My Nose is Bulbous and Nasal Tip is Overprojected Due to Fat, What Can Be Done to Improve It?

There is no fat in the tip of the nose.  The nasal tip is simply composed of very thick oily skin and wide thick cartilage.  To change the nasal tip, a portion of the tip cartilage can be removed.  The remaining portion provides structural integrity to the nasal tip and will then be sutured together to narrow and refine the tip.  This is also known as a tip plasty procedure.  This will reduce the bulbous portion of the nasal tip, but it is important to make sure that the tip is in balance with the remainder of the nose.  

Rhinoplasty in individuals such as yourself is quite tricky. The first reaction that patients often have is to make the nose smaller, however, this can be disastrous if you do not visit a board certified surgeon who has done a fair amount of ethnic rhinoplasty.  As the skin color darkens the cartilage in the nose becomes more amorphous and less rigid. This combined with the greater percentage of sebaceous glands makes the nose seem flat and bulbous. To correct such deformities an open structure rhinoplasty is often the best to make the nose more rigid and to ensure proper function. In seems counter-intuitive but making certain parts of the nose more prominent balances the whole nose and facial aesthetic.  It is important also to not lose all semblance of your ethnicity as well as this can be a tell tale sign of cosmetic surgery. Good luck!

I assume you have not had prior surgery, correct?

If that is true, and your surgeon told you that your problem is excess fatty tissue and not bulbous cartilages and not thickness of the tip skin itself, consider a non-surgical technique.

Ask your surgeon about injecting a cortisone solution under the skin to thin the fat layer.

This is not an unorthodox technique. It has been done by many surgeons for many years. There is a best concentration and volume to use, and it must be done artfully, of course. But, it can be quite impressive.

Worth a try , right?

Best of luck.

-Robert Kotler, MD, FACS

Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON