Rhinoplasty and the Health of the Skin on the Nose (A Concern About Sensitive Skin/Rosacea)?

I am planning on having revision rhinoplasty and I have a concern regarding the health of the skin on my nose. My skin is delicate and sensitive (I have rosacea) and I fear that open rhinoplasty may aggravate it. My original surgery was "closed" and my doctor used a Xylocaine with eprinephrine injection (which seemed to work rather well for my skin after surgery). The doctor for my revision wants to use "cocaine flakes". Will this anesthetic irritate my skin as opposed to the Xylocaine?

Doctor Answers 3

Rhinoplasty and the Health of the Skin on the Nose (A Concern About Sensitive Skin/Rosacea)?

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      Pictures or an exam would be helpful as well as the goals for revision.  If there is a thick skin envelope due to a treatable skin condition, it makes sense to treat the skin if the goal is to reduce the size of the nose.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Skin colour changes after revision rhinoplasty

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I wouldn't worry about the "cocaine flakes", although medical cocaine comes as a solution rather than "flakes" (?).

However I do see permanent changes in the overlying skin following multiple rhinoplasties, closed or open.  Usually these skin changes start to appear after the third or fourth nose job.  Patients at risk have thin fair skin.

Douglas J. Kibblewhite, MD
Vancouver Facial Plastic Surgeon

Revision rhinoplasty

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If  you did well with the first rhinoplasty the revision should be fine.  I have no idea about the cocaine flakes.  Some times we use cocaine solution 4% for vasoconstriction when performing a septoplasty but it is not used as an injectable anesthetic although all intractable agents are derivatives of cocaine thus the XyloCAINE.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

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