When Steven Williams, MD, was a plastic surgery resident in the early 2000s, nose job essentials included a scalpel, a nasal speculum, and a mold depicting the size and shape the post-surgery nose should be. That shape was small with a "ski jump" nose bridge and "a very narrow tip," says Dr. Williams, a board-certified plastic and reconstructive surgeon in Dublin, California, and president-elect of the American Society of Plastic Surgeons (ASPS). "It was considered the classic nose." It was also entirely Eurocentric.
Flash forward: Things are finally, slowly beginning to shift. More Black and brown people than ever are getting cosmetic procedures, according to the American Society of Plastic Surgeons — 1.7 million in 2020, compared with just over 1 million in 2010. (The white patient population went from 9.2 million to 10.3 million during this same period.) At the same time, plastic surgery is evolving, with more focus on individual beauty and preserving ethnic differences instead of, say, giving everyone the same pert nose.
Meet the experts:
- Steven Williams, MD, is a board-certified plastic and reconstructive surgeon in Dublin, California, and president-elect of the American Society of Plastic Surgeons (ASPS).
- Charles Boyd, MD, is a board-certified facial plastic surgeon in Birmingham, Michigan, and treasurer of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).
- Kelly Bolden, MD, is a board-certified plastic and reconstructive surgeon in Washington, DC.
- Kristin Denise Rowe, PhD, is assistant professor of American studies at California State University, Fullerton.
In a culture where Black women have been held to dominant Eurocentric beauty standards, this slow but steady shift in plastic surgery ideals indicates that we are moving in a different direction. Not only are more Black patients seeking cosmetic surgery, they are going into providers' offices knowing what they want and, maybe more important, what they don't want. The best of aesthetic medical providers are listening to the concerns of these patients and empowering their individuality.
"Black don't crack" has been a mantra of pride, but it has wrongly informed skin-care and aesthetics decisions.
Black patients — and Black surgeons — have been underrepresented in plastic surgery. Only 11% of patients who get cosmetic surgery are Black, according to 2020 statistics from the ASPS, and some estimates show about 2 to 3% of plastic surgeons are Black. But the fact that more Black patients are seeking out these services may indicate that they are overcoming psychological barriers to care for themselves in this way, says Dr. Williams.
For decades, the phrase "Black don't crack" has been a mantra of pride for the Black community, but it has wrongly informed important skin-care decisions, like what is adequate sunscreen use. The phrase is also behind some of the reservations Black people have when considering cosmetic procedures, says Charles Boyd, MD, a board-certified facial plastic surgeon in Birmingham, Michigan, and treasurer of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). "I say, 'It is true that black doesn't crack — we don't get as many lines or wrinkles,'" Dr. Boyd explains. "'But it does sag and droop.'"