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Is It Possible to Thin the Skin with a Closed Rhinoplasty?

asked 7 months ago by Lidia737
Latest answer by William Portuese, MD
Question viewed 153 times
Tags: closed, thin skin

As far as i know the reason for a bulbous tip are thick skin, and large cartilages. Now my question is, is it possible to thin the skin with a closet rhinoplasty? to achieve adequate drapping over the refined structure? And is thinning of the skin necessary? cause i heard its dangerous? Thanks Lidia

14 answers to Is It Possible to Thin the Skin with a Closed Rhinoplasty?

+1

Thinning nasal skin through closed rhinoplasty

It is possible in some cases to thin the skin through closed rhinoplasty. It really depends on whether there is an excess buildup of scar tissue versus purely granulation tissue from the previous surgery. It also depends on how many previous rhinoplasties have been performed and the degree of scar tissue formation in the tip. The healing process with thick olive oily skin is less predictable and may require taping of the nasal dorsum and cortisone shots to help the bulbous... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Thin Nasal Tip Skin in Closed Rhinoplasty

The nasal tip skin can be thinned with a closed rhinoplasty to try to improve the results achieved when operating on a bulbous tip. Make sure you have an experienced rhinoplasty surgeon to determine if this is necessary because tip circulation can be compromised with this technique. Don't pick the technique, pick the surgeon.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Rhinoplasty for bulbous tip

Surgery is always dependent onthe surgeons experience: it is usually easier to get a more defined tip open yes the skin can be thinned either way it is safer open how is your surgeon shaping the cartilage sutures trimming alone grafts
Jed H. Horowitz, MD

Orange County Plastic Surgeon
+1

Thinning skin during rhinoplasty to improve bulbous tip

Depending on your surgeon's preference the nasal tip skin can be thinned using either approach. I tend to prefer using an open approach in these cases to make sure symmetric removal is done. Thinning does need to be done conservatively; in many cases what is able to be removed is a fibrofatty layer of tissue that adds bulk to the tip. That being said thinning of the tip is not always necessary and in many cases the tip can be refined nicely without thinning the skin. Addressing lower... more
Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon
+1

Thinning the skin in rhinoplasty

Thinning of the fat beneath the skin is what you are talking about. Careful removal of small amounts of fat beneath the skin of the nasal tip can and should be done in specific noses in order to get the best results. It can be done much more liberally in closed rhinoplasty. The circulation must always be respected.
Ronald Schuster, MD

Baltimore Plastic Surgeon
+1

Thick skin and rhinoplasty

Thick skin can make tip rhinoplasty contouring difficult to apppreciate. However, thinning the skin is usually not recommended because it can cause irregularities and even skin necrosis if not done conservatively.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Is It Possible to Thin the Skin with a Closed Rhinoplasty?

I think you may be confusing two different aspects of Rhinoplasty and dealing with the skin. In thick skin, there's an increased subcutaneous layer (sub Q) that hides the shape of the nasal tip making it appear wider than it would with thin nasal skin. Closed Rhinoplasty can, to a limited, extent due to the limited dissection of the tip area, remove this excess sub Q tissue. An Open Rhinoplasty, if appropriate (limits of how much the tip is already roated before... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Thinning of nasal skin

The nasal skin can be thinned with open or closed technique. This needs to be done with caution due to possible skin vascular compromise. Donald R. Nunn MD Atlanta Plastic Surgeon.
Donald Nunn, MD, DDS

Atlanta Plastic Surgeon
+1

Closed

If your surgeon has enough expreience with the closed technique, then skin thinning can be done. The real problem is taht scar tissue often forms negating the thinning process
David A. Bray, Sr., MD

Los Angeles Facial Plastic Surgeon
+1

Thinning is best done with the open approach

In my rhinoplasty consultations, i discuss with patients the merits and demerits of the closed versus the open approach. By your question, i am gettting the sense that you a picking surgeons by the technique that they use presumably for a quicker recovery time. I would choose a surgeon based more on their expertise in nasal surgery and the consistency of their results. In regards to your specific question, the open approach allows much easier and precise thinning of the skin... more
Pramit Malhotra, MD

Ann Arbor Plastic Surgeon
+1

Thinning skin difficult to do with closed rhinoplasty

Pictures would do wonders in giving you a recommendation on this. But I think if you have a truly sebaceous or thick skin envelope and you're looking for a finer tip, then I don't know of a better way to thin the skin envelope safely and thoroughly without an open rhinoplasty approach. Thinning the skin can be dangerous, and if you don't have good visualization, then you can develop a small hole or, even worse, sloughing of a larger area of skin on your nose.... more
Andre Panossian, MD

Los Angeles Plastic Surgeon
+1

Closed rhinoplasty techniques

Generally speakin, yes you can thin the skin a bit BUT: 1. You are correct in a sense. Thinning the skin isn't dangerous but it's not always very reliable. If you have thick skin you need to make more dramatic changes to the cartilage below and then be patient. With time the skin will redrape very nicely. 2. You can do almost anything with closed rhinoplasty. Best of luck Chase Lay, MD
Chase Lay, MD

Bay Area Facial Plastic Surgeon
+1

Closed rhinoplasties work well

It is possible to do an entire rhinoplasty using the closed technique. Fixing the cartel ages may give you what you want without thinning the skin.
William B. Rosenblatt, MD

New York Plastic Surgeon
+1

Be careful

If you put tent fabric over tent framework, you see the framework. If you put a bearskin rug over, you don't see much definition. If your nose skin is bearskin rug, you can't change it into tent fabric. That said, if the surgeon in an open rhinoplasty elevates the skin in a nice, even plane and then removes any extra tissue from the cartilages, you can get some thinning in a safe manner. Agressive thinin of the under side of the tip skin is indeed hazzardous.... more
Mark D. Wigod, MD

Boise Plastic Surgeon

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