The surgical exercise is the same for the African-American Rhinoplasty as it would be for any other rhinoplasty. Often, however, the flat, thick tip requires more attention. Ethnic procedures during surgery that might be employed are grafting a piece of cartilage taken from the nasal interior such that the tip will be stronger and less flat and receding. Also, fat may have to be removed from the tip and that is done by withdrawing cartilage, via internal incisions, from the nose, “ working on the tip cartilage, including shaving off the fat and trimming excess cartilage and then returning the reshaped cartilages back into their natural bed within the nose.