Can my Nose Tip Be Refined and Deprojected - I Have Very Thick Nasal Skin?

Question

I am 15 months post op and due for a revision with same surgeon in two weeks. My surgeon said I will not get a substantial result and he might not be able to define my tip from the front anymore. He also made my nose alot wider and scooped which he is fixing in the revision. Can I get a good result as I have thick nasal skin? He is using the suture technique to shorten and refine my tip but not removing any cartilage. I have provided some pictures of post op and pre op Thank you

Paul S. Nassif, MD · Answer

It is possible to improve the appearance of your nose with a revision. But keep in mind that patients with thick skin may not always achieve the level of definition they desire, and swelling may linger for a longer period of time. The final result of a revision may not be evident for 18-24 months after surgery. In general, swelling can be influenced by the thickness of the patient's skin, whether the procedure is a revision, whether tip work was performed, and whether or not the procedure was open or closed. I would recommend establishing good communication with your surgeon, as this is essential for obtaining a result you are happy with. I hope this helps, and I wish you the best of luck.

Paul F. Vanek Jr, MD · Answer

It looks like your dorsum requires augmentation with cartilage or an inlay material, which you should discuss with your plastic surgeon. The inner base width can be improved with revision if its something you’d like to pursue. Your skin thickness offers some challenges, but nothing too great to handle with appropriate surgical technique. Of course, your surgery will not affect the thickness of your skin on the dorsum of your nose. I caution you about doing anything because your nose looks great, and the enemy of “good” is “better.”

	You can see from some of the photos on the link below that patients have come to my Cleveland plastic surgery office for rhinoplasty with this same problem. 

	To your health and beauty,

	Dr. Paul Vanek

	Board Certified Cleveland OH plastic surgeon

Kenneth Hughes, MD · Answer

The scooped out look can be fixed in this revision, but the tip width does appear to be improved.  Kenneth Hughes, MD Los Angeles, CA

Darryl J. Blinski, MD · Answer

Maybe I am missing something but my comparison of the before and after posted photos shows you have obtained an excellent result. I recommend no further surgery.

Can my Nose Tip Be Refined and Deprojected - I Have Very Thick Nasal Skin?

Answers (4)