I’m African American and I had a nose job 3 years ago to narrow my tip and make my nostrils less flared. I initially like my results but now I feel like the tip has become bulbous. What would make this happen after so many years and what can be done to fix it?

One potential cause for bulbous appearance of the nose is the development of scar tissue at the nasal tip. This does not occur right away, but rather may develop over time. Sometimes injection of steroid may be of benefit. You may wish to consider consulting with your original surgeon. When I see patients for revision rhinoplasty with similar concern as you, we may consider a revision procedure to remove scar tissue, if present. As well, I may use a variety of techniques to effectively minimize the appearance of bulbous nasal tip, such as suture techniques, and/or placement of cartilage in specific areas to refine the appearance of bulbous nasal tip, such as lateral crural strut grafts. Finally, you may have thick nasal skin, which may be a challenge when attempting to achieve refinement in the nasal tip.