African American Rhinoplasty Techniques?

In most cases is it necessary to remove mucoperichondrial (SMAS) tissue from the nasal tip to create more definition in thick skin patients? It's my observation that when too much cartilage or tissue removed results in a unnatural look. Leaving some natural tissue avoids the plastic surgury refinement appearance. What techniques help refine the best? Especially noses with fibrous fatty tissues...

Doctor Answers 6

African American Rhinoplasty

SMAS modification is one tool in refining the tip but is not always necessary. Cartilage contouring without removal is the cornerstone. If you haven't already scheduled an initial consultation with a board certified plastic surgeon who has experience in dealing with African American rhinoplasty surgeries, I suggest doing this first and foremost. 

Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 9 reviews

African American Rhinoplasty


African American rhinoplasty is highly specialized. It takes years to perfect the techniques. The Bulbous tip is not from the SMAS layer rather from the fibrofatty tissue just under the skin. This is typically defatted to remove the fatty tissue layer. See links below to which demonstrate techniques and anatomical differences in African American Rhinoplasty.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

African American Rhinoplasty Techniques

You are correct, that in an African American Rhinoplasty most patients request procedures which make the nasal tip less bulbous and add definition.  Reduction of the lower lateral cartilages and debulking the mucoperichondrial tissues in the nasal tip can achieve this goal, however there is an art to the surgery in not resecting too much tissue.  The ala of the nostrils can also be reduced, but again the art is in avoiding over resection.  The trick is getting the proportions correct to balance with your other facial features.  As plastic surgeons we are attempting to refine and enhance ones ethnic features, not erase them.  Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

African American Rhinoplasty

There are several common findings in African American nose surgery.  These are soft cartilages, a wide base, increased fibrofatty tip tissues and often wide bones.  You may or may not have some of these findings.  Based on what is a concern and findings on exam, each area would be addressed to refine your nose in such a way that it still fits your face. RB

Ramin Behmand, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 39 reviews

African American Rhinoplasty

 The nasal anatomy in African Americans does not fit into one simple category. Nevertheless, there are some common findings, like more fibro-fatty tissue, thicker skin, wider nasal bones and poorly defined lower nasal cartilages. The surgical technique needs to address all the elements.  Some of the maneuvers that I utilize to achieve a natural and yet more refined appearance involves judicious debulking of the soft tissues of the tip, appropriate cartilage grafts and nasal base reduction.  Make sure that you discuss your expectations with your surgeon, and that he can explain to you how those expectations will be met.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 56 reviews

African American rhinoplasty.

The best technique for these noses in my 35 years of doing this is to remove all of the EXCESS fatty tissue and part of the cartilage while adding additional cartilage to define the parts that make the tip have definition without a pinched look.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.