Rhinoplasty for thick skin
The thickness of your skin will limit the amount of refinement that is possible with the tip of your nose during rhinoplasty. The challenge with thick skin is that even if definition is created to the nose and cartilage underneath the skin, these changes will not show through the skin. In these cases additional support and structure is necessary to create definition in the tip of the nose. Using grafts made from your own cartilage will be the best approach for a natural-appearing, lasting result.
Thanks for your question.Your nose can be improved with rhinoplasty. In my opinion, you would benefit from the typical techniques used in Asian rhinoplasty to refine the tip of your nose. An advanced technique, a septal extension graft, will likely be needed to reshape the tip of your nose. The nose can also be narrowed with alar base excisions so that it will not seem as wide when you smile. These are common requests from our patients. Please see a board certified plastic surgeon for a consult.
Fat nose reflects cartilage shape
Aloha, your photos show a common "boxy tip" deformity that is corrected by reshaping the lower lateral cartilages for tip refinement. The widening of your nostrils can be minimized with resection of the alar wings. These are popular requests in Honolulu due to the large percentage of Asian mix in our community. Discuss before and after photos of other patients with your chosen surgeon to be sure your result is natural and meets your expectations.
rhinoplasty candidate for fat nose
There is no fat located in the nose,however there is a wide and divergent lower lateral cartilages of the nasal tip, also known as a bulbous tip. To reduce the bulbous tip, requires suture techniques and a conservative cartilage removal rhinoplasty procedure. Thick skin in the tip of the nose is a significant impediment to improving the refinement in that area. For many examples of bulbous tip reduction, please see the link and the video below
Improving Fat Nose
Your tip can be improved by changing the contour of the underlying tip cartilages and placing cartilage grafts from your septum to provide support to narrow the frequently soft cartilages. The refinement of your tip will be compromised in a patient with thick skin but significant improvement can be achieved. We cannot limit the movement of the nostrils when smiling but we can narrow the base so that this width will be decreased when you smile after surgery.
How to deal with a wide nose
You have a combination of excess cartilage of the tip and wide alar base. Also the skin on the tip looks thick. The excess cartilage can be reduced as well as the base of the alar can be reduced to reduce alar flare. The thick skin is another issue. Sometimes there is a little fatty tissue and that can be removed to thin the tip but the thickness of the skin can not be reduced surgically.
What to do about a "Fat Nose"
Your nose has excessive cartilage which contributes to the "fat" look you describe. Depending on your desired result, you might benefit from either a Weir procedure or an internal suturing technique that could help slenderize your nose. Without an in-office consultation, it is difficult to determine which would be most appropriate. Please do your research carefully in choosing a plastic surgeon, looking for a board certified plastic surgeon with years of experience.