Realistic Expectation on Rhinoplasty for Patients with Thick Skin?

Hi, I want to get Rhinoplasty when I am about 17 years old. I'm a male. Me and my mom are looking for a surgeon and are looking at what is reasonable to expect.

I think I broke my nose around 6th grade and I never really went in to get a diagnosis of it. It is now crooked and seemingly VERY bulbous. I read alot about the procedure but I am scared that I have thick skin on my nose which would really limit results. Is my nose skin thick and will complicate the surgery? Thank you.

Doctor Answers 10

Rhinoplasty on thick nose skin

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It's hard to tell if your skin is thick except by examining it and feeling the thickness. If your skin is thick, then a reduction rhinoplasty where cartilage is removed to refine the nose may not work because the skin will not redrape as well. For thicker skinned people, you need augment the nose and bridge to make it appear more narrow and refined. This is counterintuitive but is the only technique that works with thick skinned noses.

Good luck!

Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Crooked nose and bulbous tip

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Thank you for your inquiry!

It seems that you are a good candidate for a corrective rhinoplasty that will improve the way your nose looks to complement your facial features in a natural fashion. I would not be surprised if you have breathing issues. Also the thick skin will lengthen the time required for recovery, especially the dissipation of the edema after the surgery. However, without a physical examination it is not possible to provide you with specific details. I highly recommend that you schedule a consultation with a well-experienced surgeon.

It is important to mention that the finest cosmetic results in any particular case are based on a variety of factors, including: the unique anatomy of the patient, realistic expectations, a well-informed and detailed discussion with your plastic surgeon concerning the best options for you especially covering a deep understanding of the pros and cons of any given choice you will adopt.

Please keep in mind that following the advice from a surgeon online who offers to tell you what to do without a physical examination covering the nature and the status of the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative solution would not be in your best interest. With that in mind, it is the safest and for your best interest to find a plastic surgeon with solid experience and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.

Good luck!!!

Ali Sajjadian, MD FACS

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Rhinoplasty limitations for patients with thick skin

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Indeed, thick, olive, oily skin does limit the amount of improvement that can be accomplished with rhinoplasty. Some patients get subdermal fibrosis and thickening and fluid retention and scar formation in the supratip area, which are addressed through a series of cortisone shots to the area. The first cortisone shot is given at the time of the surgery and after surgery every 4-6 weeks up to six months if needed. This is to prevent the thickening that can occur in the supratip area. Certainly a large bony and cartilaginous hump can be addressed through the rhinoplasty procedure to make the nose more harmonious and in balance with the facial features.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

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Rhinoplasty with thick skin

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First of all, it is important to wait until you are physicially mature before having rhinoplasty surgery. The challenge with thick skin is achieving definition in the tip. These noses are improved everyday by changing the contour of the tip cartilages or using cartilage grafts to increase projection. Don't give up hope; talk to an experienced surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Thick skin can be thinned

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Along with this, the nose can have more definition with grafts. Wait until you are done growing, then see an experienced rhinoplasty surgeon whose work on noses like yours is what you are looking for. 

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

Rhinoplasty and skin type

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It does not appear that your nose has the typical thick skin that makes rhinoplasty more difficult. These patients are mostly older with more sebaceous (oily) skin. The skin thinkness just makes the work done underneath show up less. Therefore, less defined.

In your case, you should not have this problem. A bulbous tip would be an easy thing to correct. Also, since you broke your nose in the past, you may also have some functional problems that may be reimbursed by your insurance company. This can really help with the cost of a rhinoplasty.

Henry Daniel Sandel IV, MD
Annapolis Facial Plastic Surgeon

Rhinoplasty can accommodate thicker skin

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Techniques in rhinoplasty today can accommodate thicker skin. The shape and form of the nose is produced by changing the support under the skin, the bone and cartilage upon which the skin is draped. Much of rhinoplasty is shaping the tissues underneath by means of reducing, or building up structure within the nose. Individuals with thicker skin can have a very nice result, and most will require cartilage grafts to improve support and projection which will show through the thicker skin.

Best of luck!

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews


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Without a formal exam it is difficult to give an adequate assessment of your concerns. If the skin is very thick, it can be difficult to get a really defined tip. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Realistic Rhinoplasty Expectations

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Hi Isam,

It is difficult to answer your question without examining your nose and determining the strength of your cartilaginous skeleton. It appears that your nose and skin can undergo rhinoplasty with good results, but your rhinoplasty surgeon will need to be the one who makes that decision.

As young men get older, thick and oily nasal skin may become less oily and not as thick. Sometimes it is worth waiting a few extra years before undergoing the surgery if your nose isn't bothering you too much.

Realistic expectations are the key to your happiness with your rhinoplasty, so make sure that your communicate well at your consultations.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Thick skin is no deterrent to a good Rhinoplasty result

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Think of reconstructive or aesthetic rhinoplasty as a modification of the underlying structures such as the substructure of poles that hold up a circus tent. The skin is analogous to the canvas covering of the tent. Thin skin readjusts itself quicker and it shows the underlying structure of the nose more than thick skin, which takes longer to shrink and readjust. The surgeon will take that into consideration in determining what approach to use and how to modify the underlying structure by subtracting or adding cartilage, bone, etc., or rearranging it.

I suggest you wait until you are in your later teens or early twenties to undergo surgery, as noses in males continue to grow and change until that time. Of course, if you have structural deformities that impede your breathing , corrective surgery should be entertained earlier.

Jack A. Friedland, MD
Phoenix Plastic Surgeon

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.