Will cutting off subcutaneous tissues in the nose trigger the growth of scar tissues?

Dear San Francisco Friend:

I am assuming the tip of your nose is large, the question
is, is it large because there is too much cartilage or because the skin is very
thick and that will add a lot of fatty tissue?
I cannot make that judgment without seeing you in person. For some patients it is important to thin the
skin out just a little bit, but that is to be done very conservatively. However, banking on just removal of some of
the fat under the skin to narrow the tip is not wise because that alone is
rarely successful. Generally, in
rhinoplasty, bulky tips are made smaller by the removal of or sculpture of the
tip cartilage.

I would suggest that you have consultations with doctors
who specialize in nasal surgery. Those
who major in it work to the exclusion of other procedures. This is very important. You want someone who is experienced and has a
good anesthetic sense and who has “been around the block a few times.”

Have computer imaging when you go for consultation. You want to see the doctor’s vision of the
outcome. It is always good to bring
friends or family members to be with you so you can learn the most. Before you go, prepare your questions. Visit lots of websites. Look at a lot of before and after
photos. See what the patient comments
and reviews are. Read books, study up,
learn as much as you can, and when you go to your consultation spend enough
time to be well informed.

Consider a Skype consultation to get a sense of the
doctor’s view of what may be accomplished.


Best wishes,

Robert
Kotler, MD, FACS

Over
4,500 nasal procedures performed

When the nasal tip skin is very thick, often the only option to obtain tip definition is to thin the skin. This has to be done carefully because if the skin is thinned too much it can start to have an irregular appearance on the outside. There will definitely be scar tissue forming between the skin and the underlying framework of the nose. This scar tissue is advantageous because helps the skin to drape over the nose and add refinement. The scar tissue rarely forms in excess. If it does we sometimes use steroid injections to calm it down. Your surgeon can keep a close eye on this.

Reducing or thinning the nasal skin is an advanced approach. If the skin is very thick, it doesn't matter what is done underneath... the skin will camouflage it. Scar tissue will form, but it should be thinner than your current nasal skin, not thicker.