Regarding the Scope of Getting a Sharp Nose by Rhinoplasty if Having a Thick Skin?

I'm a cleft patient and am 20 yrs female. I have underwent surgeries for repairing my cleft. In this process I took 2 rhinoplasty's too. But i'm not satisfied with the results. My doctor says that i'm having a very thick skin on my nose and so slim nose isn't possible to achieve. If they do so i'll be left with a scar on my nose. My nose is also slant, uneveness and also both nostrils are of different shape. I'm really fed up with this thing. Please suggest me any possible scope for a sharp nose ??

Doctor Answers 4

Cleft lip, cleft nose rhinoplasty

Achieving symmetry of the nose in cleft patients is challenging.  I understand your frustration having undergone multiple surgical procedures and still being left with a nose that is not aesthetically satisfying to you.  Commonly multiple revision surgeries are necessary to achieve a satisfactory result.  Your doctor is right in that the level of tip refinement is limited by the thickness of your skin, but it may be possible that the appearance of your nose could be improved with revision surgery.  If you want the best idea of what is possible for your nose, do your due diligence, find an experienced surgeon, and have him/her evaluate you in person and discuss your options.  

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Thick skin and rhinoplasty

Hello, and sorry to hear you were not satisfied with your results. In general, patients with thick skin may not always achieve the level of definition they desire. You may also be swollen for a longer period of time following surgery. A revision rhinoplasty will help you make great improvements to restore symmetry (this includes the nostrils with alar base surgery) but it is not possible to always get the nose 100% symmetric. Having realistic expectations prior to  rhinoplasty is very important, and it is essential to establish good communication with your surgeon before having any procedures. I would recommend a consultation with a board certified specialist who does a lot of rhinoplasty revisons. He or she may use computer imaging software, which will allow them to morph your photo and help give an idea of how your final result may appear. Thanks and best of luck!

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Thinning a thick nose

Cleft noses generally are more challenging than more routine nasal deformities and often need several operations over the life time of that individual to obtain the most optimal result. Cleft patient noses are not necessarily always thick. Thickness of the skin and soft tissue envelope is a unique problem unto itself. This too can be a difficult problem to address. Thinning of an excessively thick nose may not only require a reduction of some of the cartilage support structures, but may also require thinning of the subcutaneous fat of the nose. This can be a risky procedure because when underlying fat of the nose is excised, the circulation to the skin can become compromised, which can lead to necrosis and unwanted contour deformities. You should make sure you seek out the attention of an experienced Plastic Surgeon. 

Michael A. Epstein, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 48 reviews

Cleft lip and nose issue

Cleft lip/nose patients are a bit more complex than non cleft patients. Obvioulsy asymmetry is the big issue and flattening of the alar on the affected side.  As for the thick skin, it is quite difficult to get a significantly thinner apearance in some patients.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 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.