What rhinoplasty procedure is best for bulbous, flat, Asian nose with wide nostrils? (photos)

Question

I feel like a rhinoplasty will help balance out my face and achieve the more "feminine" and "cute" nose that fits my face and remains true to my ethnicity (but just better). I've tried filler along the bridge and tip but it doesn't help with the wideness of my nose. What rhinoplasty procedures will I need to achieve this based on my picture? I would like to avoid a fake, obvious and pinched look where the nose bridge is too high and nose tip is too thin. Thank you and much appreciated!

Edmund Kwan, MD · Answer

From the picture, the bridge of the nose is relatively flat, tip is bulbous, and the nostrils are wide. This is typical for an Asian nose. Each area of the nose is addressed separately. The bridge or the dorsum of the nose need height and the best material is a synthetic material like a silicone. Silicone is easy to carve and has much lower complication rate than a cartilage graft. The surgical time is much shorter and much less expensive. Clinical research shows the efficacy of the implant. I have published a study showing 20 year experience with minimal complication. The result at the end of the surgery is the result you get. With cartilage grafts there can be warping and resorption at any point in time. It is totally unpredictable. The tip of the nose must be treated by itself. The problems rise when the surgeon tries to use an L-shaped implant or an implant that is too long or too thick. I use a cartilage that is obtained from inside of the nose called the septal cartilage. The tip will have projection and shape. The nostril can be reduced to fit the nose. You can obtain a natural looking nose that will retain your ethnic identity and give a beautiful nose.

Edwin Kwon, MD, FACS · Answer

A more feminine or cute nose is definitely something you can achieve while remaining true to your ethnicity.  Augmenting your nasal dorsum, increasing projection and refining your nasal tip will help achieve your goals and can be done in a very natural way to avoid an overly stylized appearance.  I advise seeking out a plastic surgeon to discuss specifics on how you can achieve your goals.  Overall, I think you would be a great candidate for a rhinoplasty.

Stephen M. Krant, MD, FACS · Answer

Not an easy solution, but I would do a tip plasty to give you
more definition by sculpting the cartilages and add a cartilage graft to the
tip for projection. Reducing the width of the nostrils will also give a thinner
appearing nose. The incision is hidden in the alar crease. Third, if the nose
needs more definition on the dorsum, then I would use crushed cartilage in the
midline.  Good luck!

Donald B. Yoo, MD, FACS · Answer

A 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) depending on the thickness of your skin. DCF (Diced cartilage fascia) provides permanent results without the risk of warping or resorption of en bloc rib cartilage, and with a much lower rate of migration, infection, or extrusion than synthetic grafts. 
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 @asianrhinoplasty

Tanveer Janjua, MD · Answer

It is important to make sure that the nose fits the face. Your present nose looks very good on your face. I would advise against a rhinoplasty.Regards Dr.Janjua

Jin-Sung Kim, MD · Answer

When the nose bridge is not high enough, a nose bridge implant can be placed. This is often known as dorsal augmentation. It enlarges and straightens the nose bridge to proper proportions. The best types of implants to use are silicone and Gore-Tex. Please note that silicone is easier to remove if you ever need to and so it is recommended in most cases.
If you have a wide nose bridge then the sides of the nose bridge can be reduced via an osteotomy to provide a more refined look. This procedure narrows the nose bridge and if needed, an implant can be placed on the nose bridge for added height.

Sang Hoon Park, PhD, MD · Answer

Greetings. Thank you for your question. 
I think you are a good candidate for a alar reduction surgery. Nose alar reduction is a popular surgery in Korea  among patients who have large nose alars. Wide nose alars make brim of nostril look wide and bulbous and affect overall facial look.  Ideal width of nostrils is same as the distance between eyes, but it should be shorter than the width of lips.
Alar reduction surgery creates smaller alars and nostrils, making nose line look more elegant and slim.
The benefits of alar reduction include but not limited to adjusting nose shape individually and fixing asymmetry, no visible scarring, creating an ideal nose tip that fits facial balance and fast recovery time. This surgery takes 1 – 1.5 hours and it is proceeded under sleeping anesthesia. Patient doesn’t need hospitalization after surgery. Surgeon removes stitches after 5-7 days, and you can go back your daily life right after.
Best wishes, 
Park Sang Hoon, ID Hospital, South Korea

William Portuese, MD · Answer

It might be best to just start out performing just an alar-plasty which can accomplish narrowing wide nostrils.  The Incision located at the inside base of the nostril floor. This procedure can be performed  under a local anesthesia. It is impossible to thin out thick skin in the tip of the nose.

Michael Elam, MD (retired) · Answer

You can seek some complimentary consultations aided with digital imaging to show you some proposed changes that can be accomplished with surgery. Whether these would provide you with the results you are looking for is something you would need to decide. You can reduce the alar base with alar-plasty. Your dorsum appears high enough and I personally think that your nose is well balanced. With your thick skin you would likely not see much more refinement in the tip and while some small refinements can be made you may want to refrain from surgery. Best regards, Michael V. Elam, M.D.

What rhinoplasty procedure is best for bulbous, flat, Asian nose with wide nostrils? (photos)

Answers (9)

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