Possible way to thin out thick nasal tip skin in preparation for or after rhinoplasty?

Question

Thank you @Dr. Ronald J Edelson for always answering my questions! I was hoping I could get lots of opinions here... Why don't we investigate the administration of triamcinolone to thick skin nasal tip using tattoo equipment (MMP or “Microinfusão de Medicamentos na Pele” technique)? Would reach dermis only, and microdosing would likely evenly thin this layer without irregular skin atrophy/dents. Has been successfully tried for alopecia areata. No harm to skin. Doi: 10.1159/000506314

Eric M. Joseph, MD · Answer

I am not aware of microneedling of steroids as a therapy for thinning somebody's nasal skin. And cautiously thin the undersurface of the skin intraoperatively. Additionally, many people have wide nasal appearances due to thick and oily nasal tip skin. Sometimes these patients may be happy after a course of isotretinoin, which works to decrease the size of oil glands. That may lead to a narrower nasal tip appearance without the use of surgery. Thank you for this question, and I hope it helps. Sincerely, Dr Joseph

Robert Ciardullo, MD · Answer

Kenalog injection after rhinoplasty: Kenalog, an injectable form of triamcinolone, is frequently injected into the subcutaneous tissue after nasal surgery to dissolve scar tissue, reduce swelling, and atrophy the subcutaneous tissue and to some extent the skin, to bring more definition to the tip and supra tip area in people with thick skin.

Mats Hagstrom, MD (license on probation) · Answer

Anti-inflammatory steroids typically do not reduce subcutaneous fat. This can happen, though it is a fairly unusual and often severe side effect that is highly undesirable. Steroids Should not be used to try to reduce subcutaneous fat. If true fat atrophy ensues , the results are usually not at all even and rather devastating. It’s a fairly rare side effect, and when it happens, and the results are often disastrous. I suggest not attempting to reinvent the wheel and let those who have proper training and experience do what has been proven to work. Defatting of nasal skin is best done in conjunction with rhinoplasty surgery. 
Best,
Mats Hagstrom, MD

Possible way to thin out thick nasal tip skin in preparation for or after rhinoplasty?

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