Suggestions for Bulbous, Upturned Asian Nose? (photo)

I am really keen for an rhinoplasty . I have a bulbous nose with thick skin and slightly upturned tip. However , I have consult with a few surgeon their suggestions was placing implant on bridge and cartilage graft for tip but none mention about thinning the fatty tissue in the skin. Pls give me More advice and suggestion

Doctor Answers 13

Suggestions for Bulbous, Upturned Asian Nose? (photo)

Most experienced plastic surgeons would prefer using autologous bone and cartilage for nasal surgery.  Implants in the nose have a high rejection and infection rate.  The reason they are so popular in the orient is because they are fairly simple to insert.  However, as you have mentioned your main problem is thickness of the tip skin and that cannot be "thinned out" surgically.  Whether a tip cartilage graft will give you more tip definition is unpredictable.  Just make sure you are under the care of a board-certified plastic surgeon who has expertise in Asian noses and can show you convincing sample photos, because your type of nose is often better left alone.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Definitely consider non-surgical or injection rhinoplasty. Raising the bridge with a permanent filler works very well.

Dear Weiling;

Here in California, with a huge Asian-American population, we have many calls for similar improvement.Raising the bridge can be done without a formal surgical procedure that might include grafting of bone or cartilage.You should consider the permanent non-surgical injection rhinoplasty technique.

Non-surgical rhinoplasty works because tiny drops of Silikon 1000 are injected just under the nasal skin. Over time, the body walls off those drops with new tissue which provides the plumping action to fill in divots, marks in the nose or augment a nasal bridge. The same effect can happen with plain salt water to provide a preview how the nose will look on completion of treatment. The Kotler Saline Demo lasts perhaps two hours, but long enough to take a photo of what the finished nose will look like.

Best wishes,

Robert Kotler, MD, FACS

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 86 reviews

Asian Rhinoplasty –

The Asian rhinoplasty usually requires augmentation on the dorsum and tip as well as alar base resections, possibly using the patient’s own cartilage either from the septum and/or rib which requires the expertise of an experienced rhinoplasty surgeon with a considerable depth of knowledge and expertise in the management of the ethnic nose.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 63 reviews

Tip refinement and dorsal augmentation during Asian rhinoplasty

I think building the bridge of your nose and refining the tip by reducing its width and some of its bulbosity will help to give you a more balanced and attractive nose.  I would recommend using grafts only made from your own tissue as foreign implants have a higher rate of complications, and are rarely a permanent solution.
You have goo tip projection, so matching that projection by building up your bridge will improve your profile and make your nose appear more narrow from frontal view.  The tip can be refined by projecting it, removing some of the excess cartilage and supporting the rest, and conservatively removing fatty tissue (nasal SMAS).  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Rhinoplasty questions

Any surgeons use a silicone implant to augment the nasal bridge, but reasonably, I think they look weird. You can definitely get some tip refinement with simple rhinoplasty techniques. The toughest thing will be to try and lengthen your turned up tip. That is very difficult to achieve reliably.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Bulbous Upturned Asian Nose

Your bridge can be augmented to provide more projection and grafts placed in the bulbous tip to increase the length of your nose and improve tip definition. Fat can be removed deep in the skin but this does not make a dramatic difference. For the past 35 years I've always recommended that we avoid silicone implants because of the increased risk of infection and movement or extrusion of these implants. I prefer to use the patient's own cartilage.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

How you can treat your bulbous, upturned nose with Asian Rhinoplasty

There are a few ways of achieving the look you seem to want. I prefer using cartilage grafting to augment the bridge, but silicone or gortex are other ways of raising the height of the dorsum.

It is also possible to lessen the upturned nature of your tip. At the same time it is often possible to defat some of the soft tissue of the tip to make the nose "thinner" as it were.

After examining your nose your surgeon should be able to perform digital morphing with you to come up with a plan on what can be done during your rhinoplasty.

You can read more about Asian rhinoplasty at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Suggestions for Bulbous, Upturned Asian Nose?

There are several techniques available to treat your nose. Because the tip is over rotated, a caudal extension graft may be used in conjuction with a tip graft to improve overall tip dynamics. Additionally, the fibrofatty tissue in your nasal tip can be used as pedicled graft to further augment your dorsum. What does all that mean? You can extend the length of your nose with a cartilage graft attached to the septum. You can imrpove tip definition with the tip graft. And during the dissection of the tip, the fibrofatty pad can be turned around and used with another graft to improve the height of the bridge.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Suggestions for Bulbous, Upturned Asian Nose?

                 The fatty tissue can certainly be thinned along with performing the other modifications.  I often let the patient select the implant vs the cartilage approach.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Thinning the nose

There are a few components to your surgery:

  1. Adding projection to your bridge - I prefer cartilage over an implant
  2. Adding tip support - again using cartilage grafts
  3. Thinning the fatty tissue over the tip

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.