Reduce thick skin for best rhinoplasty results? (Photo)

I have thick skin and a bulbous tip. I was told I may not get the results I am wanting to achieve as the tip of my nose may not look much different after the fact. Will rhinoplasty make much of a difference for my tip? Is there anything I can do to help reduce the thickness prior to surgery like retin-a?

Doctor Answers 8

Rhinoplasty - Thick skin and bulbous tip

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The challenge with thick skin is that even if definition is created to the nose and cartilage underneath the skin, these changes will not show through the skin. In these cases additional support and structure is necessary to create definition in the tip of the nose. Using grafts made from your own cartilage will be the best approach for a natural-appearing, lasting result.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Reduce thick skin for best rhinoplasty results?

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Dear lalaacout

Although I agree that you don't have thin skin, you don't appear to have very thick skin and I think you can have a good improvement in your tip definition with a rhinoplasty. Look for an experienced surgeon who is properly trained and is certified by the American Board of Plastic Surgery (or Facial). See more than one consult and make a well informed decision.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 58 reviews

Closed rhinoplasty candidate, some advices:

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Thank you very much for sharing your concerns with us.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 372 reviews

Tip definition

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There are several ways to improve tip definition in the nose, even with thick sebaceous skin. Sometimes this can be done with a cephalic trim and tip defining sutures to improve the projection and shape of the tip. That being said, the overlying skin drapes on top of the construct that is made and sometimes a cartilage tip graft can help improve tip definition. Consultation with a plastic surgeon certified by the American Board of Plastic Surgery is great way to start. Best, MMT

Bulbous tips, thick skin and rhinoplasty

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In rhinoplasty, many patients desire to refine their bulbous tip. The strategies are different depending on the skin thickness.

Patients with thinner skin may need adjustments in the size, shape, and position of the tip cartilage to refine the nasal tip.

Patients with thicker skin may need cartilage grafts to stretch the skin to make it appear more refined. Simply removing tip cartilage in these patients bunches up the thick skin, creating an even more rounded nasal tip. 

I recommend sitting down with a surgeon who specializes in rhinoplasty, so they can examine your nose. They can also explain this skin thickness concept to you in detail specific to your nose. With this information they can determine a safe treatment plan for you.

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Bulbous tip with thick skin

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Hi lala,

Thanks for your question and photos. I think in experienced hands a reasonable result is well within reach. However, if you would like to see something that is not realistic then it may be hard to find a surgeon to give you that. Rhinoplasty will certainly make a difference. You need to find a good and qualified surgeon to help you. You skin seems thick but only an in person examination were your expectations can be discussed will determine what is best for you. Sometimes fractional CO2 can help decrease the thickness of the nasal skin like in cases with lots of sebeous glands. Good luck.

All the best,
Carlos Mata MD, MBA, FACS

Carlos Mata, MD, MBA, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 38 reviews

Rhinoplasty for the bulbous thick skinned nose?

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Rhinoplasty for the bulbous thick skinned nose? The skin itself cannot be thinned but the subcutaneous tissue can be. In addition removal of excess cartilage can give you a much more attractive and smaller nose. See several experienced rhinoplasty surgeons who can show good results in nose is like yours. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Reduce thick skin for best rhinoplasty results?

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The areas that you described and would like improved can be addressed with a natural appearing rhinoplasty performed by an expert artistic plastic surgeon with extensive rhinoplasty experience. Patients with thicker skin can get a significant improvement in the appearance of the nose but need to be realistic about the result.

There is no way for you to thin the skin with any medications or supplements.

Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the proposed operative procedure with you and your parents may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.