Why Does Skin Thickness Matter for Nose Surgery?

Skin thickness is important because it can adversely affect the final result of your nose surgery, if not taken into account by your surgeon. The skin of the nose varies in thickness from the bridge, where it is generally thin, to the tip and nostrils, where it can become thicker. Some ethnicities tend to have thicker skin on the nose than others.

Thick skin can limit the amount of narrowing or refinement one can obtain in the tip of the nose. On the other hand, it can also disguise slight asymmetries in the underlying cartilage and bone framework of the nose. Thick skin can be made thinner by adding more projection to the nose (the way the lining of a balloon thins as it is inflated) or by carefully removing fat from underneath the skin.

Thin skin allows a more refined nasal tip, however, irregularities or asymmetries in the underlying framework can become more visible over time. Thin skin can be thickened by placing soft tissue grafts underneath the thin portion of skin.

Remember, however, these techniques to thin or thicken the skin only work to a limited extent.

Dear Realself user,
With a thick skin it can be much more difficult to achieve the desired level of definition and refinement because sharp lines and angles can appear blunted under a thick cover It is not like it is not possible to operate patients who own thick skin butjust be aware of that the healing process will be a bit more complicated compared to other patients.Thick skin may be a challenging procedure , but a satisfying result can be achieved by the right surgeon.Before the surgery there are some methods that could be performed to help thenose skin get thinner and this will create a much more desired outcome.
Patients with a thin skinned type of nose are the lucky ones compared to patients with thick skin because they tend to recover way faster than those with a thick skin. Thin skin will allow for a high degree of refinement but any tiny irregularities or asymmetries may also show through. This can be especially true if you have thin skin and very strong prominent cartilage underneath. You can recognize this in someone whose entire tip cartilage outline can be seen easily through the skin.

TAS Aesthetic Surgery Clinic

Skin thickness is important for rhinoplasty surgery because differences in the thickness of the skin can change the way the nose will appear with time. Patients with very thin skin are prone to show more minor irregularities, while patients with skin that is too thick my have less definition to the nose. The thickness of the skin on your nose is one of many factors your surgeon needs to consider in an in-person consultation.

Skin thickness is an essential component of evaluation for rhinoplasty.  Thick skin will take longer to  contract over the cartilaginous/bony framework and will limit how much smaller one can make the nose.  Think of a comforter (thick skin) wrapped tightly around a statue.  You would not be able to delineate the details of the statue very well. Now think of a bed sheet (thin skin) wrapped tightly around it.   Those details are now more apparent.  Thick skinned noses CAN be made smaller, just not quite like thin skinned noses.

The advantage to thicker skin is that any minor irregularity is easily hidden.  Thinner skinned patients do not have that luxury.  

 

 

When performing rhinoplasty, it is important to take skin thickness into consideration. The best way to illustrate this is with an example. If you have a diamond ring and I cover it with a fine silk sheet, you will likely see the shape transmitted through the sheet. If,  however, you cover it with a comforter, you are not likely to see anytning other than possibly a small bump. The same goes for your nose.

The way that I describe the effect of skin thickness on rhinoplasty results is to use the analogy of a down comforter versus a fine Egyption cotton sheet. A thick comforter lying over an object makes it difficult to see the shape of the object while a thin sheet allows one to see every edge and contour.

The underlying cartilage and bony structure of the nose will show through easily in thin-skinned patients which allows for increased refinement of the nose. However, it is critical to make sure that there are no prominent edges or grafts as these may show through the skin over time as the swelling resolves. In these cases, I often place a soft tissue graft (such as temporalis fascia) to camouflage grafts at the tip, for example.

In thicker skinned patients, there may be limitations in the degree to which the nose can be narrowed and refined. The skin envelope can be carefully thinned to a certain extent, however, the key in these cases is to create a prominent and strong underlying framework. 

During your consultation, an experienced rhinoplasty surgeon should be able to assess your skin thickness and explain its impact on your surgical outcome. 

  Skin matters when it comes down to nasal surgery. As a surgeon you can fine tune the cartilages of the nose , but if the skin is very thick it will not show through in the final outcome. Cartilage grafts may be needed to accentuate the tip definition when a patient has thicker skin. The skin thickness may be changed by "de-fatting" the skin or injecting small amounts of steroids into the thick skin area. If you have thick skin make sure you discuss your concerns with your physician.

Good Luck

The nasal skin determines the limits of how big or small it can be made. The limit is based on the soft tissue envelope of the nose (the skin). Imagine the skin of the nose being like a dress, and the underlying nasal structure like a person's body. If you placed too small of a body on a thick, large dress, you would have excess material. Likewise, in a rhinoplasty making the nose too small can lead to a pollybeak deformity where excess bulk is seen in the tip. A surgeon with extensive experience will work with your nose to create one which fits with your facial features.

This is a a good question.  Skin thickness affects the outcome of  rhinoplasty.  The thicker the skin more difficult it is to see the finer corrections of rhinoplasty. Example, it difficult to produce a thin well sculptured tip because the thick covers up the finely sculpted tip.

Dr. ES 

Thicker skin hides contours and redrapes differently over the fine cartilage structure that are sculpted at the time of Rhinoplasty. I use this analogy with my patients: 

In the summer, you sleep with a single sheet on your bed, which when covering your feet, shows the outlines of all of your toes and you can see and count them all. (Thin skin, sculpted, defined anatomy)

In the winter, when it is cold, you sleep with a thicker comforter to keep you warm, which when draped over your feet reveals your feet, but you really cannot see each toe like you can the single sheet. (Thick skin, less fine detail and definition).

Hope this brief description and analogy helps!

Dr. C