Nose is losing it's shape and thickening with age. Will rhinoplasty help? (Photos)

I am a 47 year old female and feel that my nose is getting thicker with age and losing shape. 25 years ago I consulted a plastic surgeon about rhinoplasty, as my nose was thick at that time, but to a much lesser extent, and his opinion was that not much could be done due to thick skin and lots of cartilage. Have there been any new techniques over the years that may help give my nose more shape and make it look smaller and less thick?

Doctor Answers 11

Aging nose

Hi there, thanks for sharing your photos.  It appears you may have some excess cartilage in the tip of your nose, causing it to appear disproportionately larger.  This can be trimmed to reduce the overall size and improve definition.  While it's hard for me to evaluate the thickness of your nasal tip skin from the photos, you don't appear to have excessively thick nasal tip skin.

Please consult with several experienced rhinoplasty specialists to find the best surgeon for your needs, and good luck!

Portland Facial Plastic Surgeon
4.9 out of 5 stars 29 reviews

Nose is losing it's shape and thickening with age. Will rhinoplasty help?

Your nose is quite wide. The bone and especially the lower half of the nose as well as the base and nostril are quite wide. All of these features could be contoured and made narrow and thinner.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Closed rhinoplasty, some advices:

Thank you very much for sharing your concerns with us.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 273 reviews

Rhinoplasty and thick skin

Dear lisakov
Most noses can be improved with rhinoplasty in order to appear more proportionate and fit the face better. Many factors determine the degree and type of change possible.  In cases with thicker skin this change is more limited however in a majority  of cases this improvement is safe, consistent and predictable. In your case, your tip can be made smaller and possibly your alar base reduced. Look for an experience plastic surgeon certified by the American Board of plastic surgery. See more than one consultation and make a well informed decision. 

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 57 reviews

Nose is losing it's shape and thickening with age. Will rhinoplasty help?

Hello lisakov2,
Thanks for your question.
There have been advancements made in preop skin preparation to try and thin out thicker skin envelopes prior to rhinoplasty surgery.  They involve the use of Accutane, the acne medication.
Dr. Kosins, in Newport Beach, had done a lot of work in this area and is a great rhinoplasty surgeon.
You have evidence of thicker nasal structures, but I have a feeling that you would do well with rhinoplasty as long as you maintain reasonable expectations.
Good luck,
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 56 reviews


Nasal skin thickness can limit the results following a rhinoplasty.  However, thick nasal skin is common with ethnic patients and rhinoplasty surgery can be successfully done to narrow the nasal tip and refine the nasal shape.  The best recommendation is to consult with a board certified specialist who can assist you in achieving the results you seek. 3-dimensional computer imaging can help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Rhinoplasty for Patient with Thickening Skin

Although it is sometimes difficult to determine skin thickness in these pictures your skin does not appear to be thick despite your concern about the difference in the appearance of your nose. Like all body parts the nose does change as we get older. A rhinoplasty can be done to narrow your wide tip and nasal base. Select an experienced rhinoplasty expert do you achieve a natural feminine result.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Rhinoplasty candidate

  When patients have thick and wide nasal tip cartilages, this is known as a bulbous nasal tip. The tip can be refined and reduced when the cartilages themselves are wide and excessive. This is accomplished with suture techniques, cartilage grafts, and a conservative cartilage removal. Thick skin can be an impediment to seeing a really refined result in the tip of the nose, and is only diagnosed at the time of the examination. The nasal bones can also be narrowed with osteotomies placed in them. For more information and many examples  please see the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Aging of the Nose in a Patient with Bulbous Tip

Thanks for the question.  The shape of your nose does tend to change as we age.  The soft tissue envelope will tend to droop over time while the structural elements of cartilage and bone tend to stay relatively the same.  Based on your photo, this does not appear to be an issue for you.  Your main issue is that your nasal lacks the definition and feminine shape that you desire.  The lower third of your nose may also be wider than what you want.  It does not appear that the nasal skin is overly thickened.  With this in mind, you would be a candidate for a rhinoplasty to address these structural issues.  With changes in the underlying cartilage and bone, a more refined and feminine nasal tip would be achievable.  Rhinoplasty techniques have advanced since 25 years ago, and patients with noses that may not have been treatable then are more amenable to treatment now.

Robert J .Paresi Jr., MD, MPH
Chicago Plastic Surgeon
4.9 out of 5 stars 16 reviews

Rhinoplasty with thick skin?

 You do not have thick skin. You have a bulbous tip and the cartilage can be contoured to give you a much more attractive and feminine nose.  See several surgeons that do natural noses for the best results 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.