I would like rhinoplasty but the surgeon I asked said my nose was not a good candidate? My skin was too thick etc (Photos)

Doctor Answers 12

Rhinoplasty for patients with thick skin

It is very important to have realistic expectations for patients who have thick skin, especially in the tip of the nose. Patients with thick skin in the tip of the nose do not respond well to rhinoplasty, due to fluid retention in that area of the nose. Make appointments with three very busy rhinoplasty surgeons in your area to get more opinions about being a candidate for the procedure


Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Rhinoplasty and thick skin.

Rhinoplasty is a surgery to improve the shape of the nose for breathing or appearance.

Skin thickness does not preclude someone from rhinoplasty; however, it does need to be considered. Simply removing tissue will not make the nose smaller. It will create an amorphous blob in the thick-skinned patient. Patients with thick skin require a structured rhinoplasty approach to put the skin on stretch to create definition. I recommend discussing with a rhinoplasty specialist who understands that different techniques are used patients with thick vs thin skin for a safe and happy result. Safety comes first.

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Rhinoplasty Candidate

Based on the photos you have shared, you are an excellent candidate for Rhinoplasty in spite of the thick skin.  Consult with a highly experienced board certified plastic surgeon to discuss your options and expectations.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 62 reviews

I think you can still get a large improvement from a rhinoplasty. See my morphs of your nose.

Click on the "Web reference" link, just below my response, or go here:

FacialSurgery.com/RealSelf/RealSelf_BettyBeeson.html

I made a couple of computer morphs of your nose, and animations of the morphs, to show the changes that are possible for your nose in truly expert hands. I brought the tip of your nose back closer to your face, and elevated the tip. I also simulated narrowing the tip.

From these photos, your skin might be a bit thicker than average, but the important consideration is how strong the cartilages are underneath the skin. If you have thicker skin, but the cartilages are strong, then you can still get a good improvement, and from these photos, your cartilages seem to be very strong.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 41 reviews

Am I a Good Candidate for Rhinoplasty

As long as you have reasonable expectations you are a good candidate for rhinoplasty surgery. Thick skin will limit what can be achieved in the tip are but the tip can be reduced even though you may not be able to establish great definition. The remainder of your result will not be compromised because of the skin. I suggest you consult with another experienced rhinoplasty specialist so you can make an educated decision.

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

Rhinoplasty and skin thickness

Hello and thank you for your question. Skin thickness alone is not an absolute contraindication for reductive rhinoplasty if you have realistic expectations. The procedure to reduce the nasal skeleton is performed and then the existing skin must shrink to its new smaller more refined size. This takes time and is limited by skin thickness, prolonged swelling and also from the skin's elasticity itself. Based strictly on your photos, you could probably expect some improvement in your nasal appearance but your results may be tempered by those factors.

R. Graham Boyce, MD
Covington Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Rhinoplasty

Thank you for the question and the photos and I would go on more complimentary consults with experts in your area and look at photos of similar patients because certainly you would benefit from a rhinoplasty.


Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 reviews

Rhinoplasty for patients with thicker nasal skin #plasticsurgery

Rhinoplasty with dorsal hump reduction and improved tip support will make some nice changes to your nose - thick nasal skin can be a problem when changes are made to the shape of the nasal tip itself - thicker nasal skin with post operative swelling can disguise these underlying improvements.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Thick skin rhinoplasty

Thick skin creates some limitations for rhinoplasty but doesn't preclude it.  The height of the dorsum and width of the nose can be addressed with the usual techniques.  The width of the nostrils (alar base) can be treated as well in patients with thick skin. The problem area is the nasal tip.  One can narrow the underlying cartilages but the skin will not shrink to cover them and the nose may look shapeless. Using structure to make a better shape is possible.  Also judicious use of post-op steroid injections can help.  Basically see an experience surgeon and set reasonable expectations.

Wayne F. Larrabee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Rhinoplasty for patients with thick skin

If the appearance of your nose concerns you, it can be improved can be addressed with a natural appearing rhinoplasty performed by an expert artistic plastic surgeon with extensive rhinoplasty experience. Patients with thicker skin can get a significant improvement in the appearance of the nose but need to be realistic about the result. 

Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the proposed operative procedure with you and your parents may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or Canadian Society for Aesthetic Plastic Surgery (CSAPS) 
that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. 

Robert Singer, MD FACS  

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 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.