How Can I Tell Whether It is Thick Skin or Cartilages Causing my Bulbous Tip?

Thick nose skin is typically more oily and makes it hard to see the underlying cartilages of the tip. Having thicker skin can limit your rhinoplasty result but it is pretty rare that it would make it so no improvement could be made.

The tip cartilages can give a more bulbous look to the tip as well. In this case the cartilages are either too convex (bowed outward) and/or wide.

Hi,

The best way is to have an experienced rhinoplasty surgeon examine your nose. However, one can usually tell by feeling the tip cartilages of the nose. If you can feel the cartilage, then it's probably bulbous due to the overdeveloped cartilages. If you can't feel the cartilages then it's probably due to thick skin.

Best,

Dr.S.

A bulbous nasal tip which is caused by thick skin is usually associated with thick, oily skin throughout the entire central face. Through this skin, it may be impossible to make out the outlines of the tip cartilages. In the most extreme cases, it may be associated with a skin condition know as Rosacea and the tip may become so bulbous that it is termed a "rhinophyma".

When thick skin is the basis for a bulbous nasal tip, there may limits to how much the tip appearance can be surgically improved. Some benefit, however, should always be possible through a well executed rhinoplasty.

When the tip cartilages can be easily visualized through the overlying skin, the implication is normal nasal tip skin thickness. These individuals are ideal candidates for tip improvement through rhinoplasty. Reshaping of the tip cartilages is necessary.

An exception to this line of reasoning comes into play with some "ethnic" nasal tips. In these individuals, there is often a layer of thick tissue (fibroareolar tissue) that contributes significantly to the bulbous tip. It lies as a layer between the overlying nasal tip skin and the underlying tip cartilages. Surgical excision of this layer during rhinoplasty is often beneficial when redefining the nasal tip.

A bulbous tip can be caused by either or both. The reason for consultation is to physically evaluate your nose, discuss alterrnative treatments to improve nasal function and appearance, and to establish reasonable expectations. Thick skin can compromise the results of  rhinoplasty , but it is very rare that nasal appearance cannot be improved.