Do Plastic Surgeons Typically Remove Skin During Rhinoplasy?

What are the side effects of removing skin during rhinoplasty particularly if the nose has a bulbous tip and is really wide.

Doctor Answers 4

Rhinoplasty and Skin Excision?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question.

Generally, skin is not removed during a standard rhinoplasty procedure (except for narrowing the alar base of the nose).

Best wishes.

Skin not usually removed during rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The whole premise of a rhinoplasty is to modify the firm structures under the skin, the cartilage and bone, so when the skin is re-draped over them it takes on this new shape.  The skin of the nose has a certain ability to contract, so even though it appears there is too much skin when trying to make a large nose smaller, the skin will usually conform.  The area skin may be removed is to narrow the nostrils if they are too wide.  Placing incisions in any other area of the nose would leave very visible scars and possibly cause loss of blood supply to areas of skin of the nose.

Removing skin during rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

We don't normally remove any skin during rhinoplasty no matter how big it is. The skin will contract with time on its own. The skin doesn't have an infinite capacity to contract, though. This is why there are limits to how small we can make the nose during rhinoplasty.

The only exception to removing skin is during nostril narrowing surgery where wedge of skin may be removed to help narrow the nasal base.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Rhinoplasty surgeons rarely remove skin!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

No matter how big and bulbous your nasal tip is, the skin contracts and settles over its new underlying support configuration. Not only is excision of (excess) skin NOT necessary, the circulation would be impaired by incisions, and scars on the nasal tip will be visible even if they are skillfully and precisely sutured.

Of course, when skin cancers of the nasal skin require removal, incisions are made, and scars result. The same occurs with nasal injuries that lacerate the skin.

But for elective cosmetic surgery of the nose, your skin elasticity is more than adequate to contract precisely and completely over the surgical changes your surgeon creates in the cartilages and bones of your nose. Excessive width of the nasal base can be improved by Weir excisions, which leave scars along the cheek-nose interface (adjacent to the nasal alae). Your surgeon can discuss this with you, but in most cases where this is necessary, the scarring is very minimal and nearly imperceptible when healed.

Good luck and best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 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.