Why Does Skin Thickness Matter for Nose Surgery? Doctor Answers, Tips
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Why Does Skin Thickness Matter for Nose Surgery?

How does the thickness of my skin affect the results of my rhinoplasty surgery?

37 Doctor Answers | Asked by anon
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Noses with thicker skin are more difficult to refine at...

Noses with thicker skin are more difficult to refine at the tip and have a tendency to retain fluid. This complication is especially common with African-American noses and Hispanic noses. These patients require cortisone shots in the postoperative phase to ensure a pollybeak deformity does not occur. A pollybeak deformity occurs when excess edema and scar tissue accumulate just above the tip of the nose.
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Rhinoplasty results vary significantly depending on skin thickness

Skin quality and thickness is one of the most important factors in determining your final Rhinoplasty result. And it can also be one of the hardest to predict. When we perform Rhinoplasty, most of what we do involves altering the cartilage and bone that makes up the nasal skeleton. We shape the cartilage and bone in many ways to take on the new desired contour. During the healing period for many months after surgery, the skin and soft tissue that lays over this skeleton must contract inwards... more
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Thickness will affect the results

Overlying nasal skin quality and thickness are probably the most important fact that patient and surgeon must carefully evaluate prior to surgery. Both "limit" situations (too thin or too thick skin and soft tissue layer) are not good when planning a rhinoplasty (they affect adversely). So definitely this fact will affect the results of a rhinoplasty surgery. Obviously it will depend on the amount of cartilaginous and bone structures planned to be altered (removed) during the nose... more

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Effect of skin thickness on rhinoplasty results

The way that I describe the effect of skin thickness on rhinoplasty results is to use the analogy of a down comforter versus a fine Egyption cotton sheet. A thick comforter lying over an object makes it difficult to see the shape of the object while a thin sheet allows one to see every edge and contour. The underlying cartilage and bony structure of the nose will show through easily in thin-skinned patients which allows for increased refinement of the nose. However, it is critical to... more
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Skin Thickness Matters!

In most Rhinoplasty, the surgeon reshapes the nose by reshaping the skeleton of cartilage and bone. This framework of support for the nose shapes the overlying nasal skin. Imagine covering a chair with a fine silk cloth: you'll see every angle f the chair and easily discern it's shape. Now cover the chair with a rug: the result is amount that may not even look like a chair. In this analogy, thin skin is like the silk cloth and thick skin is like the rug. How... more
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Understanding Skin Thickness is Vital in Rhinoplasty

Skin thickness is important because it can adversely affect the final result of your nose surgery, if not taken into account by your surgeon. The skin of the nose varies in thickness from the bridge, where it is generally thin, to the tip and nostrils, where it can become thicker. Some ethnicities tend to have thicker skin on the nose than others. Thick skin can limit the amount of narrowing or refinement one can obtain in the tip of the nose. On the other hand, it can also disguise... more
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Skin Thickness and Rhinoplasty Results

The type and thickness of a patient's skin can have a big impact on the rhinoplasty results. For thick-skinned patients, the postoperative swelling can be more pronounced and can persist longer. Additionally, with very thick skin, the tip may not be as refined appearing. Thin-skinned patients run the risk of have visible irregularity of the tip cartilages (if they are modified).
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Skin thickness in rhinoplasty

Skin thickness is absolutely an important determinant of your final outcome with rhinoplasty. Thick skin generally hides or blunts some of the changes made with rhinoplasty, particularly in the tip region where the skin is thickest. Thin skinned noses on the other hand can reveal any small contour irregularity, and therefore demand great precision. Thick skinned noses generally require a greater time period to see the final result due to prolonged post operative swelling. more
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Skin thickness affecting outcome of rhinoplasty

Fantastic question! The thickness of the skin contributes to the appearance of the postoperative nose even after bony work has been performed. Drape corduroy over a pencil and then try it with silk. Huge difference! The nasal tip can be defatted to achieve a more defined appearance.
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Skin thickness and rhinoplasty - nose job

Skin thickness is an essential component of evaluation for rhinoplasty. Thick skin will take longer to contract over the cartilaginous/bony framework and will limit how much smaller one can make the nose. Think of a comforter (thick skin) wrapped tightly around a statue. You would not be able to delineate the details of the statue very well. Now think of a bed sheet (thin skin) wrapped tightly around it. Those details are now more apparent. Thick skinned... more
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How does skin thickness affect Rhinoplasty results?

