How to defat small Asian nasal tip subtly without implants? (photo)

Question

Most Asian rhinoplasty involves some sorts of implants to heighten the bridge of the nose. I like the side profile and don't need the bridge to be high. My concern is that its alar base flares up badly, especially when I smile. I also don't like the nasal tip. The nasal tip is just a little bit thick skin and bulbous. The problem isn't the shape of cartilage (according to my touch), it's more of fat thick skin. I just need very subtle decrease in size of the tip.

Donald B. Yoo, MD, FACS · Answer

An Asian rhinoplasty specialist will be able to comprehensively address the issues you have with your nose.One thing to keep in mind though is that there is a limitation to the amount of tip refinement you can achieve (how small/narrow) because of the thickness of your skin. While there are a variety of approaches and techniques employed by various surgeons, it is up to you to do your due diligence to find a rhinoplasty specialist experienced in Asian rhinoplasty in order to achieve the best results possible. Using autologous grafts (tissue and cartilage from your own body) will provide the safest and most permanent results.Consult with 2-3 of these surgeons in person and determine your comfort level with their approach, demeanor, and before and after results. Good luck.

Edwin Kwon, MD, FACS · Answer

Some patients are looking for a very small or subtle change.  In your case, it appears that you are looking to change your tip in your ala.  The ala can be narrowed by itself or you can combine this with other things including tip refinement.  One thing to be cautious of is that as you begin to change her nasal tip, it may not fit the rest of your nose.  Right now you are generally satisfied with her nose except for the 2 issues that you mention.  However as you start affecting the nasal tip, you might notice that the tip is no longer congruent with your nasal bridge.
When you had your consultation for your rhinoplasty, mention the kind of changes that you are looking for and how that would affect the appearance of your nose overall.

Jonathan Kulbersh, MD · Answer

Asian noses tend to have:
Weak bridge or dorsumBulbous tipWide nostrilsThick SkinEach ethnicity has its own cultural ideas of beauty that must be appreciated and enhanced with any plastic surgery procedure that is performed. If you are interested in ethnic rhinoplasty that respects your cultural identity, please take the time to find a professional who has experience in this area. I hope this helps

Philip J. Miller, MD, FACS · Answer

Your concerns regarding your nose is not uncommon, especially for those of Asian descent. As a specialist in rhinoplasty surgery as it pertains to ethnic rhinoplasty, I can tell you that these are the most common issues I hear patients discuss with me regarding their reasons for wanting to alter the appearance of their nose while still maintaining their ethnic identity:
Asian rhinoplasty patients discuss their dissatisfaction with the following: 
Flat nasal profileSlight nasal bridgeFlared nostrilsWide nasal tipPoor nasal tip strengthI employ specialized surgical techniques for Asian Rhinoplasty and my number one goal is to have a unified vision with my patient. I do not want to harm a patient's ethnic identity, however, I want to allow for each patient achieve the very best results they can and that occurs by having a highly personalized and customized surgical plan. I have over two decades of experience in facial plastic surgery and am able to preserve the ethnic characteristics of my patients while delivering the results they desire. 
When selecting a rhinoplasty surgeon, it is of the utmost importance that you choose a surgeon who is board certified in facial plastic surgery. Board certification matters. Especially, when you are considering ethnic rhinoplasty. You want your face and nose in the hands of an experienced and qualified surgeon. 
I am including a website link about Asian Rhinoplasty as well as video that discusses in detail the specifics of this procedure. I hope you find this information helpful. Please feel free to reach out to our New York City office if we can help answer any questions you might have in your decision making process.
Sincerely,
Philip J. Miller, MD, FACS
Double Board Certified Facial Plastic Surgeon

Bahman Guyuron, MD · Answer

The nose tip can be better defined using a small cartilage graft from the septum or the ear, if the septum is missing. Rib cartilage is not ideal since it is too firm. This can be done through a closed technique. You may want to consult a plastic surgeon who is experienced in creation of more pleasing tip definition.

Joshua A. Halpern, MD, PA · Answer

I don’t see a basal view. This is important to help evaluate your nasel tip. From what I can see, you would be a good candidate for a rhynoplasty. A alar rim reduction will improve your alar base. When performing a tip plasty one can CONSERVATIVELY defat the tip of nose if indicated. FYI, aggressive defating can decrease the blood supply to the skin resulting the skin dieing and “falling off” the nose. In my experience in performing Rhinoplasties on your type of nose, I have had great success in narrowing the nasel tip utilizing advanced suturing techniques. I hope you find this information useful. For more information please watch the enclosed video.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,Yes you can defat the tip to get more definition. You may also need to cartilage work in the tip to enhance definition and reduce bulbosity.Best,Dr.S.

How to defat small Asian nasal tip subtly without implants? (photo)

Answers (7)

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