Is my Skin Too Thin for Revision Rhinoplasty? (photo)

I had my rhinoplasty in 2007 for a deviated septum and he also reduced the tip and projection. The tip of my nose is quite thin and i have been told by my surgeon here that the skin is too thin to have a revision. He said that any kind of graft etc will show through. He also mentioned that even if the results are good initally over time the grafts will show through and long term i will regret my decision. Could you please advise if this is the case. Also what would you recommend to fix my nose.

Doctor Answers 8

Cartilage grafts and thin skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thin skin may expose more subtleties of a tip graft.  However, there are means of buffering the cartilage grafts to make them less noticeable. I use fascial wraps to hide some of these subtle features.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Revision rhinoplasty, skin condition

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Unless the skin is heavily scarred, with careful attention to surgical technique, it should not be a problem with revision rhinoplasty.  From the appearance of the photograph, it should not be a significant problem.  The surgeon should be very familiar with rhinoplasty.  It can be difficult to tell from photos, but from the photograph it would appear that you would benefit.  Cartilage grafts, and fascial grafts can often be very useful, but sometimes, careful removal of scar tissue is the major manuever needed.

Thin Skin in Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thin skin does make a revision rhinoplasty technically challenging. However a revision specialist can address this problem by carefully sculpting the grafts or placing fascia over the cartilage to hide any irregularities. Nostril asymmetry should also be improved. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Skin too thin for revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question and the photos. Thining of the skin can happen after rhinoplasty, but usually revision can be performed with no problems.  The only problem here is its difficult to comment on your nose just by looking at the photos. You need to see another plastic surgeon who has interest in revision nasal surgery. I hope this is helpful

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Skin NOT too thin for Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I definitely recommend a revision of your rhinoplasty. Your skin type will not compromise the final outcome, if proper technique is used. 

Kris Conrad, MD
Toronto Facial Plastic Surgeon
4.0 out of 5 stars 11 reviews

Thin skin for revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thin skin does not usually preclude revision rhinoplasty.  However, tin skin does increase the chance that surface irregularities show post rhinoplasty.  For this reason, itis important for te surgeon to bevel the edges of ay cartilage grafts and to not allow any sharp cartilage edges atthe end of the procedure.  Occasionally. a fascial graft is used in thin-skinned patients to obscure any surface irregularities.

Jonathan Sykes, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 28 reviews

You may proceed with revision rhinoplasty in qualified hands

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello Zahra,  While in some cases thin skin may be a deterrent to revisional procedures on the nose, your pictures certainly do not show this.  While in some cases fascia grafts can be used to camouflage grafts, in others a properly shaped and placed graft should not be visible through medium thickness skin.  The pictures you have posted show notching of the alae (nostrils) and fullness in the lateral supratip area (alar groove).  This type of deformity can be corrected in many cases by simply repositioning cartilage of the lateral portion of the tip cartilage and may not require grafts at all.  I would suggest you seek other opinions in person by qualified rhinoplasty surgeons in your area.

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 17 reviews

Techniques to camouflage grafts in patients with thin skin during rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thin skin alone does not preclude you from being a candidate for revision rhinoplasty.  Your surgeon is certainly correct to say the chance of grafts and other irregularities being visible in your tip is higher with thin skin, but there are techniques to camouflage them.  One of these techniques is to use fascia (thin covering around your scalp) to camouflage these grafts.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.