How to Get a Smaller African American Nose Tip?

Regardless of Race, it is important for rhinoplasty doctor to understand the patient's goals.  Most African American rhinoplasty patients desire increased tip definition, a slight decrease in nostril width or size and more definition of the nasal bridge.   They don't want a "Caucasian Nose".  

Tip definition is the most important change. This definition can be acheived by contolling skin thickness, shaping the existing  tip cartilage domes and finally adding more cartilage grafts to the  tip for greater definition, projection and shape.  

Nostril width reduction involves removing small wedge of nostril skin right where the nostril skin meets the cheek/lip skin.   

If the nasal bridge needs increased definition, cartilage grafts or implants can be used to enhance the profile.

It IS possible to get a smaller, more defined tip for African Americans; in general, it can't be as well defined as a caucasian nose, but a more defined tip is definitely possible.  Generally, adding height to the nose, with cartilage or implant, while creating a smaller tip creates definition to the African American tip.  A small portion of African Americans have very thick skin with a thicker fat pad and definition in these tips can be challenging but can definitely be improved.

Hello,
Increasing tip projection and maybe a tip graft would be of benefit if you have thick skin. In addition, alar base reduction would be used to create the appearance of a smaller tip. Hope this helps answer your question.
Dr. Nassif

There is generally no single maneuver to create the well defined tip in a "typical" African American nose. As you have stated and have been told in the past, it is more difficult to obtain extreme definition in thicker skinned noses. That does not necessarily mean that you cannot have significantly improved definition when the surgery is performed appropriately.
I have a large ethnic population of rhinoplasty patients and the metaphor I use to explain the changes we are going to make to the nose is as follows: Your nose shape and size has a great deal to do with the framework that the skin lies over. Like a tent, if the support structure is placed in a trapezoid shape, you will have a trapezoid tent. The skin (or canvas of the tent) simply drapes over the structural support that we create with cartilage, bone, and occasionally implants. If your tent (nose) has a very thin canvas (skin) then every detail of the structure beneath that canvas will show through the canvas.
If you have a very thick canvas (or thick skin), the surgeon needs to accentuate the structure of your nose so that it will show through the skin, giving you more tip definition. How this is performed will vary but, you can expect a combination of tip sutures, tip grafts, and what we call columella struts. All of these techniques lend support to your tip so that your tip structure will support the skin envelope and thus, give you more tip definition.
Finally, your surgeon may also elect to thin the canvas (skin) by defatting the skin, but this will be performed in a very conservative manner. Hope this helps.

Typically a compbination of procedures are performed. Commonly, a reduction of cartilages and stitches to control the shape with conservative defatting of the skin with selective grafting of the tip and dorsum to provide enhanced definition and projection is performed in combination with nostril wedge resections.

As in all ethnicities, there are a variety of noses and a variety of techniques. In what is considered a "typical" African American nose, we create definition the opposite way than in a typical Caucasian rhinoplasty. Not only is the skin thick but the cartilage is usually soft. If you push on the tip of your nose, you will likely see that it is very soft and there is little resistance. To get definition in thick skin, I use grafts of your own cartilage in between and on top of your own tip cartilage. This creates strength to push into the skin giving the appearance of a more defined nasal tip.
This can be a tricky operation so I suggest you seek out a specialist in rhinoplasty if you are considering surgery.

African American rhinoplasty is a cosmetic surgery procedure that reshapes the nose to improve its appearance and function while preserving the patient's ethnic features. It's also known as an ethnic rhinoplasty, a term used by many plastic surgeons to describe nose surgeries for non-European patients. The goal of African American rhinoplasty is to achieve a natural-looking result that complements the patient's other facial features. It can address a variety of concerns, such as:A wide nasal bridgeFlared nostrilsA deviated septumThe size, shape, or function of the nose The type of technique used depends on the patient's goals and specific characteristics. Some common techniques include:Alarplasty: Narrows the nostrils by removing soft tissueDorsum surgery: Narrows the cartilage and bone that runs down the nasal bridgeTip rhinoplasty: Reshapes, refines, or lifts the nasal tip Patients who are good candidates for African American rhinoplasty are usually in good health, non-smokers, and have realistic expectations.

Tip definition and refinement is a common goal of many African American patients. The tip and bridge are both augmented using cartilage grafts and suturing techniques that will create more projection and definition in the tip. A well projected and defined tip can counteract the thick skin which is often encountered in these cases and also give the appearance of a small sharper nose. 

Hello and thank you for your question.  The most important thing is to find a doctor with experience in this procedure who has before/after photos of African American rhinoplasty patients that you like.  You can absolutely get more definition and height in the African American nose, but your true tip definition will depend on skin thickness and your willingness to have the surgeon take grafts.  Rib cartilage (or at least ear cartilage) can often be necessary as I do not use foreign implants in the nose.  Good luck.Aaron Kosins, MDPlastic & Rhinoplasty Surgeon

Hello. Excellent question and your suspicions are correct. To achieve a smaller tip and the "look" that you want involves not only management of the nasal tip but also the bridge and sometimes the nostrils. It is difficult to achieve these goals without a cartilage graft and selective defatting of the nasal tip. Accordingly these maneuvers and attention to the nasal base need to be addressed. Respect for your ethnic features should be of the utmost importance to your surgeon. Please discuss with a BCPS.  Good luck and good looks!-