Thick Skinned Bulbous Tip - What Can be Done?

Hi there, I've attached 2 pictures of my nose showing front and side views. I've had an appointment with my surgeon who basically told me he couldn't do anything because I have very thick skin and im not really prepared to pay £3500 for nothing.

As you can see I've got wide nostrils and if I press my nose tip in it goes in about 1/2 cm before reaching any bone. Surely something can be done? What sort of results can I expect 3-4 months after the OP?

Doctor Answers 4

Thick bulbous tip

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Thank you for your inquiry!

It seems that you are a good candidate for a rhinoplasty that will improve the way your nose looks to complement your facial features in a natural fashion. However, without a physical examination it is not possible to provide you with specific details. I highly recommend that you schedule a consultation with a well-experienced surgeon.

It is important to mention that the finest cosmetic results in any particular case are based on a variety of factors, including: the unique anatomy of the patient, realistic expectations, a well-informed and detailed discussion with your plastic surgeon concerning the best options for you especially covering a deep understanding of the pros and cons of any given choice you will adopt.

Please keep in mind that following the advice from a surgeon online who offers to tell you what to do without a physical examination covering the nature and the status of the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative solution would not be in your best interest. With that in mind, it is the safest and for your best interest to find a plastic surgeon with solid experience and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.

Good luck!!!

Ali Sajjadian, MD FACS

Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Rhinoplasty for bulbous tip with thick skin

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While thick skin is quite a limitation to rhinoplasty, there are some limited results that can occur through the rhinoplasty procedure.  It is important to discuss this thoroughly with your rhinoplasty surgeon.  Make sure your surgeon has performed thousands of rhinoplasties to address your issues.  While the cartilage can be resculpted and refined, the skin can be slightly thinned if thickened in the tip area.  This can all be done through an endonasal technique, but the thick skin will still limit the overall results, compared to results achieved with more thin-skinned patients.  Just have realistic expectations prior to undergoing the elective rhinoplasty procedure.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Rhinoplasty in thick skinned bulbous tip

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It depends on what you are looking to refine about the appearance of your nose. Surgery can serve to narrowness the nasal base and/or nostril openings. To refine your tip and provide more support, you will need cartilage grafting to project into your thick skin.

Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon

Tip rhinoplasty

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Sorry to say but these limited view photos are not helpful in anyway. Technically nostrils are the openings at the bottom of the nose. It is hard to tell from the photos but it looks like the nostril rims are thick and the openings are slightly smaller as a result. The optimal rim width is about 5mm. If that is the case the fat inside the rims can be thinned to narrow the rims. As for the movement of the tip when it is pressed that is usually due to lax or torn ligaments between the tip cartilages and the septal cartilage. That can be corrected by suturing these cartilages together during surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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.