This photo of an African-American woman who desired subtle but distinct change in her appearance. She underwent bridge elevation to make the tip appear smaller and she also had her nasal tip refined by narrowing the tip and removing extra cartilage. What she did not have done was what is called an alar-base reduction. The reason for this is that an alar-base reduction leads to prolonged recovery and potential visible scarring and is avoided if at all possible. But the real reason behind a selective avoidance of traditional alar base reduction is the effacement of ethnicity, where the individual does not appear natural because they do not look African-American. In my opinion this is the most glaring problem with most African-American rhinoplasty procedures is the removal of a natural appearance through alar-base reduction. However, for very broad bases that are unattractive, I prefer in most cases to perform what is known as a nasal sill reduction that narrows the width of the nostril but does not take away the shape of the nose or radically alter identity. Watch her rhinoplasty video testimonial.