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Big Nose, Thick Skin, Bulbous Tip...any Hope?

asked 9 months ago by Jersey Gina in Central New Jersey
Latest answer by William Portuese, MD
Question viewed 497 times
Tags: big nose, bulbous, options, thick skin

I've already made my consulation appointments, which has inspired my father to do the same. He was once told, years ago, that he has the most "meaty" nose the surgeon had ever seen. That comment left him discouraged and down. Is there anything that can be done with his nose? He has a very bulbous tip with what appears to be thick skin (with a large nose in general.) Is there anything that can be done for him?

8 answers to Big Nose, Thick Skin, Bulbous Tip...any Hope?

+2

Thick nose

This is a very challenging nose as it's shape is effected by thick soft tissue and not prominent cartilage. It can be improved however. Contemporary rhinoplasty techniques would lower the profile, raise the tip and add structure to develop more shape. Realistic expectations are a must though.
Michael L. Schwartz, MD

West Palm Beach Plastic Surgeon

www.palmbeachface.com

+2

Not an easy nose

But it can be improved. He would need to have reasonable expectations and not expect a miracle. The skin is not as pliable as a younger individual.
William B. Rosenblatt, MD

New York Plastic Surgeon
+2

The position of the tip cartilags deterines tip shape

Your father has an anatomical variation of his tip cartilages--they do not parallel the nostril rims but run up toward the inner corner of the eye. This normal variation is present in 50% of the population, according to my research. Sheen described the variation in 1978 and I have also written about it. These cartilages need to be repositioned and the tip restructured. The skin, which is heavy, is the other half of the problem. His nose cannot be reduced because the... more
Mark B. Constantian, MD

Nashua Plastic Surgeon
+2

Bulbous tip

Hi, The reason the tip looks bulbous is because the cartilage under the skin is very bulky. This is one of the easiest bulbous tips to fix with a rhinoplasty. It only requires reshaping of the tip cartilages. The skin is not that thick and will conform to the new cartilage shape. Best, Dr.S.
Oleh Slupchynskyj, MD

New York Facial Plastic Surgeon

www.facechange.org

+2

Droopy nose

Honestly? I think he's got a tough nose to get a great result. The main reasons are because of his age and thick skin it is going to be very hard get the tip up and get it to stay there. The problem is the thick skin above the tip. The tip shape itself is due to the cartilage which can be improved without too much difficulty. It may actually take "thinking outside the box" from an experienced rhinoplasty surgeon to be able to help him in one operation. One thought I have would... more
Ronald Schuster, MD

Baltimore Plastic Surgeon
+1

Improving a big bulbous nose with thick skin

It is important to note that while indeed the nose is very wide, beefy and bulbous, there are some improvements that can be made to the nose if the patient has realistic expectations. The tip cartilages can be appropriately narrowed, adjusted, and trimmed; sometimes the tip cartilage is sewn together as part of a tip plasty operation. Further refinement of the midthird of the nose can be performed to narrow and refine it to further balance the nose. The nose can also be... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Big Nose, Thick Skin, Bulbous Tip...any Hope?

I have performed Rhinoplasty for over 20 years and IMHO, minimal change would occur even after a very aggressive open Rhinoplasty. The tip can be thinned, excess subcutaneous tissue taken but the excess skin and over-active sebaceous glands will still hide the smaleer nasal structures below. This would require a resurfacing laser to thin the skin externally at 1 year after the open Rhinoplasty. Bottom line, if your Dad hates the nose, go for it but with reasonable and... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Bulbous nose can be improved.

There are 2 issues- the thick skin on hte tip and the bulbous nose. The thick skin can be improved slightly with a properly used fractionated CO2 laser. The nasal tip cartilage can be treated with an open rhinoplasty. Therein, the tip will need to be elevated with a carefully sewn-in graft (your dad's nasal tip is heavy) and carefully sculpted lower lateral cartilages that also need to be properly suspended. This is not an easy nose for the... more
David Alessi, MD

Beverly Hills Facial Plastic Surgeon

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