Asian Rhinoplasty and Rhinoplasty for the Thick Skin Patient: My Approach to Natural, Structural, Harmonized Results

Rhinoplasty is not a one-size-fits-all procedure. Every nose has its own anatomy, heritage, proportions, and structural characteristics. When I perform rhinoplasty on patients of diverse backgrounds — whether Middle Eastern, Persian, Armenian, Hispanic/Latina, African American, or East/Southeast Asian — my goal is always the same: NATURAL AND FITTING FOR THE FACE

Enhance, not erase.
Refine, not homogenize.
Elevate features without losing identity.

But, most important is understanding that some patients will need augmentation not reduction (tip projection and or bridge height increases)

Because I use a modern structural approach, I’m able to fine-tune shape, definition, support, and breathing in a way that holds up long-term across all skin types and cartilage strengths.

Here’s how I think about ethnic and Asian rhinoplasty in a clear, honest, and comprehensive way.

Understanding the Key Differences in Ethnic and Asian Anatomy

Every patient is unique, but there are some anatomical nuances we must appreciate in this broad category (not everyone of Asian descent fall into this of course):

1. Thicker skin

Many ethnic and Asian noses have thicker skin, especially over the tip.
This affects:

  • definition

  • light reflex

  • swelling

  • healing pattern

2. Weaker or softer cartilage

The lower lateral cartilages may be more flexible or less robust.

This means:

  • more need for structural support

  • need for close follow up after surgery to modulate and maintain results

3. Lower dorsum or flatter bridge

Some patients naturally have:

  • a lower profile

  • wider midvault

  • less dorsal height

  • so these patient need augmentation

4. Wider or less defined tip

Often due to soft tissue thickness and weaker cartilage.

5. Unique ethnic aesthetic preferences

Not every patient wants a “Westernized” look — most simply want refinement, balance, and harmony while preserving identity.

The key is understanding what you want and respecting what makes your face yours.

My Core Philosophy: Structure, Support, and Harmony

Ethnic and Asian rhinoplasty is not about making the nose smaller — it’s about creating balanced refinement that fits the face.

I use the same structural principles I use in all cases, but with modifications tailored to this anatomy.

1. Strong tip support is essential

Because the tip cartilage may be softer or weaker, I rely on:

  • septal extension grafts (SEG)

  • precise tip sutures

  • structural reinforcement

This creates definition and prevents long-term drooping.

2. Building the bridge (when needed)

For patients who want a higher dorsum or more definition, I use:

  • Structural techniques to augment the bridge. Which technique depends on how much height is necessary.

I avoid synthetic implants in all cases.

3. Refining the tip — without over-reduction

With thicker skin, removing cartilage does not create definition — it creates weakness.

So instead:

  • I reshape

  • I suture

  • I support

  • I project the tip appropriately

4. Narrowing the nose appropriately

Nasal width should be narrowed in harmony with the face — not overly pinched.

Avoiding a "Westernized" Appearance

One of the biggest fears among patients is losing their identity.

The goal is refinement, not replacement.

I avoid:

  • overly narrow dorsum

  • overly rotated tip

  • pinched nostrils

  • aggressive cephalic trim

  • excessive projection

Instead, I focus on:

  • soft, natural definition

  • balanced projection

  • light reflex that looks real, not artificial

  • smooth lines that complement your heritage

A good result should make you look like you — just more refined and confident.

My Surgical Approach Step-by-Step

1. Septal Extension Graft

Provides long-term support and control over projection and rotation.

2. Minimal cartilage removal

Preservation > reduction.

3. Cartilage grafting when needed

To support, define, or build structure.

4. Component dorsal modification

Allows precise control over the dorsum without destabilizing the bridge.

5. Piezo / ultrasonic bone work

Creates smooth, controlled contours when narrowing or adjusting bone.

6. Tip definition with sutures

Gentle definition even under thicker skin.

7. Nostril and alar base modification (when appropriate)

Performed conservatively to maintain natural proportions.

Common Goals in Ethnic and Asian Rhinoplasty

Patients often want:

✔ A higher, more defined bridge
✔ A more projected and refined tip
✔ Narrowing of the nose in a natural way
✔ Better symmetry
✔ Maintaining their ethnic identity
✔ A nose that fits their face, not someone else’s

My job is to translate those goals into a stable, long-lasting structure.

Results That Respect Identity

The best rhinoplasty is one that friends and family see as:

“You look great — did you do your hair?”
“You look refreshed.”
“You look like yourself.”

Not:

“You got a new nose.”

That’s the level of subtlety and harmony I aim for.

Interested in ethnic or Asian rhinoplasty? Click here to book a consultation with Dr. Hyman.

asian rhinoplasty, ethnic rhinoplasty, thick skin rhinoplastyARI HYMANethnic rhinoplasty, asian rhinoplasty, dorsal augmentation, nose refinement, dr ari hyman, structural rhinoplasty, rhinoplasty los angeles