A doctor told me that the skin on my tip was too thick and that that would really limit the amount of tip refinement I could get.I was wondering whether or not the pictures below are realistic expectations or not? Also,I've read here that the best thing for thick skin is to actually add more cartilage or reshape it rather than remove.So is that the solution for me?And since want a smaller profile,is possible to strengthen the cartilage AND reduce my profile?
Expectations for a Thick Skin Tip Rhinoplasty?
Doctor Answers 9
It is difficult to say for sure if you skin is thick without seeing it in person but if I was to guess based on the photos then I would say your skin is not "too thick". Also, I think you are a good candidate for rhinoplasty and should get good results by just making the tip less bulbus and take down the small hump. I am not for cartilage grafting for your type of nose as I think you want to make your nose softer and less bulky and adding to it would be like adding volume to it. Who ever you decide to go to for your surgery it should be based on results and the best way to do this is by looking at the before/after photos of the surgeon your interested in and also ask to speak and/see some patients who recently had surgery with the doctor your interested in.
Thick skin and results after Rhinoplasty
I have performed Rhinoplasty for over 20 years and your skin is not what i would classify as thick as it pertains to results after Rhinoplasty. Your nasal tip is wide and you have a slight bony dorsal bump. The tip can be thinned and the bump removed without undue concerns about thick skin, in your particular case.
Thick skin and rhinoplasty
Your skin does look a bit thin but I believe a formal rhinoplasty will give you a more refined result. I would not recommend a cartilage graft. The pictures you show are of models with extremely sculpted tips. You will look more refined but not like these models.
Talmage J. Raine MD FACS
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Rhinoplasty results with thick skin.
Tip definition is definitely achievable with cartilage shield graft and cartilage reshaping. In your, case the skin is moderately thick but still not as thick as some ethnicity's. The small hump can also be easily shaved down to de-project your profile. Make sure you have computer imaging to see what your nose will look like after surgery.
Thick skin rhinoplasty
If the 2 pictures on the left are you, it does not look like your tip skin is very thick. You look like you have average to slightly above average skin based on the photos but I would have to feel your nose to judge more precisely.
It is correct that with very thick skin, adding tip grafts and using sutures to bend the cartilages are more important then removing cartilage but other factors such as dissecting in the proper plane to avoid damaging the muscle and skin and creating more scar tissue is very important as well.
While the photo of the model you have attached shows a woman with thinner skin I think you can get very nice results as well if you choose the correct surgeon with the proper rhinoplasty skills.
Tip shape and thick skin
You should be able to get nice improvement in your tip with structural rhinoplasty techniques. Forget about the model photos, that's not your face. Your result will look great on you.
Thick skin and rhinoplasty
I tell my patients that with thick skin to expect three dimensional improvement but not to expect refined details, expecailly in the tip.
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