Revision Rhinoplasty and skin thickening

Raffy Karamanoukian, MD answers: Why does the skin thicken after rhinoplasty surgery?

I have had 3 rhinoplastys due to a couple of errors, and now the middle part (the skin) of my nose has thickened. It doesn't look natural because my tip is thin and the above part of my nose is thick.

My last operation I had the skin thinned, but it didn't really help. Why has this happened? And what are my options? Is cortisone therapy an option? Thank you for reading this. Please help!

Raffy Karamanoukian, MD
10 months ago

It is most likely that the thickening of the skin on the nasal bridge and dorsum is due to deposition of collagen, or scar, along the nasal dorsum and cartilage. This may affect skin aesthetics and texture. Speak to your surgeon as they may be able to use a special injection to soften the scar tissue.

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A: Most likely scar tissue and skin type

Michael A. Persky, MD
17 months ago

Hi Ms Smith,

Sorry to hear about your unsatisfactory rhinoplasty results. It is difficult to answer your question without before and after pictures of your nose.

Thick, oily nasal skin is difficult to work with. With this type of skin, if too much cartilage and bone are removed, the nose may lose definition, and the skin may appear to thicken. In some patients there is scar tissue formation after nasal surgery that may take months to years to resolve.

Steroid (Kenalog) injections may help a little, but one must be careful to avoid atrophy of the skin (too much shrinkage). It is best to discuss your concerns with your surgeon, or see another revision rhinoplasty specialist. As you probably have been told, it does get more difficult to achieve excellent results with each additional nasal surgery. Good luck and be well.

Dr. P

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