Our aim was to evaluate the use of open rhinoplasty for cosmesis on African-American noses. Thirty African-American patients with Fitzpatrick skin type V or VI and typical African-American noses who had had open rhinoplasty between January 1997 and November 2000, and at least 3-years' follow-up were selected and their casenotes examined retrospectively. Patients' evaluations were recorded at all consultations and the data was recorded on standard protocols together with objective measurements including wound healing and complications. All patients thought that the definition and projection of the tip was successful and 27 of the under projected tips were improved. Two had a persistently slightly wider interalar distance than they wanted. In one the nostrils were asymmetrical. The nasal dorsum was improved in all patients, with no complaints of under or over correction. Revision was necessary in one patient who complained of mobility of the silicone rubber (Silastic) implant that had been placed over the anterior nasal spine. Only one patient was unsatisfied on the subjective evaluation. Columellar scarring was noticed only by the staff, and there were no signs of keloid and hypopigmentation, or hyperpigmentation. Postoperatively, there were two synechiae and one haemorrhage. Open rhinoplasty using the transcolumellar external incision for aesthetic correction of African-American noses gives satisfactory results with few complications.