often involves a kind of optical illusion. The ideal nose harmonizes with the features around it by balancing them out, but a competent San Francisco facial plastic surgeon also needs to address how the other facial factors like eye location, cheekbone height and angle, and the form and size of the mouth determine the right balance for a more aesthetically pleasing nose.

Popular Options for a Sampling of Nose Shapes

• For African-American noses, small nasal implants at the nose tip often slim and lengthen the look of the nose, improving projection without losing ethnic characteristics. Sometimes a patient will require reduction of flesh at the tip, and many will choose to have me sculpt a higher, straighter bridge to even out the changes and prevent a “ski-slope” look. Nostril correction is only sometimes a component, as many African-American patients find that wider nostrils maintain a more balanced look.
• Because of the fleshier composition of their noses, Asian patients can often choose the San Francisco nonsurgical rhinoplasty, which uses injectable dermal fillers to refine the nose tip or create a higher-profile bridge. At the same time, they will often choose subtle correction for evident nostrils, either by direct nostril surgery or by adding to the tip to minimize a “snub-nosed” appearance.
• Nose surgery in San Francisco to correct a Mediterranean nasal “hump” typically involves two steps. First, through any of a selection of approaches, I will remove excess cartilage or bone from the nasal bridge. Then, I may also cut the tiny muscle that causes the nose to point down when the patient smiles. Thinner nostrils are also more popular with my Mediterranean patients, but only moderate nostril adjustment is usually sufficient to balance out faces that tend to be a little more angular.

Hispanic, African-American, and Asian patients account for over 21% of cosmetic surgery patients nationally, and in cities like Baltimore that are also home to Arabic and Mediterranean patients, those numbers are even higher.

Until lately, most cosmetic surgery approaches were developed to enhance the Caucasian face, and may fail to address the unique concerns of ethnic Americans. Fortunately, new approaches allow patients at my Baltimore plastic surgery practice to take advantage of cosmetic surgery options carefully tailored to retain and compliment their ethnicity.

Retain Your Natural Look

As a person who is proud of their ethnic identity, it’s important to you that your Baltimore facelift clarifies the natural beauty inherent in your features, rather than replacing your look according to a standard that does not make sense for your facial features.

A good plastic surgeon will appreciate this desire, and be able to plan an approach that will take into account the natural benefits of your facial contour, like higher cheekbones or a specific nose shape, as well as address problems like sagging eyelid and neck skin, which affect most people in similar ways.

To find out if your surgeon is capable to meet this need:

• Ask for photos of previous patients. A gallery of people who look nothing like you suggests that your surgeon has limited experience adapting procedures to a range of facial structures.
• Inquire about training and qualifications. Surgeons certified by the American Board of Plastic Surgery have to prove their skill and knowledge in head-to-toe cosmetic and reconstructive approaches, and spend years in surgical residencies to expand their skills. A surgeon thoroughly trained in a variety of procedures will be more likely to approach your needs on an individual basis.

Prevent Scarring

Darker skin tends to change pigmentation and scar more easily, with the formation of keloid scars a particular concern for African American patients. During a consultation, you should ask what steps your surgeon will take to make sure your surgery minimizes the kind of tissue damage that makes scars more obvious. For instance, many African American women have concerns that Baltimore breast enhancements such as breast reduction might cause abnormal scarring because breast tissues are thinner.

Some surgical approaches create more scarring than others, so compare results in surgeons’ patient photos and ask your surgeon about different surgical approaches that can minimize both tissue trauma and scarring. A few laser treatments can help correct scarring when it does occur.

Maintain Healthy, Dark Skin

Older laser treatments tended to be ineffective or harmful for darker skin, but new laser technology can actually help minimize scarring and correct pigmentation problems for a wide cross-section of patients. Levulan® Photodynamic therapy and V-Beam® laser treatments are both gentle and effective on darker-skinned patients, and laser hair removal options allow ethnic patients to permanently reduce the amount of unwanted hair.

For the physical characteristics you would like to improve, you deserve to put your trust in a surgeon who values your natural look and takes your skin color and tissue structure into account. Take the time to ask the right questions, and you will be much more likely to get the kind of results you want.

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