Is it possible to significantly reduce a bulbous nose with thick skin?

I had rhinoplasty with septal and ear cartilage for the tip and alar reduction 2 years ago. I had a very bulbous tip with thick skin. However, after the surgery my nose tip is even bigger with more definition, but my nose was already too big for my face, now it just looks very odd. Also I believe I have a lot of scar tissue underneath which is making my nose uneven and crooked. Is it possible with revision to remove scar tissue and straighten the rose? and make the tip a lot smaller?

Doctor Answers 6

Is it possible to significantly reduce a bulbous nose with thick skin?

In general, patients with thick skin are not always able to achieve the level of definition they desire. However, improvements can still be made. An exam would really be necessary to provide you with the best advice. I would recommend seeking the advice of a board certified revision rhinoplasty specialist. He/she may use computer imaging software to morph a photo of you, which will give you an idea of how the final result may appear. I hope this helps, and I wish you the best of luck. 

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Is it possible to significantly reduce a bulbous nose with thick skin?

    I do not use cartilage grafts unless necessary for structure, because it creates just the issue you have brought to light.  I would remove the grafts unless necessary for overall height of the tip or the dorsum.  The tip can then be refined through other methods.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Revision rhinoplasty for bulbous nose

Dear Kiyomi, thank you for your question.Revision rhinoplasty is a complex procedure that requires experience and skill, and is a focus of our San Diego practice. Look for an experienced board certified Facial Plastic Surgeon who can demonstrate excellent results. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Revision rhinoplasty candidate

It is very important to have realistic expectations regarding thick skin and revision rhinoplasty. The thick skin will be an impediment to seeing a very fine result in the tip. Also important to bring your surgical op notes from your previous surgery to your new perspective surgeons, so they can review what was performed in the first surgery. For many examples of rhinoplasty, please see  the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Bulbous tip and reducing it

It is certainly possible to reduce a bulbous tip, but it is essential to be evaluated in person to examine you and see what can be done.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Bulbous tip after surgery

It is possible to make a bulbous tip smaller. It is difficult to say what has happened in your case without examining your nose or looking at some photographs, but it is possible that you have some scar tissue that has formed in the tip. Some times, the judicious use of injected steroids over a period of months will diminish the scar and significantly improve the result. Other times, a revision surgery is required to reshape the tip, remove some of the scar and improve the size and shape of the tip.

Andres Gantous, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 25 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.