Tip Rhinoplasty for Nose with Thin Skin?

I don't like the tip of my nose. I think it's too boxy, large, and one side is higher up than the other. I don't like the look of it from front on. My cartilage is split in half and very obvious from front and 45 degree angle. I do like the bridge and don't want to fix that. I am worried that my nose will look FAKE! I was also told that my nose is complicated because I have thin skin. Will my rhinoplasty cost more because of how complicated it is?

Doctor Answers 22

Thin vs thick skin for a rhinoplasty

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If you had to choose between thick or thin skin to get a decent rhinoplasty you'd pick thin every time.  While thin skin may show any irregularities more, it will also show the nice improvements in shape and definition you might achieve.  Costs shouldn't change at all.

Rhinoplasty with thin skin

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Thin skin will make the operation more challenging because the underlying cartilage and bone are more visible. However, much better refinement and definition are possible because the exact size and contour  is not hidden by thick skin. It is all about refinement.

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

Tip rhinoplasty for boxy tip in thin skinned individual

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Your costs will essentially be a function of the time it takes to complete the procedure and that can only be estimated prior to surgery. You have common concerns that are addressed in a a typical rhinoplasty. Reducting the boxy appearance is accomplished by manipulating the paired cartilages in the tip of the nose. IF you desire a subtle change, let your surgeon be aare of your preferences.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Tip rhinoplasty in thin skin

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Although it is not exactly visible from your photo, it does not appear that your skin is any thinner than most caucasian women. A tip rhinoplasty is the answer to correct a boxy tip.

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

Tip Rhinoplasty for Nose with Thin Skin?

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First of all, your nose should not look FAKE if done by an experienced, skilled surgeon.  You look like you have:

1. Overprojected, droopy tip (requiring repositioning of the cartilages)

2. Slight bump (needs to be brought down to match the new tip)

3. Normal to thin skin (can use lining or crushed cartilage to hide sharp edges of cartilage if necessary)

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 179 reviews

Tip Rhinoplasty in Patient with Thin Skin

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A tip rhinoplasty would appear to be a good choice, given your concerns. This can be performed through a 'closed' or 'open' approach and would entail trimming and reshaping of the tip cartilages. Cartilage grafting might be appropriate if the tip lacked support and if your aesthetic goals were consistent with a more projecting tip. Thin skin can be an issue as far as seeing irregularities after surgery. The surgeon must be careful to reduce the chance of this happening by gentle and precise dissection. In the hands of an experienced surgeon you should expect a very high likelihood of a nice natural appearing result that definitely does not look fake! Best of luck  - Dr Harrell

Tip rhinoplasty and noses with thin skin

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Wide, thick, bulbous tips can be feminized, refined, and improved by sculpting the tip itself by using tip suturing techniques, cartilage grafts, and removal of cartilage to feminize and improve the look of the tip. It is important to be able to make the tip balance with the remainder of the nose. Thin skin can complicate the process because every little tiny irregularity can show through the skin. Thin-skinned individuals tend to have more revision touchups than thick-skinned individuals.

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

Tip Rhinoplasty can have different outcomes with different skin types

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Surgery to narrow the tip of your nose or to reshape cartilage can be performed without altering your profile if you so desire and can be done leaving the rest of your nose alone.

Patients with thicker skinned noses tend to have better camoflauge for any tip irregularities when surgery is done there; however, they often have more of an amorphous or less defined tip. Patients with thinner skin can actually get better results from tip surgery and how it looks depends upon your and your surgeon's preference.

You are right in that if too much is done to the tip it can look fake. However, if you simply want it brought into a more symmetrical position and narrowed slightly vis a vis correcting the split that can actually be more easily done in a thinned skin nose. If you want a lot of tip alteration which requires cutting the cartilage at the tip like creating a boxy or upturned tip then it is more risky in thin skinned nose as you can see cartilage irregularities.

I actually prefer operating on patients with thin skin on the tip especially patient who do not want a created look to the tip as the results are much more predictable. The costs however should be the same and the surgeon should not charge more because of your skin type. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Complexity Does add to Cost

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While each office has different policies. The complexity of the case typically increases anesthesia time and expenses which is billed on an hourly basis.  Therefore, there would be a greater total fee for complex cases.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Tip-plasty for thin skinned individuals

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Tip-plasty can be a very challenging surgery especially on patients with thin skin.  There are essentially two ways to access the tip cartilages, through a closed technique and through an open technique.  There are many surgeons who will perform tip-plasties through the closed technique and get excellent results, but in my practice I have found for patients with very thin skin that will show every little detail in the underlying cartilage, that the open technique is superior.  Exacting precision can be achieved with the open technique in order to design the nasal tip, in particular what shows through the skin after the swelling has resolved.  The negative is there is a small incision across the collumela (skin between nostrils) which does leave a scar, thought the scar is usually nearly imperceptible.  The nose may also stay swollen a bit longer than with the closed technique. 

Leif Rogers, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 26 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.