Hi Mr. R, traditional rhinoplasty techniques used by most surgeon’s leave the nose looking pinched, turned up and in poor overall harmony with the patients face. This makes the nose looked “done.” The shape of the African American (AA) nose comes from 1) the shape of the bone and cartilage under the skin and 2) the skin and soft tissue that drapes over the bone/cartilage. The rhinoplasty will change the shape of the bone/cartilage as it redrapes the skin over the new frame to get the desired result. However, in the AA nose, this framework is usually not supportive due to the small/flat nasal bones and weak/floppy cartilage. With the skin and soft tissue being relatively thick and rigid, it will not reflect the changes made to the bone and cartilage beneath, very well. These peculiarities make it crucial that you find a surgeon that has a deep understanding of the aesthetics of the AA nose. Special techniques designed for the AA patient must be applied skilfully to achieve excellent results. A customized plan based on the surgeons understanding of the unique structure of the AA nose and the individual patient’s desires both have to be taken into consideration.