Skin elasticity in older patients (47) - is reductive rhinoplasty possible?

Without photos or an evaluation, I can only share my general ideas and thoughts on the subject matter. I am generally cautious with significant deprojection in a thick or thicker skin nose. If the goal is to create definition to the tip and bridge, often augmentation is required to show that definition through thicker skin. My analogy is would be to consider a large, thick sweater on a child versus a large body builder - you will see more definition in the latter than the former.

Yes, your skin should still shrink to the cartilage framework appropriately in your 40s (and even beyond). In older patients and thick-skinned patients, it is especially important to plan the surgery in a way that closes dead space in the nose and controls the way the tissue retracts, so your rhinoplasty surgeon should have a plan in place for doing this.

Dear Reliable,
Typically, the nasal skin shrinks down to take the shape of the nasal "skeleton" that is made from the bones and cartilage under the skin. You should not worry especially since a reputable surgeon told you that you will be fine.

Without the benefit of physical exam, and posted photos- it's difficult to comment accurately. Healing after Rhinoplasty may be unpredictable especially in revision case, it may take longer than a full year to achieve full refinements. I suggest that you consult with an experienced Board Certified PS with a wide gallery of before and after photos that demonstrate consistent results

Your question is a good one but impossible to address without photos. Please resubmit your question and I’ll answer it

The shrink wrap phenomenon is usually associated with thin nasal skin and firm nasal cartilages, not age. We have performed reduction rhinoplasty on patients over 65 without issues of skin redraping. Hope this helps! Dr Joseph

Hello! Thanks for the great questions. At 47 years old, you can achieve a natural reduction in the size of your nose. Strong cartilage grafting provides a framework for the skin to "shrink-wrap" onto as it heals. The important thing is to make sure the reduction isn't too dramatic where the nose appears irregular or operated in appearance. For thicker skin, I recommend taping, compressions, and steroid injections post-operatively to assist with a nice outcome. Hope this helps!

Skin elasticity for rhinoplasty in middle aged patients: The skin of the nose after rhinoplasty shrinks remarkably well even in middle aged and older patients. I have done rhinoplasty‘s in patients up to 70 years old not experienced any problem with skin shrinkage. This is particularly true of the upper 2/3 of the nose. If someone has a very bulbous tip, at any age, If the skin is thick it will take a long time to shrink and contract.

Your skin should conform nicely to your newly reduced nose. Despite reductive changes, the skin is quite elastic and recoils nicely to conform to the newly shaped nose. I would not caution you against having the rhinoplasty you desire for this reason. You mentioned a highly reputable surgeon which also makes me feel more comfortable about your evaluation. That surgeon should help to allay your concerns and reassure you that skin excess should not be an issue.

In our practice, we formed rhinoplasty I'm people in their 80s, and they have done just fine. The skin just simply re-drapes over the new framework. We also perform closed rhinoplasty with all of the incisions placed completely on the inside of the nose. No external incisions are required, and no painful packing is required either