I have performed Rhinoplasty for over 20 years and this is a great question. The thicker, the nasal skin, the less a sculpted tip underneath this thick skin can show through. Thin skin shows every detail of a sculted, thin tip that's created during Rhinoplasty while thick skin will not. The subcutaneous tissues can be thinned but there's another difficult aspect of thick, especially thick and oily skin. This type of skin has a tendency to create... more
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Rhinoplasty and Skin Thickness

Rhinoplasty can change bone, cartilage, and the soft tissue including skin. Thin skin can show more tip definition as a positive  yet can allow more imperfections of underlying bone or cartilage to become apparent, In order to correct for situations, the surgeon may opt to add padding with fascia or crushed cartliage to soften certain areas.  In thicker skin, the surgeon may opt to thin the skin in order to allow highlights of the cartilage... more
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Skin thickness and rhinoplasty

The thicker the skin the more difficult it is to see the definition of refined structures that were altered during surgery.
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Skin thickness in rhinoplasty

When performing rhinoplasty, it is important to take skin thickness into consideration. The best way to illustrate this is with an example. If you have a diamond ring and I cover it with a fine silk sheet, you will likely see the shape transmitted through the sheet. If,  however, you cover it with a comforter, you are not likely to see anytning other than possibly a small bump. The same goes for your nose. see video
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Skin Thickness and Rhinoplasty

The thickness of the nasal skin plays a major role in the ultimate result that can be achieved, especially with the nasal tip where skin characteristics tend to vary the most from patient to patient.  The skin of the nasal tip contains varying amounts of sebaceous glands, fatty tissue, dermis, and connective tissue.  Redraping of this skin over the underlying cartilages of the nasal tip determines how much detail will ultimately be appreciated when swelling has resolved.... more
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Skin thickness changes the shape of you final nose

I frequently tell my patients that everything has plusses and minuses.  You can thin of skin as wrapping paper over the underlying cartilage framework.  Thin skin allows excellent definition of detail structures.  However, the other side of that is that every miniscule irregularity will clearly be visible under the skin envelope.  Thick skin allows excellent camouflage of miniscule irregularities.  But things like tip definition become very hard.  Not... more
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Skin thickness matters in Rhinoplasty

  Skin matters when it comes down to nasal surgery. As a surgeon you can fine tune the cartilages of the nose , but if the skin is very thick it will not show through in the final outcome. Cartilage grafts may be needed to accentuate the tip definition when a patient has thicker skin. The skin thickness may be changed by "de-fatting" the skin or injecting small amounts of steroids into the thick skin area. If you have thick skin make sure you discuss your concerns... more
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Skin and rhinoplasty

The nasal skin determines the limits of how big or small it can be made. The limit is based on the soft tissue envelope of the nose (the skin). Imagine the skin of the nose being like a dress, and the underlying nasal structure like a person's body. If you placed too small of a body on a thick, large dress, you would have excess material. Likewise, in a rhinoplasty making the nose too small can lead to a pollybeak deformity where excess bulk is seen in the tip. A surgeon with... more
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Skin Thickness and Rhinoplasty

This is a a good question.  Skin thickness affects the outcome of  rhinoplasty.  The thicker the skin more difficult it is to see the finer corrections of rhinoplasty. Example, it difficult to produce a thin well sculptured tip because the thick covers up the finely sculpted tip. Dr. ES 
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Skin thickness is a key factor in rhinoplasty

The thickness of the skin plays a large factor in rhinoplasty results.  In essence a rhinoplasty reshapes the tissues under the skin to change the appearance of the nose. If the skin is too thick the underlying changes will not be seen through the thick skin.  If the skin is too thin every underlying cut or imperfection will be visible under the skin. The rhinoplasty surgeon must be experienced in all skin types to determine what techniques will best work with the particular skin type. more
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Skin Thickness in Rhinoplasty

Thicker skin hides contours and redrapes differently over the fine cartilage structure that are sculpted at the time of Rhinoplasty. I use this analogy with my patients:  In the summer, you sleep with a single sheet on your bed, which when covering your feet, shows the outlines of all of your toes and you can see and count them all. (Thin skin, sculpted, defined anatomy) In the winter, when it is cold, you sleep with a thicker comforter to keep you warm, which when draped over... more
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Skin thickness and rhinoplasty

The best analogy i ever heard concerning rhinoplasty is the constructing of a tent. First you erect the tent poles and then you lay the tarp over the poles and you have a certain structure of a tent. If you change the tent poles ( i.e. the cartilage and bone) you have a different tent. If you change the thickness of the tarp you will get a similar tent but more or less well defined, based o the thickness of the tarp. Looking at noses of models in... more
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Skin thickeness matters in rhinoplasty.

