Usually, in Caucasian and African American patients, the goal is to make the nose smaller and more refined. During the procedure typically Dr. Smith will trim the nasal cartilage and suture it together to narrow and refine the tip. The surgeon may also rasp down the dorsum to remove a nasal hump. Men usually prefer the nasal dorsum to be straight and women usually like a small scoop to the nose. Dr. Smith will chisel down the nasal bones carefully with a small chisel from the inside of the nose and then push inward to narrow the nose (if the nose needs to be narrowed.)
Asian or Filipino patients often want larger noses, so the rhinoplasty procedure in these patients is completely different from a Caucasian patient. In these patients, Dr. Smith will usually build up the nose with cartilage taken from the nasal septum.