I have a small Asian nose with a bulbous tip, all I want to do is just make it pointy and refined. Surgery or fillers? (photo)

Thanks for your question and your photos. While it is difficult to make an assessment based on pictures alone, it does appear that you would be a good candidate for rhinoplasty to meet your goal of a pointier, more refined nasal tip. Dermal fillers would not likely give you the results you are looking for, plus the outcome you do achieve is only temporary. Rhinoplasty performed on Asian patients is more challenging for a variety of reasons, including the thickness of the skin and the need to enhance the appearance without compromising your heritage entirely. Choose a surgeon with the necessary qualifications and experience in this procedure to ensure the best possible results. Best wishes on your surgery!
- Andrew L. Greensmith, MBChB, FRACS

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) because of the thickness of your skin. While there are a variety of approaches and techniques employed by various surgeons, it is up to you to do your due diligence to find a rhinoplasty specialist experienced in Asian rhinoplasty in order to achieve the best results possible. Using autologous grafts (tissue and cartilage from your own body) will provide the safest and most permanent results.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. 

You won't be able to sharpen and narrow your nose without surgery. 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.

Hello,
Fillers will not give you pleasing definition to your tip because they doen't have structural rigidity to shape the thick, overlying skin.  You will need a rhinoplasty that can provide this structure using stiff cartilage grafts taken from your septum or rib. Please visit a few ABPS certified/ASAPS member surgeons (or their AAFPRS equivalents) who specialize in rhinoplasty. Best of luck!

Thank you for the great question! The decision between surgery and fillers really is based on 1) the exact type of aesthetic change you desire; and 2) whether or not you mind having repeated injections. For non-surgical rhinoplasty, I use Radiesse or Restylane (depending on the area of the nose and the skin type). This treatment is quite good at evening out small irregularities in the bridge or giving overall more bridge height. However, it is somewhat difficult to get a more angular or "pointy" nose using this technique. Changes like that may require modification of the existing tip structure and/or placement of cartilage grafts in the tip region.

Rhinoplasty or fillers for the Asian nose. Fillers will not give you what you want-only rhinoplasty will do that. See a very experienced rhinoplasty surgeon for this that does natural noses.

In my opinion you will get a better permanent result by having surgery. When I inject fillers into the nose, I tell the patients the results are temporary. As a art artist, from the LA County Museum of Art I like to use advanced suturing techniques and cartlidge grafts in order to obtain a narrower more refined nasal tip. I incorporate the FINNESSE technique, which I invented. Bleeding, bruising and pain are minimal versus traditional techniques. I don't routinely pack the nose. I hope you find this information useful. For more information please watch the enclosed video.  

Fillers can not refine the nose as they ADD volume to the existing structures. If you are looking for a finer tip then surgery is required. Fillers in the nose at best can straighten the profile by raising low areas to meet the higher bump, or can fill indentations for a smoother contour, but they do not reduce the nose to create more delicate features.

 Most Asian noses have very thick nasal tip skin, therefore it can be difficult to give significant refinement in that area. Surgery will be required, not fillers.

Hi,
Based on the photos you provided, you seem to have a bulbous wide tip. The bulbous tip needs to be reshaped; grafts may need to be used for the tip as well as the bridge of your nose. The bridge of your nose will have to be reconstructed, the nostrils narrowed. This surgery can be customized to each individual based on desired results. Ethnic Rhinoplasty is by far the most challenging cosmetic operation 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. Surgeons before and afters will help you with that. Choosing the right surgeon who has experience is imperative; you want to avoid any revision in the future. 

Best,
Dr.S.