Rhinoplasty for Sebaceous Nose?

Question

I am 50 with very oily skin since 13, worsening with time. I must wash my face approximately every 30 minutes; especially the nose and forehead. I've never seen a worse case.I would like to have a Rhinoplasty to decrease the size of the bulb, but have heard that it is extremely difficult for a surgeon to obtain a thin refined tip on a sebaceous nose. Is this true? And if so, is there any way to safely eradicate the glands to decrease oil so I can have surgery? Like laser or that concentrated vitamin A oil on the net?

Shahram Salemy, MD, FACS · Answer

Rhinoplasty on patients with thick, oily skin has one major unique challenge compared to rhinoplasty on patients with thin skin-- it's tougher to see the refinement and details of the underlying tip cartilage that has been reshaped.  For this reason, it's important to examine you and lay out what some reasonable expectations should be.  In addition, it will take longer to see the final results, up to a year or longer, and during that time, you will likely need some minor in-office procedures to help refine the results and calm the swelling.
The key here is that you can get improvement, but it is not as dramatic as in some patients with a different type of skin.  If you check out the websites of surgeons who do rhinoplasties, you should see a range of results on a range of different patients with different skin types-- this will give you an idea at least of which patients get more dramatic results and which get more subtle ones.  Ultimately, your best source of information with be a direct conversation with your surgeon.  After he examines you, he'll give you his take on what you can expect.
Good luck!
Dr. Salemy

Michael A. Persky, MD · Answer

Hi Bama Hayseed,
Thick oily skin does present problems for rhinoplasty.  It is difficult to obtain a thin, defined tip on a bulbous, sebaceous nose. 
You may consider a course of Accutane if your physicians feel that you are a good candidate.  There are down sides to taking Accutane which need to be carefully considered before committing to the treatment.
Patients who have taken Accutane must wait at least 6 months before having any type of surgery.
I prefer external/open approach structural augmentative rhinoplasty in patients with your type of nose.
I would not count on laser, and would certainly not spend $ on the concentrated Vit A oil on the internet.
Good luck , be well, and Roll Tide.
Dr. P

Vincent N. Zubowicz, MD · Answer

If you are suffering from rhinophyma (sebaceous thickening of the nasal skin) there is a simple procedure using the CO2 laser to plane down the skin. The procedure doesn't hurt much. Takes about a week for the nose to resurface. Lasts a very long time, if not a lifetime.

William Portuese, MD · Answer

Rhinoplasty is not performed for sebaceous oily skin.  A rhinoplasty operation is designed for sculpting the bone and the cartilage of the nose and is not skin surgery.  The skin itself is lifted up, and the bone and cartilage are sculpted to the anatomical shape and the skin put back down.  If you have a rhinophyma, the thickness of this can be reduced in size with dermabrasion.

Shervin Naderi, MD, FACS · Answer

Hi,
I agree with the other surgeons.  Thick, oily skin is not likely to result in a very refined tip.  However, there are options and all hope is not lost.
Depending on your skin, during surgery the under surface can be thinnned out or "de-fatted."
Structural grafting and suture techniques also are often used in thicker skinned patients to give them very nice improvements in their tip. 
Computer imaging to see what exactly is realistic as far as outcome is paramount.  You have to see what is possible before you go through any surgery.  If you like what you see then you can consider proceeding but if you think the imaged picture's tip is just not as narrow or refined as you had hoped, well then you don't have to go through surgery.
Now for the big one:  Accutane, which is a very serious medicine used for severe cystic or nodular acne can usually thin out the skin and reduce the oil glands very nicely!  The problem is that the medicine itself can have very serious side effects and no one in the U.S. will prescribe it for the purpose of getting a more refined nasal tip but it is used in other parts of the world for this purpose. I would not recommend you doing it but it is an option you should be aware of.
The important thing is to know that the old methods of cartilage excision to narrow the tip do not work on patients with thick oily skin and usually end up making the tip more amorphous and round in the long term.
Good luck.

Rhinoplasty for Sebaceous Nose?

Answers (7)

Answer: Rhinoplasty not skin surgery

Answer: Rhinoplasty not skin surgery

Answer: Accutane but wait.....

Answer: Accutane but wait.....

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Everything you need to know about Rhinoplasty

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Rhinoplasty for Sebaceous Nose?

Answers (7)

Answer: Rhinoplasty not skin surgery

Answer: Rhinoplasty not skin surgery

Answer: Accutane but wait.....

Answer: Accutane but wait.....

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.