Thick Skin - Best Technique to Narrow a Bulbous Tip?

The most common way we create defined nasal tips is by removing some of the tip cartilages. For patients with strong cartilages and thin skin, the tip skin shrinks around this smaller framework making the tip smaller. However, when the skin is thick and cartilage weak, removing cartilage has the opposite effect. The way we often create tip definition in thick skin noses is to add cartilage to increase strength. Grafts called shield grafts are also used to press into the thicker skin to provide more underlying structure and shape.

See an experienced revision rhinoplasty surgeon who can examine your nose and tell you if anything further can be done. In some patients the skin is so thick that you can only thin it so much and no more.

When very thick skin is present on the tip, the patient is just not a good candidate for a rhinoplasty. Two previous rhinoplasties are not making this type of surgery any easier. It is important not to remove structural cartilage for fear of the nose collapsing. There is some defatting of the skin that can occur during the rhinoplasty procedure whereby the skin is thinned along with removal of some scar tissue. Frequent cortisone injections in the first six months after the surgery are also a technique that is employed as part of postoperative care. Blenderm tape applied at night is another technique that helps to prevent recurrence of fluid and scar tissue in the super tip area of the nose.