Big nose, thick and oily skin, bulbous tip. Any hope? (Photo)

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you very much for the questions.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.With this procedure you get a delicate nose, better harmonize with your other facial features.Kind regards

Nasal skin thickness definitely is a factor when correcting a bulbous tip.  Patients with thick tip skin typically will not see the degree of tip refinement, other patients with normal skin thickness achieve.  That being said, tip refinement in patients with thick tip skin can still be achieved with rhinoplasty.  Tip sutures, cartilage grafting, and tip defatting are just some techniques which will help to reduce a bulbous tip.  The key is that patient have more conservative expectations.  I suggest you follow up with a surgeon specializing in rhinoplasty surgery for a consultation.  I have provided  a link below.  Good Luck!

When patients have thick and oily skin, it is important to have realistic expectations on what can and cannot be accomplished with a rhinoplasty procedure.  The bulbous tip can be reduced with suture techniques and a conservative cartilage removal.  The dorsal hump can be shaved down.  Osteotomies placed in the nasal bones can accomplish narrowing of the bridge line.  An alar-plasty can accomplish narrowing wide nostrils.  For more information  and many before and after results of rhinoplasty, please see the video and the link below

It is hard to tell from one photo, but a rhinoplasty can be performed even on thick skin patients. But they have to realize, that they may not get the same definition as a very thin skinned patient.

Thick skin can make a rhinoplasty more difficult, but that does not mean that the surgery wouldn't improve your appearance. The important thing is for you to have reasonable expectations. I would suggest that you schedule a consultation with a board certified plastic surgeon in your area who can assess you in person and with whom you can then have a honest conversation about exactly what your rhinoplasty would achieve. Kindly,Kouros Azar

thick skin in rhinoplasty is certainly a difficult problem. There are certain improvements that can be made with overall length, angles, and width. Tip definition will be tricky and you have to have reasonable expectations. Only you can decide if it's worth it for you. Talk to surgeons and see what they can achieve after an exam. Good luck 

Hi,Surgical techniques such as tip defatting, cartilage grafting, and/or reshaping of the nose can reduce the width and bulbosity of the nose tip. Patients with thick skin may receive a different outcome compared to patients with thinner skin. Either way, tip refinement in thick skin can still be achieved. It is very important to research facial plastic surgeons who have extensive experience with thick/oily skin and schedule an in person consultation to better access your nose. Many websites will provide you with before and after photos, that will give you an idea of the surgeons work. In good hands, you should get a great result. 

Best,Dr. S

Thank you for your question and photograph.I would recommend that you schedule a consultation with a board certified plastic surgeon who specializes in rhinoplasty so they can perform a nasal examination and give you the best options. From what I can tell in your photo, you would benefit from a rhinoplasty to thin out the bridge of the nose and a tip rhinoplasty to reduce the size of the tip of your nose. This includes trimming the lower lateral cartilages and placing precision sutures to refine the tip and make it look more pleasing and proportional to the rest of your face. Best of luck in your endeavors.Sincerely,

James Fernau, MD, FACSBoard Certified ENTBoard Certified Plastic SurgeryMember of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science