If the skin is thick, then the changes to the underlying cartilage and bony structures cant be appreciated. So the improvement is limited. The skin cant redrape well.
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Quality of nasal skin and final results in rhinoplasty

It is important for the surgeon to asses the quality of your nasal skin to achieve optimum results in rhinoplasty.  With experience and innate talent the surgeon learns to pick a specific technique for each skin type.  In patients with thicker nasal skin I would use special techniques ( various grafts, less reductive maneuvers, more re-balancing of nasal aesthetics) that would not be used in someone with thin skin.  The final goal is the same, a balanced,... more
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Rhinoplasty and Skin Thickness

Essentially, rhinoplasty involves sculpting the bones and cartilage, then relying on the cover (the skin) to redrape through which the results can be seen. Thicker skin does not contract as much, and the advantages of thicker skin is that small irregularities won’t show through, but it will be more difficult to achieve a more refined, well defined tip.
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Skin thickness and rhinoplasty results

The changes made under the skin of the nose (bone and cartilage) during a rhinoplasty will not be as easily seen with thicker skin.  On the other hand, thinner skin will more likely show very small irregularities and imperfections.  The differences may be similar to you looking at your fingers by placing a thin silk hanky over one hand and a piece of burlap over your other hand. 
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Thickness of skin and rhinoplasty

Rhinoplasty is a popular and effective surgery to recontour the shape of your nose. The thickness of your skin is an important factor that your surgeon will take into account. Patients with thick skin will be more of a challenge to create definition of the underlying framework. In our practice, we commonly addressed this by removing a small amount of fat under the skin, using small pieces of cartilage graft to help enhance the definition, or other techniques. In our practice, we find the... more
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Skin thickness is very important for rhinoplasty

Skin may be the most important variable in rhinoplasty. It is the factor the surgeon has the least control over. If a patient has very thin skin anything that is done to the cartilage and bone to change the nose can end up being visible though the skin as little bumps and dips. This can be a very frustrating problem for the patient and the surgeon. If on the other hand a patient has very thick skin, all the hard work to change the cartilage and bone may not be visible under the thick skin... more
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Skin thickness with Rhinoplasty Surgery

Skin thickness is a major factor with rhinoplasty surgery. The nasal skin is thicker for everyone in the tip of the nose. Very thick skin, which is more common in non-Caucasian noses such as Middle Eastern or Persian, has higher chance of scarring & swelling after nasal surgery. On the other hand, very thin skin has higher chance of asymmetry after rhinoplasty.
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Effect of Skin Thickness on Rhinoplasty Results

Most of rhinoplasty surgery involves changes in the nasal bones and cartilages. In patients with thin skin, the modifications of these underlying structures are clearly visible. A patient with thick skin will achieve improvement, but refinement and definition will be masked by that thicker envelope.
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Thick skin effects on rhinoplasty

People with thick nasal skin will have less defined noses than those people with thin skin.  You can think of the nasal skin as a blanket on your bed.  If you are lying on your bed and someone lays a thick blanket over you, the silhouette of your body will not be very well seen. If that thick blanket is replaced by a thin sheet, then the silhouette of your body will be much more evident. The exact same principles apply where thick nasal skin is like the thick blanket and thin nasal... more
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Skin thickness affecting rhinoplasty results

In general, thick skin does not shrink as well a thin skin. This can be a problem in the refinement of the tip of the nose, as the skin must shrink to respond to the removal of cartilage beneath it. However, my experience with over 5000 rhinoplasties shows that results cannot be predicted. On occasion, thick skin will shrink perfectly; and rarely, thin skin will not shrink sufficiently. This is also why no one should be using computer imaging.
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Thick skin shrouds, thin skin reveals

Changes in rhinoplasty are made to the bone and cartilage. Thin skin drapes cleanly onto these structures, meaning that the changes (including the imperfections) will be visible through the skin. Thick skin will tend to cover up these changes in countour. So it becomes more difficult to create reductive changes to the nose with thick skin. With thick skin, the better approach may to be to expand the nose where it needs it to create an overall better shape and proportion. That way the... more
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Skin thickness and rhinoplasty

The thickness of the nasal skin is important because it will influence the result. Patients with thick skin will be limited in the amount definition they can obtain from the procedure. On the other hand, patient with very thin skin are at risk of having grafts and irregularities show through. Your surgeon will need to adjust his surgical technique to your skin type. Good Luck.
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Skin Thickness in Rhinoplasty

The skin, or skin soft tissue envelope can be viewed as the shrink wrap over the underlying cartilage and bone structure of the nose. If the skin is too thin, even the most subtle structural irregularities are visible. On the other hand, thick sebaceous skin tends to mask the definition of underlying cartilaginous structures. Thick skin leads to a more amorphous appearance of the nose, affording less definition.
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Skin thickness has a lot to do with rhinoplasty outcome.

After the surgeon has finished adjusting the bone and cartilage during a rhinoplasty, the skin is then draped over the finished work. The thicker the skin, the more the definition will be obscured. Think of covering a marble with crepe paper vs a mattress. An exaggerated analogy but you get the idea. vz
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Rhinoplasty and Skin thickness

Hi, Yes, skin thickness is a big factor in rhinoplasty outcomes. Typically, Caucasians have thinner skin so anything done underneath the skin will show. Rhinoplasty for patients with thicker skin, found in African Americans and Hispanics, is more challanging because the skin needs to be thinned for any cosmetic changes to show throught the skin. Tip defatting and thinning of the dermis are hallmarks of a good rhinoplasty outcome in patients with thicker skin. Best, Dr.S.
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