Is it fixable a thick skin on the bulbous nose?

Hi ladylady101; The answer to your confusion is that the bulbous tip can be improved in almost all cases but the change will still retain the structure of the tip to some degree and is limited by the type of "bulbousness". Some tips have poor structure of the cartilage framework underlying the shape and this can be improved by adding cartilage and suture fixation, such as in an Asian tip. Others with thickened skin can be improved by surgically thinning the skin to in an effective and limited manner but also treating the skin with good topicals. Just like you can't change the framework of the body, the shape the nose can be improved but still has the character of the individual, which is desirable in most cases anyway. The key is to have your own unique nose that doesn't look operated on. We use a Vectra 3D Imaging system to help discuss the goals and limitations of these procedures on your face during our consultation. 

Thick skin rhinoplasty requires special techniques that are different than routing rhinoplasty.  Through an open approach the skin of the tip can be thinned out to improve definition. 

This question is one that is best answered via an in person consultation.  One of the greatest challenges in Rhinoplasty achieving greater tip definition in the face of thick nasal skin.  The degree of change that is achievable will vary on the thickness of the skin and experience of the Surgeon. 

Without evaluating you in person, it is difficult to tell if you have a concern that can be addressed surgically.  Often times, bulbous tips can be refined with surgery.  Thick skin can complicate things a bit, but sometimes the tissue can be thinned from underneath during the surgery.  This method may help to "de-bulk" the tip but not as well as if the skin were average thickness.  

The bulbous nasal tip can be composed of either wide cartilages, thick skin, or both. Surgery is only going to help with wide cartilages present, not thick skin. To narrow the bulbous nasal  tip cartilage suture techniques and a conservative cartilage removal are  applied to the lower lateral cartilages of the nasal tip. For many examples and more information, please see the link and the video below

Dear ladylady101, The degree of refinement on the nasal tip will depend on the patients skin thickness however most patients receive a remarkable difference and are very happy with their results. During consultation the surgeon can show you the proposed changes to the nose taking into consideration your nasal anatomy and skin thickness. Once you review these if you decide those changes would be satisfactory then you can decide to move forward with rhinoplasty surgery. See examples in the link below and video above. Best regards, Michael V. Elam, M.D.