HispanicBusiness

It's not that Petra Bonilla, a young stay-at-home mom in Queens, N.Y., had a huge problem with her nose. She just thought the tip hung down a little too far.

Late last year, after saving up a little money, the 32-year-old Hispanic mother of four went to the plastic surgeon.

When the moment of truth came -- that is, when the doctor removed the bandage -- she was horrified.

"He didn't even work on my tip," Bonilla, whose husband owns a nightclub, told HispanicBusiness.com. "It was just chopped off."

After several months of seclusion, Bonilla decided to try another doctor. This time, she did some research.

She found a plastic surgeon who specializes in ethnic surgery -- who, in fact, had designed an implant specifically for African Americans and Hispanics.

This time, the moment of truth led to a relieved smile: It was exactly what she wanted.

Recession notwithstanding, plastic surgery is on the rise among Hispanics, African Americans and other people of color -- even as the number of surgeries among Caucasians has dipped.

But because this uptick among minorities is a relatively new phenomenon -- and because cosmetic surgery on darker-skinned patients is generally more difficult -- many ethnic patients walk away from surgery dissatisfied, experts say.

"If a bad surgery does happen, it's because the surgeon might not be well-versed in ethnic skin," said Dr. Tripti Burt, a member of the American Society of Plastic Surgeons, who is herself of East Indian descent. "They might have a cookie-cutter approach about how to do rhinoplasty."

Ethnic cosmetic procedures increased 11 percent in 2008 over 2007, with more than 3 million performed, while procedures among Caucasians dropped 2 percent, to around 8.8 million, according to the American Society of Plastic Surgeons.

Burt, who sees many ethnic patients at her practice in the Chicago area, has an explanation for the phenomenon. She theorizes that the Caucasian patient-base peaked in recent years -- and therefore was susceptible to slipping during the recession -- while the ethnic patient-base is exploding so rapidly that the numbers continue to defy the recession.

"I feel like I'm having more and more Hispanic patients than ever before, even despite the economy," she said.

Indeed, from 2004 to 2008 the number of Hispanic plastic-surgery patients more than doubled, to 1.2 million, according to ASPS. The share of Hispanic patients rose in kind, to 10 percent from 6 percent.

This trend is partly the result of how plastic surgery is becoming less taboo in America -- a phenomenon that no doubt has something to do with popular reality TV shows such as the now-canceled "Extreme Makeover."

The United States isn't the only place where plastic surgery is becoming more acceptable; in Brazil, it's so mainstream that wearing a nasal cast after a surgery is downright trendy.

But changes in professional standards in many cases have lagged behind the shift in social mores.

As the famously botched job of Michael Jackson perhaps exemplifies, the difference between performing plastic surgery on ethnic patients and Caucasian patients is significant. For one thing, darker skin is more prone to scarring, or to rejuvenating in a color either too dark or too light. Also, the noses of Hispanics and African Americans tend to be wider and flatter than those of Caucasians.