Thick nasal skin? Large pores, blackheads. Rhinoplasty? (photo)

Question

I understand the only way to know is through a consultation, but when I asked a surgeon I went to, he acted like it wasn't that important and that there was no way to determine skin thickness, but told me mine was probably medium thickness. I am an 18-year-old female, Caucasian. Since I have fair skin, but lots of blackheads/large pores, is my skin likely pretty thick? If so, can rhinoplasty do much for me? My tip is rather bulbous, and my nose is large. The nasolabial angle is also 90 degrees.

Toby Mayer, MD · Answer

From your photographs you do not look like you have thick skin. You should have no problem with aesthetic rhinoplasty done by a very experienced rhinoplasty surgeon.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Kenneth Hughes, MD · Answer

Rhinoplasty can create a tip that is refined and elevated, and the overall nose can be made smaller.Find a plastic surgeon with ELITE credentials who performs hundreds  
of rhinoplasties and rhinoplasty revisions each year.  Then look at the 
 plastic surgeon's website before and after photo galleries to get a   
sense of who can deliver the results. 	Kenneth Hughes, MD Los Angeles, CA

William Portuese, MD · Answer

The rhinoplasty procedure involves narrowing the bulbous tip with suture techniques of the lower lateral cartilages, and osteotomies to narrow the nasal bones. Very thick tip skin can be an impediment to seeing the full result of a rhinoplasty.  For more information and many before and after rhinoplasty examples, please see the link and the video below

Richard W. Fleming, MD (retired) · Answer

You're correct - a rhinoplasty can change the size, contour, and position of the bone and cartilage. Minimal changes are made in the thickness and quality of the overlying skin. That is why I have patients like you consult with our aestheticians to treat their skin before and after rhinoplasty surgery - results can be significantly improved.

Thick nasal skin? Large pores, blackheads. Rhinoplasty? (photo)

Answers (5)