Rhinoplasty for a bulbous nose reshapes the tip cartilages so the tip looks narrower and more defined. Results depend on skin thickness: thin skin shows change early, while thick skin hides detail and holds swelling for a year or more. Wide, humped, crooked and droopy noses each need different steps, so the plan starts with your nose type.
This guide is part of our rhinoplasty overview. According to the American Society of Plastic Surgeons (ASPS, US), rhinoplasty can address a tip that is enlarged, bulbous, drooping, upturned or hooked, a wide bridge, humps and depressions in the profile, wide nostrils and asymmetry. Here’s how each one is usually approached.
Rhinoplasty bulbous nose and tip refinement
A bulbous tip comes from wide or rounded cartilages, thick skin or both; tip refinement reshapes the cartilage with sutures, trimming or grafts.
Round, wide lower lateral cartilages make the tip look ball-shaped. The surgeon can trim the upper edge of these cartilages, stitch them closer together and add small grafts so the tip holds its new shape. Removing too much cartilage is a known cause of later problems: in a 2017 systematic review, the tip was the site of 22.5% of revision operations.
Nose job before and after bulbous tip photos often look less dramatic than hump reductions, especially early on. Tip definition is the last thing to appear, because tip swelling lasts longest.
Bulbous nose job before and after thick skin
Thick skin sets a limit on how sharp a tip can look. The cartilage can be refined, but the skin won’t shrink tightly over it. An ASPS patient article notes that thick, oily skin is one of the factors that lengthens healing, and final results can take one to two years. A 2016 randomized trial in JAMA Facial Plastic Surgery found that taping for two to four weeks after splint removal reduced swelling in thick-skinned noses. For African-descent noses, a 2021 review in Facial Plastic Surgery Clinics of North America notes that oral isotretinoin and steroid injections may help tip definition, under medical supervision.
Wide nose and wide bridge
A wide nose is narrowed by repositioning the nasal bones for the bridge and, if needed, reducing the nostril base through small cuts in the nostril creases.
A nose job on a wide nose often combines two steps. The bones of the upper nose are cut and moved inward (osteotomies) to narrow a wide bridge. If the nostrils flare, the surgeon removes small wedges of skin at the base. ASPS (US) notes that extra incisions in the nostril creases are used to change nostril size.
Those base scars usually heal well, but not always. In a review of 124 patients by Kridel and Castellano (Archives of Facial Plastic Surgery, 2005), 25% needed dermabrasion to smooth the scar in the groove beside the nostril. Patients should know these scars can be visible.
Dorsal hump
A dorsal hump is reduced by shaving or removing bone and cartilage from the bridge, then narrowing the bones so the top of the nose stays even.
Rhinoplasty dorsal hump reduction gives some of the most visible changes in profile. People often describe a Roman nose (a high, curved bridge) or a Greek nose (a straight line from forehead to tip). A 2016 study in Facial Plastic Surgery found observers preferred an angle between the forehead and nose of about 130 degrees and rated hump-like profiles least attractive. Lowering a hump moves the profile toward that range.
Over-reduction is the main risk. Taking too much off the bridge can leave a scooped look or narrow the airway. At consultation, the first thing I look at with a hump is how it relates to the tip and chin. Sometimes lowering the hump less and supporting the tip more gives a better balance.
Crooked nose
A crooked nose usually needs the septum straightened and the bones repositioned; full symmetry isn’t realistic, but a straighter nose is.
Rhinoplasty for a crooked nose often treats breathing at the same time. ASPS (US) explains that a deviated septum can be straightened to improve airflow. The bones may also be moved back to the midline. Cartilage has memory, so a crooked nose can drift slightly after surgery. ASPS notes that every face has some asymmetry, so a fully straight nose may not be possible.
If breathing is part of the problem, insurance may cover that part of the surgery, according to ASPS, after an examination and prior approval.
Thick skin rhinoplasty
Thick skin rhinoplasty needs strong cartilage support and patience; swelling lasts longer and fine tip detail is harder to show.
Rhinoplasty on thick skin tends to go better when the surgeon builds up support instead of removing a lot of cartilage. A strong framework pushes against the heavy skin so the shape shows through. Grafts are often used. For a thick nose, recovery is slower: the ASPS article lists thicker, more oily skin, cartilage grafts and extensive dissection as factors that extend healing.
