Fascia grafting to tip - how hard is it to thicken the skin and cover my tip?

Question

I had a revision tipplasty 2 years ago and since the swelling has gone down I notice a lot of imperfections show through my skin as my surgeon said it was paper thin. I had warned him prior it was thin and he didn’t use fascia but my nose now gets so cold and shrinks to the cartilage and you can see the white through it and it’s so uncomfortable. How hard is it for a little fascia to thicken the skin and cover my tip and help circulation? Is it less healing time than the initial surgery?

Thomas A. Mustoe, MD, FACS · Answer

A fascia graft requires a formal revision with an open rhinoplasty approach, but the recovery should be faster.  It will not improve blood supply. An alternative which I have found to be successful is fat transfer which is a minor office procedure.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Fascia grafting is an excellent option to help "thicken" the skin and reduce the likelihood of imperfections from showing in the future. My choice is temporalis followed by perichondrium from the rib. In addition to help the fascia, I will often employ hyperbaric oxygen and/or micro/nanofat injections which deliver stem cells and growth factors. After surgery, the tip will appear more swollen - this is intentional and it will settle over time. Hope that answers your questions!

Fascia grafting to tip - how hard is it to thicken the skin and cover my tip?

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