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Rhinoplasty and Excess Skin

I just wonder, how can you make a big nose smaller and there's not noticable excess skin?

Doctor Answers (16)

Skin can shrink in reduction rhinoplasty, but there's a limit to how much

+3

Whether or not the skin will shrink enough to conform cleanly onto the skeleton of the nose depends on two main factors:

1. How much reduction was performed.

2. How thick the skin envelope is.

Thick skin tends to contract less. This is why we see the polybeak deformity more often in thick skin patients (polybeak refers to a complication in which the skin fails to shrink down to the bridge of the nose and a resultant fullness ensues along the bridge, most apparant on profile). But even in patients with relatively thin skin, there is a limit in how far the skin can contract. Thus, is someone with thinner skin, a massive reduction in the size of the nasal skeleton may lead to poor draping and a polybeak or other complication.


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Rhinoplasty and Excess Skin

+2

In most, if not all, cases the skin shrinks to the new size of the nose. It is not standard to excise (remove) skin during rhinoplasty. Just the act of lifting the skin off of the underlying structures to perform the surgery induces a reaction in the skin. This creates more collagen production which contracts as the tissues are healing. Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

The skin on the nose shrinks to the underlying cartilage and bone after rhinoplasty

+2

Despite popular belief, if you have a big nose and the nose is made smaller by shaving the cartilage and bone the skin will not sag, it shrinks to fit the underlying skeleton. That is the standard answer. In reality thick skin shrinks a little less than thin skin so the skin won't get baggy or droop, but you might see less refinement than would occur with thin skin.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

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The skin shrinks after rhinoplasty even in big noses

+2

The STSE known as the skin soft tissue envelope shrinks to conform to the underlying altered architecture of the cartilages and the bones after rhinoplasty. However, there are a few exceptions and therefore follow-up with your surgeon is necessary afterwards. If you have thick skin, sometimes scar tissue can build up especially in the tip region that may require treatment during the healing process.

Also, if you are over 65, sometimes the skin doesn't completely shrink to fit the nose and you may be left with some wrinkles. Other than that, the excess skin conforms to the bone and cartilages over a relatively short time period. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Skin does shrink after rhinoplasty

+1

In most instances the skin shrinks after reduction of the cartilage and bone during rhinoplasty.  The thicker the skin is the less the amount of reduction which is why thick skinned noses should not be dramatically reduced in size.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 145 reviews

Excess skin after Rhinoplasty

+1

Skin, even when thick, will shrink after reducing the size of a large nose with two exceptions. A rhinoplasty surgeon must be careful in reducing tip size because this skin does not retract well. The excess skin at the base of the nose is excised when narrowing the nasal base.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Rhinoplasty and excess skin

+1

Hello,

The nose will conform due to shrink wrappage of the skin around the new nasal skeleton. Excess skin will not be noticeable. Hope this helps answer your question. Thank you and best of luck to you.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Skin shrinkage after rhinoplasty

+1

Fortunately, there is enough elasticity in the nasal skin such that even after removal of a large hump, the skin will contract to its new shape. This can sometimes take many months, especially in thicker skin. I have never had to excise skin from the nose for this reason.

Best, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Excess skin is usually not problematic after Rhinoplasty Surgery.

+1

I recently had a patient ask the identical question. Your nose skin will redrape after Rhinoplasty Surgery, even if you have your nose made smaller. I have not had reason to excise excess skin in any of my Rhinoplasty patients.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 287 reviews

The skin shrinks after rhinoplasty.

+1

 The thicker the skin the less effect the shrinkage has. In most noses the excess skin shrinks and does not require any additional treatment such as excision, even in large noses.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.