Can a closed rhinoplasty be performed on a patient with thick skin and a bulbous nose? (photo)

Hello @Polite143778, thank you for your question. Yes a rhinoplasty can be performed on a patient with thick skin. It does not matter the shape or the nose or how thick skin the patient is because when we talk about close or open rhinoplasty we are talking about the technique to make the incision. I leave a video to shed more light on the matter. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Thank you for your question and photo. Either open or closed rhinoplasty can change the shape of your nose and address the concerns you’re referring to. The bulbous tip can be redefined and grafts may be inserted to provide adequate structural support for the skin. Keep in mind that rhinoplasty is one of the most complex of all plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to determine whether open or closed rhinoplasty would be best in your case to procure the most favorable results.

Dear Polite143778,
Thankyou for providing pictures as a reference. In my professional opinion, yes it seems you have a thick skin envelope which is a limitation in rhinoplasty and requires some preparations before surgery such as fractional CO2 laser treatment. Furthermore, you can benefit from closed atraumatic rhinoplasty which fat tissue removal can give you a more defined nose tip along with wing surgery to bring your nose in from the front. However, you need to set realistic expectations for the nose reduction as doctor can reduce as much as your nose tissues allow.
Best Regards,
TAS TEAM

Hello all to my patients I recommend to do open up rhinoplasty surgery because it is better you can see all details during the surgery

Can a closed rhinoplasty be performed on a patient with thick skin of the nasal tip? yes, a closed rhinoplasty can be performed on a patient with thick nasal tip skin. There are a few maneuvers that can be performed to improve the definition of the tip. It mostly depends on the experience and comfort level of the surgeon with the technique. In some cases, Steroid injection can be used in the recovery period to reduce scar tissue and swelling and slightly thin the skin.

Hello! I suppose you could undergo a closed rhinoplasty. People often fear the incision on the columella. If done well, it's almost unnoticeable. The open approach allows for precision and the ability to place strong cartilage grafts like a caudal septal extension. This graft allows for significant, strong projection which is often needed for narrowing a bulbous, thick-skinned nose. This can be done through a closed approach but it is very difficult. I would seek consultation with a number of surgeons who perform both techniques. Hope this is useful to you!