Bulbous nasal tips in East Asian patients are often caused by thick skin and soft tissue hypertrophy, presenting challenges in rhinoplasty. This study evaluates the efficacy and safety of supratip excision combined with cartilage reshaping to address nasal tip hypertrophy and minimize scarring.

A retrospective analysis was performed on patients who underwent bulbous nasal tip correction from January 2021 to October 2023. The surgical approach involved midline elliptical supratip excision, cartilage grafting (from septum, rib, or ear), and lateral crural adjustments. Outcomes were assessed using anthropometric measurements (nasal length, tip projection [NTP], nasolabial angle [NLA]), the Rhinoplasty Outcome Evaluation (ROE) score, and the Patient and Observer Scar Assessment Scale (POSAS).

Thirteen East Asian patients (mean age: 29.23 years) met the inclusion criteria. Postoperative results showed a 20 % reduction in nasal length (7.29 cm to 5.83 cm, p < 0.001), 8.3 % increase in NTP (18.98 mm to 20.56 mm, p < 0.001), and 7.2° improvement in NLA (82.59° to 88.64°, p < 0.001). ROE scores improved significantly (p < 0.001). Scar satisfaction was 96.16 %, with minimal irregularities noted in 15.38 % of cases.

Supratip excision effectively corrects bulbous nasal tips in East Asian patients, resulting in refined nasal contours and high patient satisfaction. Careful patient selection and scar management are paramount to ensure the success of the procedure. Further studies with larger cohorts are needed to confirm long-term outcomes.