How Many Times Can a Nose Take an Open Rhinoplasty with out Damaging the Skin?

        Provided that the nasal envelope has been properly dissected each time without thinning or devascularizing it, the surgery could be performed any number of times.  Kenneth Hughes, MD Los Angeles, CA                 

This is a great question -- and the answer is, "it depends." As others have implied, technique is very important. If the skin and soft tissue overlying the tip cartilages is dissected in the correct plane, healing is generally quicker and less scar tissue is created. This makes revision surgery easier, if needed. There is also a significant effect of the skin type of the patient -- patient's with thicker, oily or sebaceous skin may have more or more prolonged swelling, but also frequently have less visible incisions or scarring. Thinner skin can create problems with revision surgery, as any tiny imperfection in the cartilages below will show through.  In these cases, fascia grafts to help with camouflage in the tip can be a great option.

 Every time a columellar incision(open rhinoplasty) is made, the tip and columellar skin  is lifted up through open rhinoplasty, there is a division of lymphatics and blood vessels. This can compromise the healing process. Closed rhinoplasty  is less invasive and  can be used in many instances to accomplish your goals