Q: Dr. Eppley, I am interested in rhinoplasty surgery. Is it possible to to do nostril narrowing making my nostrils smaller and the tip of my bulbous nose smaller, what would you suggest ? I want a thinner and more defined nose altogether.
A: Your rhinoplasty questions are good ones and are fairly common in ethnic African-American rhinoplasty. What you have is a nose that has little underlying cartilage support with thick overlying skin. This is why it is wide, short and ‘turned up’ so to speak. It simply lacks much underlying support to hold the skin up. While it is tempting to think that just thinning out the cartilages on the nasal tip, defatting it and then narrowing the nostrils will create the desired effect, it will not. In fact, such an approach may likely end up making it look worse. What you need is an augmentative rhinoplasty (not a reductive one) that builds up the bridge of the nose and tip and pulls the skin upward (and somewhat downward at the tip or derotation) to create a thinner and more defined looking nose. If the nose is augmented then narrowing the nostrils will be more effective. I have attached some imaging of your nose to demonstrate that effect. How to achieve the augmentation is a classic debate between a rib graft or an implant.
Dr. Barry Eppley