How to Get a Smaller African American Nose Tip?

I have since found before and after pictures of the model I had in a previous question. Looking at her before nose, which is on the left in the pictures, her tip is significantly smaller. I was always informed by dr's that its NOT possible to get a lot of definition in a black nose. What technique is used to create a small tip like this?

By creating a smaller tip and a defined bridge, does this somehow create a optical illusion that the nose is smaller than it really is? Thank you :-)

Doctor Answers 17

African American Rhinoplasty

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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.

Newport Beach Plastic Surgeon
4.9 out of 5 stars 51 reviews

Ethnic rhinoplasty techniques

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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

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

African-American nasal tip

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In noses with thick skin, definition can be improved by changing cartilage shape and usually adding cartilage grafts to increase strength and maintain the desired contour. It is not about skin color, just skin thickness. All African-Americans do not have thick skin as we see in the pictures of the model you submitted.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Yes you are right

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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. 

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Look for the nose you like

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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, MD
Plastic & Rhinoplasty Surgeon

Aaron Kosins, MD
Newport Beach Plastic Surgeon

Smaller nasal tip

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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!

How to get a narrow tip with African American Rhinoplasty

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There isn't just 'one' characteristic African American Nose. Skin thickness varies, as does the thickness and stiffness of the tip cartilages. These differences can make it more or less easy to aggressively shape a nose. Better pre-existing tip support and thinner skin - easier to get a narrower tip. Heavy thick skin and weak, flimsy tip cartilages - tougher to create a sculpted looking tip. Of course, in a reasonable candidate there should be a significant amount of hope that there will be a noticeable improvement, even if you don't have the best pre-determining features. Your surgeon should help you to understand where you fit in that scale and should also be able to set your expectations at a level you can be satisfied with. Best of Luck  Dr Harrell

Techniques to refine African American nose

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By creating a smaller tip and more of a defined bridge, this does give an optical illusion that the entire nose is smaller. It appears smaller only because the tip is narrower and the bridge is higher. When the bridge is higher it gives the appearance that the nasal bones are narrower, even though they have not been narrowed. The amount of definition that can be obtained in African-American rhinoplasty depends on how thick the presenting skin is. Rhinoplasty surgery is not skin surgery; it is sculpting and reshaping cartilage of the tip. There are multiple different tip techniques that can be performed such as suturing of both cartilaginous nasal domes, which are part of the lower lateral cartilages, and multiple different tip grafts depending upon the patient’s needs, wants, and desires.

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

Modifications of Goldman technique to refine African American nose

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In most cases, the techniques that I prefer to treat the relatively typical bulbus, amorphus, ill-defined African American nasal tip are modifications of the “Goldman “ technique of vertical dome division supported by the use of cartilaginous struts and battens. In my hands and in my long-standing rhinoplasty experience, this technique affords me the best projection, definition and support of the tip in these cases.

Tip definition in the African American rhinoplasty

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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.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 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.