Do people with thick skin have bigger nose tips after surgery?

Question

I have read somewhere that people with thick skin will have a bigger nose tip after surgery and not smaller, and that people with thick skin shouldn't undergo a rhinoplasty. Is this correct?

Eric M. Joseph, MD · Answer

It is true that thick nasal tip skin can decrease the amount of nasal tip narrowing after rhinoplasty surgery. When the skin is thick, however, we have more freedom to utilize cartilage crafts like an extended shield graft to achieve tip definition, projection, and narrowing. I hope this helps! Sincerely, Dr Joseph

Rajaie Hazboun, MD, MBA · Answer

Dear Azirinye,Thank you for posting your question here.I will start by saying that having thick skin does not preclude you from having a rhinoplasty. Having thick skin makes it a little difficult for the structural changes made to underlying bone and cartilage to show but does not necessarily result in the tip becoming bigger than it was pre-op , keeping in mind that some people tend to swell up at the beginning but long term if the surgery is done right it should not make your tip bigger than it was before surgery. That being said thick skin if very sebaceous or has some skin issues can be improved pre-op with some treatments such as lasers and peels and skin care to improve eventual outcomes during surgery , and during surgery it can be thinned down a bit but there is a limit to how much it can as not to compromise it's blood supply. Moreover certain cartilage grafts can help make the structural changes made more pronounced. for recommendations tailored to your own needs please consult with a plastic surgeon .I hope this helps, Good Luck!

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination. It is not correct

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Patients with thicker skin have swelling for a longer time in the postoperative recovery but can still have a very nice result longterm. With good surgical technique, you could likely have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jeffrey M. Darrow, MD · Answer

The degree of nasal tip definition that can be achieved is dependent upon the form and strength of the cartilage and bone of your nose, as well as the thickness of your nasal tip skin.  Thick nasal tip skin masks the shape of the cartilage beneath it so it is more difficult to refine the nasal tip shape or improve its projection.  Cartilage grafts are frequently needed to give additional support to those with thick nasal tip skin.  Some plastic surgeons will carefully thin the skin of the nasal tip and while this can work, it also has some potential attendant problems associated with it.  Carefully explaining the potential improvement that is likely and setting clear expectations is the best way forward with patients with thick nasal tip skin who are considering rhinoplasty.

Mustafa Bagli, MD · Answer

Thick skin definitely does not mean you can not have rhinoplasty.The limitation with thick skin is if we reduce your nose size drastically it may cause a bulbous tip so we will be a little conservative when it comes to reducing the size. Because of that, we can say thick skin is a limitation factor in reducing nose size but still there are plenty thick skin rhinoplasty patients who are very happy with their results since we can decrease the size in some degree and most importantly increase their definition

Mats Hagstrom, MD (license on probation) · Answer

Thick skin, including thicker layer of subcutaneous fat can hide cartilage definition after a rhinoplasty.
Likewise, individuals with thin skin can show cartilage to clearly just as well.
Surgeons can trim, subcutaneous fat from the back of the skin surface sometimes compensating when this layer is thicker than ideal.
Best,
Mats Hagstrom MD

George Lefkovits, MD - Account Suspended · Answer

The nose is composed of skin, cartilage and bone . While we can manipulate the latter 2 components, there is not much we can do in terms of improving skin thickness. Therefore it is important to note that thick skin will often affect the refinement of the result and may prolong the post-operative swelling. Having said that, the vast majority of patients with thick can undergo a rhinoplasty and still achieve a very satisfactory result.

Do people with thick skin have bigger nose tips after surgery?

Answers (8)

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