Can reduction rhinoplasty remove skin tissue or only cartilage and bone?

Question

I want to know whether excess tissue inside the nose can be removed as well as cartilage.

Toby Mayer, MD · Answer

For more than 35 years I have removed both cartilage and excess subcutaneous tissue while doing rhinoplasty. When the subcutaneous tissue is thick this area between the skin and cartilage can be removed and is often quite extensive. See a very experienced rhinoplasty surgeon for this.

Christopher Khorsandi, MD · Answer

Sometimes the soft tissue can be resected in areas such as the nasal base or the nostrils to thin a nose. But typically the skin of the nose does not need to be resected because it will contract after surgery and conform to the underlying bony and cartilage framework.

Stephen Weber MD, FACS · Answer

Rhinoplasty, in most cases, removes only bone and cartilage. The skin or soft tissue envelope as it's referred to tends to contract nicely so there is no need to reduce the skin itself. In very thick skinned patients the area of the tip can be thinned from the underside but I try to avoid this whenever possible as there is always a risk of over-thinning the skin or creating an irregularity in the skin envelope. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Jay W. Granzow, MD · Answer

While skin tissue can be removed from both the outside and inside of the nose, this is rarely required.  As an Otolaryngology (ENT) and Plastic Surgery boarded surgeon, I prefer to shape the structures of the nose if possible and only remove tissue when necessary.  This is true both when addressing the external appearance and also the very important function and breathing of the nose.

Sanaz Harirchian, MD · Answer

Hi ensenada1. Rhinoplasty can involve thinning the underlying soft tissue in a patient that has thick skin. This can create a more refined nose in a thick skinned patient. Good luck. Best, Dr H

Kenneth D. Christman, MD · Answer

In most rhinoplasties, only cartilage and bone is resected, but sometimes a small amount of nasal lining can be removed if necessary.  As for the external skin, sometimes the nostrils can be narrowed by excising wedges.  Other areas could undergo skin excision, but only if necessary for redundant excess skin, which is rare.

William Portuese, MD · Answer

Reduction rhinoplasty is accomplished by shaving down  bone and cartilage. The nasal bones are narrowed with osteotomies. The dorsal hump is composed of bone and cartilage and must be shaved down in order to remove it. The tip cartilages are sutured together  to reduce a bulbous tip. A small amount of skin inside the nose can be removed, but will have no bearing on the outside of the nose. Rhinoplasty does not usually involve removal of skin on the outside of the nose because of visible scaring.  For many examples of rhinoplasty, please see the link and the video below

Michael T. Somenek, MD · Answer

Most of the work that is performed in reduction rhinoplasty involves removing cartilage and bone because that is what mainly contributes to the appearance of a larger nose. That being said, in select cases and with caution, some of the thicker skin in the nasal tip can be refined to thin these areas out and create more definition. However, this is usually something that is done in the hands of an experienced rhinoplasty specialist because removing too much can compromise the blood supply to the skin envelope and cause complications. Make sure you seek consultation with a rhinoplasty specialist to get a thorough examination and evaluation. Best of luck.

Richard W. Fleming, MD (retired) · Answer

Some subcutaneous tissue can be removed in thick skinned patients, typically in the tip area. Full thickness  skin is rarely removed except when reducing the width of the nasal base, where incisions are made at the nostril opening, because we want to avoid unfavorable scars.If I have not answered your question please explain what you're trying to achieve.

Can reduction rhinoplasty remove skin tissue or only cartilage and bone?

Answers (9)

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