Rhinoplasty - cartilage and skin changes ?

In a reduction rhinoplasty, changes underneath the skin can be performed to change the size of the nose. In general, skin can not be surgically reduced. Skin, however, is very elastic and over time will shrink or expand to accommodate the underlying structural changes. (For example if you gain weight or lose weight). With that being said, if you have a very large nose, the skin envelope may cause limitations on how small the underlying cartilage/structure can be reduced.

Cartilage reduction verse skin reduction during rhinoplasty: during rhinoplasty only the underlying skeletal framework consisting of bone and cartilage is trimmed and reduced. The skin is not cut. If the skin was cut it would leave scars. Having reduced the skeletal framework, the skin envelope must then shrink down to conform to the smaller skeletal framework. It does so very effectively particularly in the younger age group. But even in older people with less elastic skin there is no problem with skin retyping even for very large noses.

Cartilage may be reduced, or often repositioned and contoured. The skin will contract over the underlying modified framework. Skin removal is not a part of cosmetic rhinoplasty.