Rhinoplasty on thick skin. Do you think my ideal nose is achievable? (Photo)

Question

My nose is bulbous. I want my nose tip to be smaller and defined. I don't want a new nose, just an improved one. From what I've read, this isn't easily achieved if my nose skin is thick. I haven't been to a consultation yet but I think that my nose skin is thick. I'm worried that I won't achieve noticeable results and if my nose ends up looking bigger because of scar tissue. Realistically, do you think my ideal nose is achievable? Last pic is of my ideal nose.

Yannis Alexandrides, MD, FACS · Answer

Indeed, your reservations are justified because thick skin can be a limiting factor on the results on Rhinoplasty, however, Plastic Surgeons have a very wide variety of techniques they can use to optimise your results.

This will most likely require an Open Tip Rhinoplasty, with Tip Grafts. This will provide better definition, especially in the case of thick skin. Of course, a full consultation is required before you have the final recommend of this specific technique.

Oakley Smith, MD, FRCSC · Answer

Some improvement on the tip width and definition is possible with rhinoplasty surgery for persons with thick skin. It is better for you to consult with a facial plastic surgeon who can examine your nasal tissue and discuss the degree of improvement that can be achieved.

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

The Target shape that you have posted shows a different type of skin and the cartilage contours are slightly visible through it. It is not possible to achieve something of this type in your case.

In terms of the characteristics of the change, in your situation it is possible to change to a narrower framework for the nasal tip and to reduce some of the soft tissue thickness. Combined with additional cartilage support from the nasal septum this can lead to an increase in definition of the nasal tip.

Planning surgery for the thicker skin in rhinoplasty means adjusting the goal is to be aligned with the soft tissue characteristics

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.I have evaluated your case from the photos you provided.You have thick skin and you have no defined nose shape. The tip is very bulbous and the nose gets wider around the nostrils. I recommend you a rhinoplasty surgery to give you a smaller and more defined nose (especially more definition around the tip). I am happy to say that your expectation is achievable and realistic. At least you don't want something impossible and that is really great to see patients who are aware of their case, and of what can be done.
Best regards!

Eric M. Joseph, MD · Answer

Based on your photos, you may have medium thickness to your skin and firm underlying nasal tip cartilages. Since a well-performed tip-plasty may be considered for achieving your goals, please consult with several reputable rhinoplasty specialists who offer computer Imaging. I hope this is helpful! Sincerely, Dr Joseph

Ronald J. Edelson, MD · Answer

Your nose could be improved but not necessarily create the dream nose you show. I think it would still be worthwhile though

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your questions and for sharing your photographs.
Yes, you have a bulbous tip and a thick skin. Rhinoplasty can improve the aesthetic appearance of your nose but of course not to the same extend as in those with a thinner skin. If you have a realistic expectation, I expect you to be happy with the outcome. However, you must have a face-to-face consultation with an expert surgeon. You should expect a full detailed examination of your nose to assess your nasal skin, cartilage, bony structures, and your nasal airway/ breathing. This will allow the surgeon to evaluate your nasal appearance and its relation to your facial features.

The use of manipulated (morphed) digital clinical photography provides a platform for discussion as to your desires and expectations. Such images are not a guarantee of exact results, but a great tool to ensure that you and your surgeon are on the same wavelength.
Only then, you would be able to have a full discussion about the benefits vs risks of your surgery and to make an informed decision.
Best wishes,

Rhinoplasty on thick skin. Do you think my ideal nose is achievable? (Photo)

Answers (7)

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