- Expect the tip to look full for months.
- Taping may help; a 2016 trial found benefit only in thick skin.
- Final definition can take up to two years.
Droopy, long, flat and upturned noses
A droopy or long nose is lifted and shortened; a flat nose is built up with grafts; an upturned or button nose needs the tip lengthened or brought down.
| Nose type | Usual approach | What to watch for |
|---|---|---|
| Droopy tip | Tip rotated upward with sutures or a support graft | Over-rotation can look pinched or turned up |
| Long nose | Shortening the septum and tip cartilages | Balance with the upper lip |
| Flat nose | Bridge built up with cartilage grafts or implants | Implant complications such as deviation or extrusion |
| Upturned or button nose | Tip lengthened and rotated down with grafts | Often needs septal or rib cartilage |
| Big or large nose | Overall reduction of bridge, tip and base | Too much reduction can affect breathing |
Rhinoplasty on a flat nose is common in East Asian patients. A 2019 review in Plastic and Aesthetic Research found that 63% of 52 revision cases in Asian patients were related to synthetic implants, most often deviation, extrusion, infection or foreign body reaction. Our ethnic rhinoplasty guide and before and after guide show how results differ.
Frequently Asked Questions
FAQ
Short answers on bulbous tips, wide noses, thick skin, small noses and choosing a shape that suits a round face.
Can rhinoplasty fix a bulbous nose with thick skin?
It can improve it, but less sharply than with thin skin. The surgeon refines and supports the tip cartilages, while thick skin limits how much detail shows. Expect slow change over one to two years. Taping after surgery may reduce swelling in thick-skinned noses.
What do rhinoplasty before after wide nose photos usually show?
They usually show a narrower bridge from the front and smaller nostrils if the base was reduced. The change is often subtler than a hump reduction. Ask to see photos at about a year and check the scars beside the nostrils, which can sometimes be visible.
Can a small nose be made smaller?
Sometimes, but reducing an already small nose risks breathing problems and an over-operated look. Often a small change to the tip or bridge, or balancing the chin, does more. A surgeon should check the airway before removing any further support.
What nose shape suits a round face?
There’s no single shape. A straight, well-supported bridge and a tip in proportion with the face often look balanced on a round face, but skin, ethnicity and personal taste matter. Bring photos as a starting point, not a template.
Will my upturned nose drop after rhinoplasty?
An upturned look right after surgery is often caused by swelling and tape and settles over weeks to months. If a nose was over-rotated by the surgery itself, it usually needs grafts to lengthen it, which is a revision procedure.
If you’d like your nose type assessed in person, you can book a consultation with Metropole Clinic by ABmedi. You can also return to the rhinoplasty hub to compare techniques and costs.
This article is for general education and does not replace a personal medical consultation.
References
Show sources
- Rhinoplasty (overview, procedure, cost). American Society of Plastic Surgeons (ASPS, US). Accessed 2026. plasticsurgery.org
- What to expect from your rhinoplasty recovery. American Society of Plastic Surgeons (ASPS, US). 2022. plasticsurgery.org
- Crosara PFTB, et al. Rhinoplasty Complications and Reoperations: Systematic Review. Int Arch Otorhinolaryngol. 2017;21(1):97-101. scielo.br
- Ozucer B, et al. Effect of Postrhinoplasty Taping on Postoperative Edema and Nasal Draping: A Randomized Clinical Trial. JAMA Facial Plast Surg. 2016;18(3):157-163. journals.sagepub.com
- Kridel RWH, Castellano RD. A Simplified Approach to Alar Base Reduction: A Review of 124 Patients Over 20 Years. Arch Facial Plast Surg. 2005;7(2):81-93. journals.sagepub.com
- Naini FB, et al. Nasofrontal Angle and Nasal Dorsal Aesthetics. Facial Plast Surg. 2016;32(4):444-451. kingston.ac.uk
- Patrocinio LG, et al. Approach for Rhinoplasty in African Descendants. Facial Plast Surg Clin North Am. 2021;29(4):575-588. em-consulte.com
- Won TB, Jin HR. Revision rhinoplasty using autologous rib cartilage in Asians. Plast Aesthet Res. 2019;6:6. oaepublish.com
