I had a rhinoplasty consultation today and was told that I have thick skin. Is rhinoplasty impossible on thick skin like mine?

Rhinoplasty requires exceptional skill on behalf of the surgeon and great communication with the patient about realistic goals and expectations. Common cosmetic concerns include a dorsal hump, wide nose, sunken nose, irregularities, and asymmetries. Functional concerns include difficulty breathing through the nose, which can and should be addressed at the same time as your rhinoplasty.

In your situation, yes it is possible to have a rhinoplasty on thick skin bu you would need to have well defined goals for your surgeon.

Find someone you connect with, who will listen to your concerns and provide you with a framework for what is possible.

Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

A large portion of my practice involves reducing and refining noses with thicker skin envelopes. Although the skin thickness may limit the results to some extent, the changes that can be produced can still be dramatic.

Rhinoplasty surgery can certainly be performed for patients with "thick" nasal skin. The techniques involved are usually somewhat different from those used on patients with thinner skin. I would expect to use more firm cartilage grafting and to do more de-bulking of the overlying tip skin. It is hard to say how thick the skin is in your particular case from the photo. However, judging from the suggestion of facets at the end of your nose and shadows along the lateral aspects of your tip cartilages, it may not be as much as a issue as you may think. You should seek consultations with surgeons having a vast experience in rhinoplasty and revision rhinoplasty surgery.

Hi M,

Rhinoplasty can be performed in thick skinned patients. We always recommend that patients get a few consultations before deciding on their rhinoplasty surgeon, as that choice is the most important aspect of your surgery. An expert rhinoplasty surgeon can work with thick skin. I suggest consultation with Ari Hyman, MD who is extremely well trained, skilled, experienced, and has natural artistic vision. Good luck and be well.
Michael Persky, MD
Encino, CA

Thank you for your question. All skin types can get an improvement with rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate their on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Rhinoplasty for medium thickness skin. Your tissue Below the skin can be thinned and the cartilage trimmed to give you a much more attractive nose. See other very experienced rhinoplasty surgeons who can show you many photos of noses than they have done.

I would agree that your skin is moderately thick as it often is in males. That doesn’t mean you can’t have a rhinoplasty done and get a good result. It mainly means that your tip will lack the type of refinement that many want from a rhinoplasty.

Rhinoplasty is possible even in patients with thick skin. There are techniques that can be used specifically in patients with thick skin to create greater changes. There may be limit to how much definition can be seen but you can still expect great results. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Yes, rhinoplasty is certainly possible with thick skin, It is just important to have realistic expectations. The width of the bulbous nasal tip can be created from either thick-skin or wide cartilages. A Rhinoplasty procedure can only accomplish improvement on the wide cartilages. It's impossible to make the skin any thinner.

Patients with thicker skin can get a significant improvement in the appearance of the nose but need to be realistic about the result.

Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on limited photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the proposed operative procedure with you and your parents may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California