The shape of the nose is as important as the size of it. In different cultures and populations the nose has some special characteristics; therefore it is really important to know these facts and assess the patient based on these facts. Female and male face structures and lines are completely different from each other. This is one of the other facts that should be kept in mind both during the consultation and the surgery itself. Since the nose is the most prominent organ of the face; patients can have different desires and requests from the rhinoplasty operation. To understand the patient’s needs and desires is the most important step of the rhinoplasty operation.
your desires are very typical of patients wanting to improve their appearance. In your case, the procedure would be designed to narrow the tip, increase tip projection, narrow the base of the nose and augment the dorsal radix profile. Your own septal and possibly some ear cartilage would be used to achieve the desired result. An experienced rhinoplasty specialist can help you plan the procedure in consultation.
Lessing the bulbous quality of the tip and nostrils can be accomplished with tip surgery and an alar base procedure. With thicker skin, placing grafting materials is optimal. I never use foreign substances to achieve this; rather, I only use the patient's own cartilage from the nose or ear (in some cases, if necessary). This achieves the safest, more-natural, elegant result.
Best of luck!
Its not very often that having thick skin on the nose is useful but in your case using a tip graft will go towards achieving the best result and the graft will not be seen.Changing the orientation of the alar cartilages would also be necessary.
There are a number of techniques that can be used. I would look at websites to determine who creates natural results. You can have a more refined nose that is
natural in appearance with a rhinoplasty. I perform these surgeries
with closed technique
to preserve the structure of the nose and minimize visible scarring.
Kenneth Hughes, MD
Los Angeles, CA
A rhinoplasty with some defatting of the fibrofatty pad of the nasal tip with the use of cartilage grafts to achieve some degree of definition would get you the result you want.
The short answer to your question is "yes". Tip definition can be improved even in patients with relatively thick skin. There are techniques that can be done to improve tip definition in patients with thick skin, such as cartilage grafting and thinning of the skin and soft tissue envelope of the nose. I would recommend keeping in mind that if the nasal tip is too well-defined in a patient with thick skin, the nose may appear unnatural and operated – upon. You should consult with a rhinoplasty surgeon experienced in noses like yours. Regarding your question about what specific techniques would be used, this will vary depending on your physical exam findings and the nasal cartilage and bone anatomy found during surgery. Consultation with a board – certified facial plastic surgeon or plastic surgeon would be informative.
For 35 years I have done ethnic rhinoplasty with "your theory" less is more and better nose not an operated looking one. Your goals are achievable and choose an experienced rhinoplasty surgeon who does noses u like. To get definition from thinning the subcutaneous tissue and cartilage BUT you have to add septal cartilage to get the definition of the tip.
To narrow a wide nose, there are multiple procedures that can be performed during the rhinoplasty procedure. Suture techniques applied to the tip cartilages can narrow and refine them. Osteotomies of the nasal bones are required to narrow the wide bridge line. Adding a cartilage graft to the top of the bridge will increase height and will also help as well. An alar-plasty is performed when patient have wide nostrils. Thick skin will be an impediment to seeing A very refined result in the tip. For many examples, please see the link below
Your tip would be smaller with a dome delivery, cephalic trims and suturing of the domes together. You might benefit from small alar base reductions that would bring the base of the nostrils in a little. Adding a little height to the dorsum would make the tip look more balanced as well. This could all be done closed.