Often characterized by a low flat bridge and thick skin with a wide tip and a wide base, African-American rhinoplasty presents a few major challenge.
First, how to increase project of the tip in order to narrow it. Simply removing some of the tip cartilage, as many plastic surgeons do, will only make a somewhat smaller, but still wide tip.
We want to push the tip forward, which will make it more angular, increasing the projection. This results in a slimmer, more refined appearance with nicer angle views.
The bridge can then be smoothened or gently built up to match the new tip projection and give a nice slope to the profile.
Patients often ask about narrowing the base of the nose (alar wedge or alar base reduction). Most of the time, I discourage patients from this. It is often not necessary for an excellent result and the downside is permanent scarring externally.
However, in very wide noses of any ethnicity, we may opt for this technique in order to bring the base of the nose into harmony with the more refined tip.