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Bulbous nose


The characteristics of the nose of oriental people are different from those of the Westerners. It is mainly because soft tissues of oriental people's skin are thicker, while the nasal bone nasal cartilages are weaker. Such difference has caused some special nasal shapes that only belong to oriental people such as the bulbous nose and upturned nose. What I am about to discuss here is the treatment of bulbous nose.

Before introducing the treatment for bulbous nose, I would hereby briefly explain the structure of the nose. The shape of the nose is created by the nasal bone and nasal cartilages, which means that the skin and soft tissues are supported by the nasal bone and nasal cartilages. The shape of the nose, in addition to the thickness of the subcutaneous tissues, is mostly impacted by the nasal bone and nasal cartilages. The nasal bone is a triangular cone shaped bone located between the two eyes and the nose. The nasal cartilages can be divided into nasal septal cartilages, nasal cartilages and alar cartilage. (see figure)


  

The purple object is the nasal cartilage, the blue object is the nasal septum, and the green object is caused by the alar cartilage contraction.


The bulbous nose is caused by the proliferation of nasal cartilage and the nasal cartilages having overly great angle and contraction. There are less cases of proliferation of nasal cartilage for oriental people, while the angles between the alar cartilages being too large and the angle of outside alar being too small are more common.

5 Steps to Reduce the Nose Tip


Among the patients who consulted our surgeons for rhinoplasty, the most common complaint is that their noses were too flat, while the nose tip being too big ranks second. It is easy to solve the flat nose problem, but if the nose tip is too big, the issue will be more complicated.


In terms of surgical technique, to reduce the nose tip, there are five necessary steps to be taken:


        
  1. Treatment of alar cartilage
        The alar cartilage should be partially removed, and the alar cartilages on two side should be sutured to solve the problem of nose tip being too large due to the overly-large angle of the alar cartilages.
  2.     
  3. Removal of soft tissues of nose
        In some cases, having too many nose tip soft tissues also result the big nose tip. These people often don't have very large alar cartilages, and in such cases, it is very important to remove the nose tip soft tissues to reduce the nose tip.
  4.     
  5. Extension of the nasal septum
        After the above steps are completed, the surgeon should extend the nasal septum next. Pad the nose tip with removed alar cartilages and soft tissues of the collapsed nose tip, so the nose tip will be prominent and pointed.
  6.     
  7. Nose tip reconstruction
        After removing the alar cartilages, trimming the nose tip soft tissues, and extending the nasal septum, it is very important to reconstruct the nose tip with autologous cartilages. Usually we use the so-called CAP and SHIELD to achieve the purpose of the nose tip sculpturing.
  8.     
  9. Skin removal
        In some cases where the nose tip is both too large and sagging, removing some skins on the inside of the nose can also reduce the nose tip. It is kind of like altering a dress can highlight the curve of our bodies. Although the nose skin of oriental people is thicker than that of the Westerners' and cannot be sculptured into angular nose tips, proper adjustment of the alar cartilage can significantly reduce the volume of the nose tip and correct the bulbous nose. With some assistive surgeries such as nasal dorsum augmentation surgery or nose tip cartilage transplantation surgery, the surgeons can sculpture noses that fit the oriental faces.


The above is purely a case description, and the actual situation will vary from person to person.

Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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