Do I need another revision rhinoplasty? Is there a procedure for thinning the skin & removing scar tissue? (photos)

Question

Had my 3rd rhinoplasty over 10 years ago. I have extremely thick skin & had the 1st & 2nd revisions to remove scar tissue & improve definition. Skin on my nose feels squishy & loose, & hasn’t contracted on the frame of my nose. I’ve had corticosteroid injections. The right side of my nose appears to have more scar tissue than the left. Is there a procedure for thinning the skin & removing scar tissue? Do I need another revision rhinoplasty? I’m having trouble finding a specialist.

Nima Shemirani, MD · Answer

Hi @kuikat! I recommend seeing a revision rhinoplasty specialist for in person examination. There are several options for you that can be determined after examination. Best of luck, Dr. Nima!

Stephen J. Pincus, MD · Answer

Thank you for bringing up the question of persistent skin thickening and lack of tautness with a "squishy" or spongy sensation! It has been my experience that repeated surgeries with scar excision may only result in more scar formation. Additionally, steroid injections can even result in the "squishy" sensation that you're experiencing. It is true that the appropriate bony-cartilaginous framework must be first established to allow for an appropriate amount of support to the overlying skin-soft tissue envelope. However, beyond that, I have been doing wide dissections with lateral advancemenmt of the skin as well as selective skin suturing to allow for a more reliable coaptation of the skin, which also seems to lessen the post-operative swelling. This is further enhanced with the appropriate compression dressings afterwards.

Umang Mehta, MD · Answer

Thanks for the question! I remove scar tissue and thin the skin envelope very frequently in both primary and revision rhinoplasty. This must be done very carefully to preserve the blood supply to the skin. I would have to examine you in person to let you know if you are a candidate... Sometimes if the cartilages were made too small inside the nose, there is empty space between the cartilage and the body fills this space with scar tissue. Often making a nose more defined in thicker skin patients involves actually making the cartilage stronger and taller, so it can push into the skin envelope from underneath. Other nonsurgical options include more aggressive steroid injections with 5-FU before and after surgery. Accutane therapy can also help. We are updating our website, but our IG has all the latest before/afters. Feel free to reach out anytime if you have any questions!
Kind regards,
Dr. Mehta

Do I need another revision rhinoplasty? Is there a procedure for thinning the skin & removing scar tissue? (photos)

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Do I need another revision rhinoplasty? Is there a procedure for thinning the skin & removing scar tissue? (photos)

Answers (3)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.