I want a rhinoplasty to fix my bulbous tip but don’t want it to look pinched off like most Asian nose jobs. (Photos)

Question

What can be done? I feel I have a bulbous nose that doesn’t fit my face. However most Asian nose jobs i have seen it looks like an inverted, “T” where they enhance the bridge so much but the nostrils are still wide which you can clearly tell it’s been worked on and looks unnatural. What can be done to avoid this?

Charles S. Lee, MD, FACS · Answer

An unnatural result frequently occurs in Asian rhinoplasty because the tip cartilage are weak. Correction requires reinforcing the weak structure so that the tip projects beyond the rest of the bridge. As the tip get further projected, the nose on frontal view will begin to look narrower and the tip will have more definition and look less round. You need substantial amounts of cartilage to do this - the best source is a small segment of rib harvested from a 2/3" incision in your breast crease. This cartilage is used for rebuilding the tip, the sides of the nostril as well as the bridge. Like many Asian patients, your bridge is not that low - it's mainly the tip and the area between the eyes that is low. The pinched tip that frequently occurs, as you mention, results from raising the bridge with an implant (easy to perform) and ignoring the tip area, which is difficult to perform. Asian rhinoplasty is its own subspecialty within rhinoplasty and I recommend finding someone experienced in this area. Rib is such an important part of Asian rhinoplasty that the surgeon needs to be experienced with using your own (vs. donated) rib.

Donald B. Yoo, MD, FACS · Answer

The best way to determine what specific changes will look good on your face, and what changes are surgically possible, is to do your research to find the top Asian rhinoplasty specialists and consult with several of them in person.  During your consultation, your photos can be computer-morphed to show how the changes to your nose will affect your appearance.  An Asian rhinoplasty specialist will have the experience to determine whether the morphed images are surgically attainable.   Also, while there are several approaches to building up your nose during Asian rhinoplasty, using tissue from your own body will give you the safest, longest-lasting, and attractive result.

Jonathan Kulbersh, MD · Answer

Yes, your nose can be improved with rhinoplasty and you can use your own tissue. 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

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

Charles K. Lee, MD, FACS · Answer

You made some good observations about the "typical" Asian rhinoplasty that is often over-augmented with a silicone implant that is too high.  A tip-plasty can help address the cartilages at the tip of those, allow for a strut-graft that can give your nose more upward rotation.  You may also benefit from an alar base resection to narrow the base of your nose.  Good luck!

Toby Mayer, MD · Answer

Yes, you can have a natural result from a rhinoplasty IF you go to an experienced rhinoplasty surgeon who does natural noses and not the overdone look. See several experienced surgeons and choose one whose noses you like.

Michael J. Yoo, MD · Answer

Thanks for the question.  I would agree with you that most asian rhinoplasties appear unnatural in that many appear with way to high of a nasal bridge that appears out of proportion to the aesthetics of an asian face.  Beauty is in the eye of the beholder however, and some patients like this appearance.  Best to meet with a Board Certified Plastic Surgeon and review your goals and desires.  I tailor my rhinoplasties based on my patients goals, not necessarily my own, although I will give my professional input based on underlying anatomy etc.

William Portuese, MD · Answer

The Bulbous nasal tip addressed with suture technique and a conservative cartilage removal applied to the lower lateral cartilages of the nasal tip.  The bridge line can also be narrowed as well osteotomies.   All this  can be done with a closed rhinoplasty approach with all of the incisions placed on the inside of the nose.  For more information, please see the link and video below

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,
Based on the photos you provided, you  have a bulbous nasal tip with dorsal hump. The bulbous tip would need to be reshaped; grafts may need to be used for tip support .  Ethnic are by far the most challenging cosmetic operations in cosmetic surgery. This because the anatomy and skin thickness requires special techniques to achieve desired results. Do your research online and try to choose a surgeon that can deliver results that you seek. They should have numerous before and after photos with results you like and seek. Choosing the right surgeon who has experience is imperative; you want to avoid any revision in the future. You can send me your photos for computer imaging.Best,Dr.S.

Richard W. Fleming, MD (retired) · Answer

The goal of all rhinoplasty surgery is a natural result. Tour tip can be defined so it is in proportion to the surrounding nasal features. The nasal base can also be narrowed with incisions hidden inside the nose. With these pictures I cannot tell if bridge augmentation is appropriate. Consult with experienced surgeons whoosh you results that meet your expectations.

I want a rhinoplasty to fix my bulbous tip but don’t want it to look pinched off like most Asian nose jobs. (Photos)

Answers (10)

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