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.