Lost skin thickness on nasal tip - it must simply be an external matter? Solutions appreciated (Photos)

Question

I'm sorry to keep reposting, hoping better photos may help! I appreciate all the insight I've received on the prior posts! Hoping this photo is clearer that after a peel and then (accidental) extreme over-exfoliation, the amount of skin on my nasal tip has been reduced (9 months have elapsed) and it still appears buffed. I'm looking to regain the original thickness but know that what occurred was superficial, so it must simply be an external matter? Any solutions are appreciated and thanks again to all the doctors for their previous replies!

Eric M. Joseph, MD · Answer

Based on these photos, you do not appear to have an abnormality of your nasal skin which appears thin. In that regard, I do not believe you have an external problem. If you have a picture of your nose before it was exfoliated, please consider re-asking you a question with before and after photos. Thanks again for this question. Sincerely, Dr. Joseph

Steven M. Denenberg, MD · Answer

Before the peels, you had *thin* skin on the tip of your nose, covering strong and broad tip cartilages. In the before photo, you can easily see the dent between the left and right tip cartilages, and you can see the top edges of the cartilages, about half-way up the nose, where the tip stops being wide and we see the bridge of your nose. It's pretty clear what's going on: you have a nose very very much like the patient whose photos I posted in the link with this answer, except your tip cartilages aren't as prominent as hers.

After the peels, your skin actually looks a teeny-tiny bit thicker, if anything, because in the photos we can't see the outlines of the tip cartilages as well (which would suggest *thicker* skin). But I'll bet it's just the lighting. A peel wouldn't be able to make a permanent change in the thickness of the skin, and certainly it didn't *thin out* the skin.

I think the problem is that, for some situations, it's a real disadvantage for the patient's understanding that she isn't a surgeon and isn't familiar with what things look like underneath the skin. If you were, I think you'd understand what's going on here better. But I'm 99% sure that what you're seeing is not any change in thickness of the skin, or permanent damage to the skin, but is just related to the shape of the nose being controlled by the underlying cartilages, and that's a complicated topic. Most rhinoplasty surgeons are not even expert in it!

So, sorry to disagree with your ideas, but I think you're barking up the wrong tree. Again, if you want a narrower tip, investigate a rhinoplasty. Otherwise, leave it all alone, try to ignore it for now, and see what it looks like in a year.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a rhinoplasty with placement of a mastoid fascia tip graft during your surgery to help smooth the contour. 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

Lost skin thickness on nasal tip - it must simply be an external matter? Solutions appreciated (Photos)

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Lost skin thickness on nasal tip - it must simply be an external matter? Solutions appreciated (Photos)

Answers (3)

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Recommended reading

Everything you need to know about Rhinoplasty

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