Rhinoplasty to Refine Asian Nose Without Unnatural Results?

I am Asian with wide alar base, so when I laugh or smile my nose "spreads out." When I relax my facial muscles, my nose is much thinner, but not to my aesthetic desire. I read that thinning out the nose in this manner might not be possible without damaging necessary facial muscles. I would really like to augment my bridge and my bulbous tip and bring in my nose width, so it doesn't "spread out" so much when I smile. But I would still want to maintain my ethnicity. Is this possible with Rhinoplasty? I do not want a "pinched" looking nose.

Doctor Answers 10

Yes it is possible.

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 The limiting factor in the nasal width will be the smile muscles. The nostril width can be decreased, but the nose will always widen somewhat, though less, when you smile.

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Asian Rhinoplasty: How to Get Natural Results

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It is possible for Asian Rhinoplasty patients to get natural results while maintaining their ethnicity.

Most recognized aesthetic proportions for rhinoplasty are derived from the Caucasian nose, and pre-operative analysis and planning become complex when applying these aesthetic “ideals” to patients of another ethnicity. It is, therefore, very important that you seek a rhinoplasty surgeon who has considerable experience performing rhinoplasty for patients of varying ethnicities. When approaching the non-Caucasian patient, it is of the utmost importance to understand the patient’s goals and desires.

Characteristics of the Asian Nose:

  • A low, flat dorsum
  • Deficient nasofrontal angle.
  • The ideal starting point should begin at the mid-pupillary line.
  • Weak lower lateral cartilages
  • Thick sebaceous skin contributes to a lack of tip definition
  • Insufficient tip projection
  • Wide/Flaring Alar (nostril) Base

There are three main factors that the rhinoplasty surgeon must consider when planning and executing ethnic rhinoplasty – dorsal height, tip projection, and alar base width.

The goals of ethnic rhinoplasty should therefore address the patient’s desire for preservation or alteration of ethnicity, balance of surrounding features, and adherence to patient desires.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 149 reviews

You can get this result

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It is possible to achieve this - but pick a plastic surgeon with experience in Asian noses. Also, look at some pictures of patients he has done. Minor changes can be obtained without changing your overall ethnic appearance.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

It depends on what you feel is your "ethnicity"

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Your requests for nasal alteration are very typical for an Asian patient. The problem lies in the fact that many Asian patients seek fairly aggressive changes, especially at the tip, which in reality removes their "ethnicity." I would look for a surgeon with a fair amount of experience in Asian rhinoplasty and get a rhinoplasty simulation performed to help them understand what your limits would be. My feelings are that the "pinched look" occurs far too often in unskilled hands.

Good luck.

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Natural Asian rhinoplasty results

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Hard to really tell without photos or exam.  Look at your nose and ask what (reasonably) to you want to change.  Most of the time the alae and tip can be reduced.  You still want natural looking results when not smiling. Remember that you are not make out of clay and that some rhinoplasty cases can be a challenge for the most experienced surgeon.  Seek out a few experienced rhinoplasty surgeons.  Look at his/ her photos.  Interview them and see if your goals can be done.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Absolutely possible to get a natural result

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Hi, it is definitely possible for you to maintain your ethnicity with a rhinoplasty. The base of the nose can be narrowed by removing small segments of skin and tissue, and this will not damage your facial muscles. For your nasal bridge, augmentation can be done with either your own tissue (bone or cartilage) or with a silicone implant. Some surgeons feel very strongly about using one versus the other, so you may notice a difference of opinion if you see several different doctors for opinions. The nasal tip can easily be reduced to make it more narrow without looking pinched. It's great that you have your goals so clearly defined. Good luck!

Achieving natural results with Asian rhinoplasty

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The best way to achieve natural results with Asian rhinoplasty is to seek out a rhinoplasty specialist who consistently produces natural results.  Looking at before and after pictures is a great way to get a sense of a surgeon's style.  Especially with nostril reduction, it's important to find a surgeon with an extensive experience with alar base modification.  

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

The wonderful thing about noses and nasal surgery is that we can accomplish almost anything that you would hope to achieve

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The wonderful thing about noses and nasal surgery is that we can accomplish almost anything that you would hope to achieve. Often, achieving one desired goal involves two or three other considerations at the same time, so that the end result fits in with the natural shape of the face. For example, making a wide nose more narrow is often accomplished by slightly increasing the height of the nose. An easy analogy to understand this concept is that of a tent pole: If a tent pole is raised a little higher, the tent becomes narrower in appearance. If that is not enough, the base of the nostril may also be narrowed surgically. A small, “cute” and natural-looking nose is a very reasonable goal.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

It is possible to maintain the Asian ethnicity of the nose

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The rhinoplasty operation is designed as a static operation for the nose in a static position. The nose will still be wider upon smiling, which is dynamic. The bridge can be easily augmented with either natural cartilaginous tissue or Silastic synthetic implant. The facial muscles are not damaged after this type of surgery. A bulbous tip can be reduced somewhat, although the skin and tip of Asian noses is usually quite thick and is hard to refine. The nose will continue to spread somewhat, even after rhinoplasty, when smiling. It is possible to maintain the Asian ethnicity of the nose

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Many different options fro Asian nose: Surgical and non-surgical

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Botox may produce a relaxation of the alar muscles which cause your nostrils to widen with smiling but this may also cause your lip to hang a little lower as well. (Injection of the levator labii alaeque nasii muscle).

You can also achieve subtle filling of the nasal dorsum with a filler but this may be more difficult to achieve with the nasal tip.

Please realize that the above maneuvers are temporary and do not provide a long term solution. There are not without risk.

You are also talking about alot of changes although you state that you don't want a big change. Non-surgical rhinoplasty is typically performed for subtle changes which may not achieve the degree of change that you are seeking.

Alar cinching sutures are a method of limiting widening of the nostrils with smiling but this is more of a surgical intervention.

It would be best ot seek a consutlation from a qualified surgeon and a second opinion to review options which meet with your expectations.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.