In the past we used a sculpture costal cartilage of the patient to give projection to broad and undefined nose. Today we use a silicone preshape L implant to improve the tip and the dorsum of the nose at the same time, previous management of the cartilage of the tip.
I have improved the colummella portion of the silicon L shape implant to maintain the projection and support of the tip in the thick skin of the african american noses. It is produce under my name by Silimed from Brasil.
The success of this technique is to avoid the implantation trough the nostrils, and the best way for that is an external vertical intercartilage colummelar incision.