Will An African-American Rhinoplasty Look Natural?

Q: Dr. Eppley, Is it possible to thin out my large African-American nose, add a defined bridge and still look “natural”? How long does surgery take and how long is recovery?

A: Thank you for your inquiry and sending your pictures. The African-American rhinoplasty is unique  because of the very thick overlying skin and lack of a strong bone or cartilage framework underneath it. You are correct in your description of how to approach the broader and flatter nasal structure by dorsal augmentation (usually with an implant), increasing tip projection with definition with columellar strut and tip cartilage grafts and nostril narrowing. I have done some computer imaging to show some of the potential outcomes with are highly controlled by the thickness of the overlying skin and how well it can contract down over a new supporting framework. The first  imaging prediction is based on the least amount of change (thinning) that can occur while the second imaging prediction is based on what I believe to be the maximum change that can occur in a single rhinoplasty procedure. You did not provide a side view image so how that would be affected will require a profile picture. I will let the images speak to your assessment of whether such a result would be natural in appearance.

This typical African-American rhinoplasty usually takes about 2 1/2 hours to perform under general anesthesia as an outpatient procedure. Since internal breathing work does not need to be done (I am assuming) nor do nasal osteotomies or a rib graft harvest (since an implant would be used), there should be minimal pain afterward and no bruising. Recovery is more about how you look having to wear external nasal tapes and a splint for a week after surgery. Once that comes off there are no physical restrictions and one’s appearance should be socially acceptable. While the final results of a rhinoplasty can take six months to fully appreciate (maximal skin contraction and thinning), one should be reasonably comfortable returning to work and socializing again in 10 to 14 days.

Dr. Barry Eppley

Indianapolis, Indiana