How common is skin necrosis?

Thank you for posting your question here !I will base my answer on the limited information provided, for a more detailed and customized plan please consult with your plastic surgeon.
During a rhinoplasty the underlying structures (bone and cartilage ) are altered to achieve certain goals (in your case refining the tip). Having thick skin makes it more challenging for those changes to be reflected on the surface. That being said , it does not mean that you won't see a change but the changes might be more subtle.
Thinning the skin during surgery is feasible though it carries the risk of compromising the bleed supply and potentially causing skin necrosis , but if done right the chance of that happening is minimal . Other options include placing the patient on a skin care routine (including products with retinol) pre op to improve the skin quality sometimes in addition to laser or other treatments . This might take some time but it does help improve the skin quality pre-op. Some surgeons might also use additional grafts in the operation such as a shield graft to make the architectural changes more pronounced on the surface.
In general skin necrosis in a healthy non smoking patient is pretty rare especially if the surgeon does not over do the skin thinning and is mindful of the blood supply though it is never zero.
I hope this helps, best of luck!

Hello and thank you for your question. When good technique is used, true skin necrosis is extremely unlikely. 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