Is It Difficult to Get Better Results when the Nose is Thick?

Hello, I'm considering to undergo a rhinoplasty surgery. My nose is pretty thick, and the tip is bulbous. Is it more difficult to get good results in such a case? Many Thanks Mark

Doctor Answers 21

Rhinoplasty (Nose job) with thick skin

Rhinoplasty, or nasal surgery, can be performed regardless of the thickness of the skin.  Nevertheless, understand that a nose with thicker skin may not be as easy to refine as one with thin skin.  Thick skin, however, can hide any cartilaginous irregularities where thin skin may be unforgiving.  Think of a statue with a thin sheet wrapped tightly around it and then with a comforter around it.  With a thin sheet, all the details of the statue may be delineated as opposed to with the comforter.  Your nose can be made smaller with thick skin.  It is just important to have the right expectations and understand the limitations of the skin overlying the nose.

Houston Facial Plastic Surgeon
4.9 out of 5 stars 61 reviews

Rhinoplasty and skin thickness

Hi Alonaxis. Obtaining a good rhinoplasty result can be more challenging in patients with thick skin. In addition to skin thickness, another factor which often contributes to a bulbous nasal tip is the size / shape of the underlying cartilage. Your surgeon will evaluate both your nasal cartilage and your skin thickness during your consultation. He or she can then advise you about what you can reasonably expect to achieve with rhinoplasty. Good luck.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 129 reviews

Thick skin rhinoplasty just means different rules for the surgeon

Your skin is thick and will not shrink.  Therefore your surgeon cannot use a strategy that requires your skin to shrink.  Instead, if he or she reduces your bump, raises the upper third of your nose to change proportion and make the bottom seem smaller, and supports your tip, you can have a straight profile.

You are lucky that thicker skin hides underlying imperfections, so your chance of a visible postoperative irregularity is lower than in thin-skinned patients.

Find an experienced surgeon whose results in thick skinned noses you like.  Good luck.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon
4.5 out of 5 stars 25 reviews

Based on your photos, Rhinoplasty Surgery may lead to narrowing of your tip and nasal profile refinement.

I read your concern and reviewed your photos:

You appear to be a good candidate for Rhinoplasty Surgery. With well-performed nose job surgery, you could achieve tip narrowing and rotation, nostril narrowing, and a straighter appearance of your nasal profile.

You may have thick oily skin on the tip of your nose that may limit the amount of tip refinement you achieve. This would be determined pre-operatively by your surgeon, and does not appear to be severe.

All the best to you and yours in Israel.


Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Thick nose more difficult to get good result after Rhinoplasty

  Yes, it's much more difficult to get the same aesthetic result after Rhinoplasty with noses that have thick, oily skin.  The amount of subcutaneous scar tissue that forms, in those cases, is many times that which forms under thin skin.  This thickened scar tissue blunts the effects from being seen.  IMHO, the nose can be improved but the results, most likely will be less than if your had thin skin.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Thick skin doesn't show the nice results as well as thin skin but you have a nose that can have a wonderful improvement

The question about the thickness of your skin show great insight on your part. There is no question that thick skin on the nose doesn't allow for as fine a definition of the nose as thin skin. Looking at your photos, I don't think the thickness of your skin is a problem. You have a very low nasal radix (where your nose attaches to you face), a large dorsal hump, a thick tip and a tip with lack of projection. In the hands of an experienced plastic surgeon you can get a great improvement. It will require (in my opinion) an open rhinoplasty, a take down of the dorsal hump, a narrowing of the boney dorsal area, a dorsal graft to elevate the radix and a tip vectorplasty with grafts to give the tip definition and support. These are far more important than the thickness of your skin. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

Los Angeles Rhinoplasty

In thicker skin noses the improvement  in the size and shape of the nasal tip is limited due to the fact that one cannot thin the skin and the changes in the cartilagenous structure of the tip  are not visible through the thick skin.  Therefore, your expectations from the surgery should take into account these facts about the nasal tip skin thickness.

Armen Vartany, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 6 reviews

Rhinoplasty with thick skin

There are some advantages and disadvantages to thick skin with a rhinoplasty. It makes it more difficult to appreciate changes that are made and they sometimes have to be exaggerated. However, if there is some asymmetry or imperfection, it is not as noticeable with thick skin. Swelling can be slower to resolve with thick skin and can take a full year.

Richard Dale Reynolds, MD
El Paso Plastic Surgeon
4.8 out of 5 stars 37 reviews

Bulbous Tip Rhinoplasty With Thick Skin

The answer is that it is more of a challenge to create definition in the tip region with thick nasal skin. However, in experienced hands this type of rhinoplasty can lead to a very nice improvement in terms of a bulbous nasal tip. Your chosen rhinoplasty specialist does, however, have to be versed in reshaping the nose such that proper definition can be created while overcoming the thick skin issue. 

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 40 reviews

Thick noses present a manageable challenge in Rhinoplasty

A good result depends on your expectations. Yes, a thick nose does present challenges if you want a much smaller refined nose. In thick noses the lower third can be refined by altering the cartilage. The thickness of the skin also determines how much the tip can be narrowed. When looking at your nose, the dorsum would also need to be lowered and the nasal bones narrowed to maintain a natural appearance.  I do think you would see a nice improvement if you proceed with surgery. You should visit a plastic surgeon where you see many before and after photos of persons with thick noses to form a realistic expectation.

William H. Sabbagh, MD
Detroit Plastic Surgeon
4.6 out of 5 stars 38 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.