It is common to use subcutaneous tissue (from the head) when performing rhinoplasty on a nose with thin skin?

Question

Later this month I will have a rhinoplasty basically to make my nose less projected. My Doctor mentioned that since the skin on my nose is quite thin and my nose bridge is quite narrow, he would remove some subcutaneous tissue from the area behind my ear (under my hair) and would put that on my the bridge of my nose during surgery. I understand that otherwise it is possible that the bone structure will be too visible after surgery. Is that a common method to deal with thin skin/narrow bridge?

Miguel Mascaro, MD · Answer

Catherine, very good question.  In very thin noses, it works very well to give a soft and natural contour to the bony aspect of the nose, particularly if there will be extensive work on that part of the nose.  Think of it almost like laying a soft mattress pad under your sheets in your bed.  I don't do it for every surgery, but certainly for those with very thin skin who will have bony work done it is something that I discuss with my patients.  Some surgeons do it for every patient with thin skin, others never do it.  It really comes down to what your doc is comfortable with.  That being said, it is a technique well described in the literature that works very well for the right patient.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.   The best advice you can receive is from an in-person consultation.  This technique can be used but truly depends on your individual anatomy.  Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results. 
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Kenneth Hughes, MD · Answer

It is something that can be done, but I have not found that to be necessary in the rhinoplasties I have performed.

Eric M. Joseph, MD · Answer

This technique has been described and may be used by many rhinoplasty surgeons. We no not use this approach with thin skin patients who request rhinoplasty surgery, since formation of scar tissue is variable, and most patients with thin skin do not experience irregularities after rhinoplasty. In our practice, should minor irregularities occur, we may consider microdroplet Silikon-1000 injections postoperatively. Wishing you well. Dr Joseph

Thomas Hubbard, MD, FACS · Answer

For the occasional patient with extremely thin skin, adding such temporalis fascia as a very fine layer of padding is wonderful long term. Since swelling can take a year and half or more to completely go away. The advantage of this may not been seen for years, but probably will be worth it for the long run.

Again, in that occasional patient with thin skin. An in person consultation with a Board Certified Plastic Surgeon is always advisable.

I hope you find this information helpful.

Again, in that occasional patient with thin skin.  An in person consultation with a Board Certified Plastic Surgeon is always advisable.

I hope you find this information helpful.

Barry L. Eppley, MD, DMD · Answer

The use of autologous soft tissue grafts, such as fascia and pericranium, are well known to be of use in rhinoplasty for bony and cartilaginous camouflage.

Steven Wallach, MD · Answer

Some surgeon will use fascia from the side of the scalp to add a layer of coverage under a thin skin envelope.

It is common to use subcutaneous tissue (from the head) when performing rhinoplasty on a nose with thin skin?

Answers (7)

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