Rhinoplasty: Q&A

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Rhinoplasty for Sebaceous Nose?

I am 50 with very oily skin since 13, worsening with time. I must wash my face approximately every 30 minutes; especially the nose and forehead. I've never seen a worse case.

I would like to have a Rhinoplasty to decrease the size of the bulb, but have heard that it is extremely difficult for a surgeon to obtain a thin refined tip on a sebaceous nose. Is this true? And if so, is there any way to safely eradicate the glands to decrease oil so I can have surgery? Like laser or that concentrated vitamin A oil on the net?

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7 Doctor Answers | Asked by Bama Hayseed in Birmingham

Doctor Answers (7)
Community Comments (1)

Accutane but wait.....

Hi, I agree with the other surgeons. Thick, oily skin is not likely to result in a very refined tip. However, there are options and all hope is not lost. Depending on your skin, during surgery the under surface can be thinnned out or "de-fatted." Structural grafting and suture techniques also are often used in thicker skinned patients to give them very nice improvements in their tip. Computer imaging to see what exactly is realistic as far as outcome is paramount. You have... more

Combination laser and loop cautery can be used to sculpt the nose bulb

Excessive sebaceous gland growth that produces a large bulbous nose (like Jimmy Durante or WC fields) is called Rhinophyma. If you have this condition a traditional rhinoplasty will not improve the shape of your nasal tip. Removal of excessive sebaceous material from the tip and bulb requires external removal of the excessive sebaceous tissue. The ala and tip (bulb) of the nose can be sculpted using a wire loop cautery and CO2 laser. This procedure leaves the nose skin raw, new skin grows... more

Rhinoplasty not skin surgery

Rhinoplasty is not performed for sebaceous oily skin. A rhinoplasty operation is designed for sculpting the bone and the cartilage of the nose and is not skin surgery. The skin itself is lifted up, and the bone and cartilage are sculpted to the anatomical shape and the skin put back down. If you have a rhinophyma, the thickness of this can be reduced in size with dermabrasion.

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You're correct-- this is a tougher problem

Rhinoplasty on patients with thick, oily skin has one major unique challenge compared to rhinoplasty on patients with thin skin-- it's tougher to see the refinement and details of the underlying tip cartilage that has been reshaped. For this reason, it's important to examine you and lay out what some reasonable expectations should be. In addition, it will take longer to see the final results, up to a year or longer, and during that time, you will likely need some minor in-office... more

Rhinoplasty for Sebaceous Skin Nose

Hi Bama Hayseed, Thick oily skin does present problems for rhinoplasty. It is difficult to obtain a thin, defined tip on a bulbous, sebaceous nose. You may consider a course of Accutane if your physicians feel that you are a good candidate. There are down sides to taking Accutane which need to be carefully considered before committing to the treatment. Patients who have taken Accutane must wait at least 6 months before having any type of surgery. I prefer external/open approach... more

Michael A. Persky, MD

21 reviews

Los Angeles Facial Plastic Surgeon

drpersky.com

Thick and oily skin is tough, but improvements often possible

You are correct - it can be difficult to create a very refined appearance to the nasal tip when the skin and soft tissue is very thick. In fact, our approach is very different for patients with thick skin, in comparison to our approach in patients with thin nasal skin. Rhinoplasty really is a very individualized operation. That said, we can often achieve very nice improvements in the appearance of the nose, even in patients such as yourself. The strategy may change somewhat - for example, a... more

Rhinophyma

If you are suffering from rhinophyma (sebaceous thickening of the nasal skin) there is a simple procedure using the CO2 laser to plane down the skin. The procedure doesn't hurt much. Takes about a week for the nose to resurface. Lasts a very long time, if not a lifetime.

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Comments (1)

CopyKat
8 months ago

salycilic acid 20% - peel off the extra skin - cost $40

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