Natural looking African American rhinoplasty without implant (Photo)

Hi everyone I would like have surgery that would make my nose smaller, more narrow and straight. If I need an implant could I use tissue from my body? Should I have open or closed surgery? I don't like the way my nose spreads when I smile.

Doctor Answers 14

Natural looking African American Rhinoplasty is possible

Natural looking results are possible when choosing a plastic surgeon who is experienced not only with rhinoplasty surgery, but African American rhinoplasty. The most important factor is clearly communicating what "natural" means to you. Bringing in pictures of noses you like are very helpful in understanding what you find attractive, as well as determining if your expectations are realistic. Generally speaking, natural results are obtained when the changes are not too drastic. it is unlikely you would need any type of implant to improve the appearance of your nose. I personally perform far more open rhinoplasty surgeries than I do closed. It appears from the pictures closed may be the preferred method, if you want to reduce the size of your nose, straighten the bridge, and narrow it as well. 

Many surgeons utilize photo imaging software to demonstrate what you might expect to look like following rhinoplasty surgery. This is very helpful in determining if you would be happy with the possible look of your new nose. Keep in mind these imaging programs are only meant to provide examples, they do not represent the exact outcome you will receive. The end result ultimately depends on the skill of our surgeon, as well as other factors. 

Newport Beach Plastic Surgeon
4.7 out of 5 stars 89 reviews

African American Rhinoplasty

Based on your desires I would probably recommend an open rhinoplasty. However if we sat down and discussed your desires and significant narrowing of the tip was not a concern it would be possible to perform the surgery through a closed approach. Another factor that would impact my approach would be the crooked nature of your nose; examination in the office will allow your surgeon to choose the best approach based on your anatomy.  Narrowing of the nose at the alar base (the base of the nostrils) will lessen the spread with your smile. If you need an implant of some sort, you can definitely use cartilage from inside your nose.

Jennifer Parker Porter, MD, FACS
Bethesda Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

A smaller nose.

Hello  12daisies.  Thank you for your inquiry and posted photos. I believe that your goals are achievable. Your nasal bridge will need to be addressed to create more definition. This may involve a cartilage graft from your nasal septum or rib. Your nasal bones will need to be narrowed to provide more balance. Your nasal tip is moderately bulbous so it can be refined by reducing some of the prominent cartilage and by using various tip suture techniques. Nasal tip cartilage grafts would then be added for definition. Finally your nostril size will need to be reduced and possibly a moderate cinching stitch to reduce flaring of your nostrils while smiling. No implants necessary. I hope this information proves helpful. Please consult with a BCPS for a complete examination and evaluation. Good luck. 

Carlos Burnett, MD, FACS
Westfield Plastic Surgeon
4.9 out of 5 stars 37 reviews

Rhinoplasty, best option for you. some advices:

Thank you very much for sharing your concerns with us.
Through rhinoplasty we make small changes, but that is quite noticeable. 

In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.
With this procedure you get a delicate nose, better harmonize with your other facial features.

With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 252 reviews

No need for implant

Hello and thank you for your question. Finding the right doctor takes time and a lot of research. Do your research online and really look at before/after photos. Depending on where exactly you live, you may have to travel. Finding examples of what you like on a doctor's website is paramount. Just because a surgeon says he/she does ethnic rhinoplasty, does not mean they do a lot of it. Because I am in Southern California (for example), greater than 60% of my practice is "ethnic" rhinoplasty - African American, Asian, Hispanic, etc.

I have never used an implant in a nose for any rhinoplasty, and do not use them for African Americans either. I use a technique called diced cartilage in fascia (think of a soft burrito filled with tiny pieces of cartilage) and for you I would most likely need a graft from your ear as well as from inside your nose.  What you want is achievable without an implant.  Your nasal bones DO NOT need to be narrowed in my opinion, but the convexity does need to be taken out.  African Americans have short nasal bones and your width is coming from your tip cartilages, which can be refined.  

Aaron Kosins, MD
Plastic & Rhinoplasty Surgeon  

Aaron Kosins, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 16 reviews

Rhinoplasty without Implant

Doctors are of differing opinions concerning nasal implants. Personally, I have used them with great success in carefully chosen patients and they have decided benefits over grafting materials taken from the patient. This is particularly true when a large build up of the bridge is needed. I think the main issues that could be easily improved with your particular anatomy are narrowing and defining of the tip, narrowing of the nostrils and straightening of the nose. Your nasal bridge, although somewhat low does not appear to be a significant problem although a conservative build up could be performed. All in all you should be able to get a nice improvement with a well planned Rhinoplasty performed by a skilled surgeon.   Best of Luck   Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

Natural nose job

i would suggest an open rhinoplasty to help mold and shape the tip of your nose. this creates a cut across the skin between the nostrils. nicely hidden. your upper nose has good dimensions and may not need fracturing or "breaking", tho some rasping or "sanding" may be necessary to create more straightness. most of the work needs to be done in the lower half of the nose to help it match the upper half. this lower half could be made to look more narrow with different techniques. I do not think you need an implant, but it depends on your desires and expectations. cartilage grafting may be beneficial for your tip.

James E. Leake, MD
Marietta Plastic Surgeon
5.0 out of 5 stars 19 reviews

African American Rhinoplasty

Thank you for your question.  Rhinoplasty on the African-american nose can be challenging since the skin is thicker, making it more difficult to highlight changes made to the underlying cartilage.  The ideal candidate would be one who wants to maintain their ethnicity while changing some of the features of their nose.  In your case, you would like a narrower nose when smiling.  I have had great success with alar resections - removing a portion of the nostril skin with an incision in the groove between the nostril and lip (alar groove).  This reduces the width and 'flair' of the nostrils.  To Narrow the tip, I generally prefer the open technique to easily assess and refine the tip cartilage.  Your PS may prefer the closed technique, and that choice is unique to each provider.  Keep in mind what I said earlier, that our thicker skin may camouflage the cartilage refinements.  Lastly, if you need augmentation of the nose (which I'm not certain you do based on your photos), ear cartilage is a fine alternative to silicone (or other synthetic) implants.   Best of luck to you.  VN

Vincent A. Naman, MD
Columbus Plastic Surgeon
4.9 out of 5 stars 28 reviews

Rhinoplasty refinement

It is a reasonable request to want a smaller nose. You would certainly benefit from a rhinoplasty that would involve decreasing the width of the nostrils and well as creating more definition to your nasal tip. My preference would be an open rhinoplasty to directly visualize the underlying fatty tissue in the nasal tip in addition to the cartilaginous structures. Best of luck. 

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Rhinoplasty without implant

Dear 12daisies

you are a good candidate for a natural looking result with your rhinoplasty. What is important is that you discuss what you mean by natural with your surgeon and he/she understands what your perception of natural looking is. You also need to discuss what you want for your bridge, tip and base width ...

In term of rhinoplasty approach, both open and closed can give you a great result. If you wanted the base of your nose narrowed, a closed approach would be a safer method. Looking at your pictures, I dont see any need for an open approach. Your septal and ear cartilage are likely to be enough for a narrower and better defined bridge (dorsal augmentation).

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 55 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.