For many of our African American patients there is some real confusion as to what rhinoplasty can accomplish. The problem is that after having seen a number of different surgeons for consultation they are repeatedly told that in order to accomplish any “real” change they need to have the bridge of their nose built up.
The problem is that for most of you, it is not the profile view that has ever bothered you- it’s how wide your nose looks on front view that made you feel like your nose does not quite fit.
Unfortunately, many surgeons are not comfortable in dealing with the excessive width of the tip and nostrils and will instead focus on building up the bridge to make it look narrower. Again, while this treats part of the problem it does not address the tip and as a result your nose can still feel excessively wide. Moreover, because the surgeon often uses your septal cartilage in order to build the bridge it makes revision of the tip much more difficult.
In our experience, traditional reduction rhinoplasty generally does not work very well for African American patients. The reasons for this have been addressed in previous blogs on the topic, but suffice it to say that in most African American patients there is a layer of fibrofatty tissue that underlies the skin that covers the tip and makes the tip excessively wide and undefined. In order to create more tip definition and make it look more refined, this fibrofatty tissue often has to be dealt with during surgery and at least partially removed so that the skin can then contract down to the cartilage.
When we then couple this with suture techniques to help refine the tip and do alar base surgery (nostril narrowing) that addresses both the flare of the nostril as well as the width of the nostril (sill width) you can really tailor the procedure to address your goals in a very natural way. By combining all of this we have found that our patients are able to address the excessive width of the their nose and end up with a nose that is natural and stable so that they no longer have to think about their nose any more.