Q Am I a bad candidate for rhinoplasty? I've been told I have thick skin and its limiting on what can be done. (photos)
A It is true that thicker skin can limit tip definition in rhinoplasty. The photos show a thick skinned nasal tip with cephalic orientation of the lower lateral cartilages, accentuating the width of your nose. In such circumstances, the lower lateral (tip) cartilages can be conservatively reduced in size (7-8 mm is a safe width), and additional suture techniques are utilized to address the cephalic orientation. Reducing the size of the cartilages alone may not be enough.
A As a Facial Plastic Surgeon who has performed over 1,000 facelifts, I have performed facelifts with and without drains. As long as your Surgeon is experienced, shows you many results that impress you, and can offer a rational that makes sense to you, use of drains or lack of drains shouldn't be primary in your decision making process. One addition to my practice in the last three years is use of tranexamic acid, which drastically reduces hematomas and seromas; I do think that this is very important in reducing operative time and complications. I use drains for about 48 hours for most of my patients, but not universally.