Why isn't vertical excision of nasal tip skin more commonly done to help create better tip definition for thick skin?

There are many ways to deal with thick nasal tip skin, and if somebody were to develop a poorly healed wound on the tip of their nose, it may make the entirety of the operation not worth it. Additionally, somebody with thick skin can have their skin thinned out directly by their surgeon at the time of rhinoplasty surgery. Thank you for your question. Sincerely, Dr Joseph

Hello and thank you for your question. Placing an incision directly in the nasal tip is not a good idea. It often times results in an indented scar with loss of tissue and poor shape. Do not judge any techniques based on one result. You should be able to see hundreds and hundreds of longterm photos on your surgeon’s website with proven reliable techniques. 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

Although the result you show in that patient is very good I don’t think the skin excision was a good idea or helped in the overall result. I would not have excused skin in the way those photos show

The purpose of a rhinoplasty is to create aesthetic improvement with the least amount of scars possible. The vertical scar is more visible.

Best Wishes,

Gary Horndeski, M.D.