Crooked nose and bulbous tip
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.
Ali Sajjadian, MD FACS
Rhinoplasty limitations for patients with thick skin
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.
Rhinoplasty with thick skin
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.
Thick skin can be thinned
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.
Rhinoplasty and skin type
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.
Rhinoplasty can accommodate thicker skin
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!
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.
Realistic Rhinoplasty Expectations
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.
Thick skin is no deterrent to a good Rhinoplasty result
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.
Rhinoplasty on thick nose skin
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.