Thin skin spot on nose tip - can this be improved? (Photos)

Question

I am looking for advice on whether there is anything I could or should do to improve the appearance of my nasal tip. I have a patch of skin that appears to have become progressively thinner over time. One plastic surgeon previously told me it was a mole, while another said it was the cartilage of my nasal tip being slightly uneven. (For context, I have not had a previous rhinoplasty.) I feel it has become more noticeable following two pregnancies At the time (approximately 18 months ago), both plastic surgeons advised that I would likely be better off leaving it alone rather than risking scars or other complications that may come with surgery. I am looking for some further opinions on this. Would filler help? Or, even better, are there any creams or retinol products that could improve the appearance? Would you suggest a rhinoplasty, noting that I am happy with all other aspects of my nose and hate t idea of dealing with revisions etc. Or do you think I would be best to continue leaving it as it is for now? Im feeling quite self conscious.

Philip Wasicek, MD · Answer

What you are describing sounds most consistent with very thin nasal tip skin with either a slightly prominent underlying cartilage edge or a small contour irregularity becoming more visible over time. Pregnancy-related hormonal and soft tissue changes can sometimes make these types of areas appear more noticeable, particularly in patients with thinner skin.
Without an in-person examination it is impossible to say definitively whether this is related to cartilage shape, thinning soft tissue coverage, a benign skin lesion, or a combination of factors. In general, creams, retinols, or topical skin care products are unlikely to significantly improve this type of issue if the underlying problem is structural thinness or cartilage visibility. Retinoids may improve overall skin quality slightly, but they typically will not meaningfully camouflage an underlying contour irregularity.
Filler is unlikely to camouflage the area, and is likely to disperse to the surrounding area--not to mention the nasal tip is a high-risk area for filler and should be approached very cautiously by someone experienced with rhinoplasty anatomy and nasal injections. 
If the area truly bothers you and has become progressively more noticeable, the most definitive solution is often a very conservative surgical approach aimed at improving the soft tissue coverage and smoothing the contour rather than dramatically changing the shape of the nose. This may involve:
1) placement of a small soft tissue graft/fascia graft for camouflage2) subtle refinement of the underlying cartilage if needed3) occasionally both
Importantly, this can sometimes be accomplished through a limited or closed rhinoplasty approach rather than a major cosmetic rhinoplasty. Since you are otherwise happy with your nose and understandably want to avoid unnecessary surgery or revision risk, the goal would be subtle improvement and camouflage &mdash; not transformation.
That said, I would be cautious about pursuing surgery unless the issue truly bothers you consistently, as even small nasal procedures carry risks and healing unpredictability.
My recommendation would be to be evaluated in person by a board-certified plastic surgeon who specializes heavily in rhinoplasty, particularly structural and revision work. Thin-skinned noses require careful judgment, and an experienced rhinoplasty surgeon will be able to give you the best recommendation.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. This is cartilage with pressure against thin nasal tip skin. Maneuvers for your surgery would include nasal tip deprojection, placement of a fascial tip graft for improved tip contour, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thomas Trevisani, MD · Answer

In person exam is essential. Based on limited photos - it appears that the area of concern could be a shifted cartilage. If you are seeking improvements and are self conscious about it- then I suggest that you seek an in person consultation with an experience Board Certified PS with extensive Rhinoplasty experience preferably performed through a closed technique

Thin skin spot on nose tip - can this be improved? (Photos)

Answers (3)

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