Rhinoplasty for patients with thick skin

Patients who have thick nasal skin can have rhinoplasty to improve the shape of their nose.  However, there are limitations.  The way a rhinoplasty is performed is that the skin is raised off the bony-cartilaginous framework of the nose and the framework is reshaped to give the desired external nasal appearance.  However, for the nose to look good, the skin needs to fit tightly around the newly shaped framework.  Because thick skin has flexibility and elasticity as thinner skin, it will not drape as well or fit as tight.  Therefore, it is more difficult to get as much sculpting or decrease in size as can be done with thinner skin noses.  The type of thick skin nose that can be helped the most is one with a wide tip and decreased tip projection.  By increasing the tip projection, tension is placed on the very tip causing it to get thinner and the flared side walls tend to straighten.  Also, some of the bulk of the fat side walls (where the walls meet the cheeks) can be removed by taking out  a wedge of tissue in that area and hiding the scar in the nose-cheek crease.  This will make the nose look narrower and less bulky.

Hi,

Thinning the nasal tip skin is a relative misnomer.  To safely reduce the thickness of the soft tissue overlying the nasal tip cartilage, conservative reduction of the fat and glandular tissue deep to the skin can be performed.  Reducing the undersurface of the skin itself has significant risk associated it ; in particular, nasal tip skin death (necrosis).

Best of luck.  Hope this helps.

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