Do I Have Thick Skin or Excess Cartilage?

My rhinoplasty specialist is great,but I was surprised to hear him say that my skin is not particularly thick when I asked him.I know thick skin is especially difficult when scupting the nasal tip,so I want to make sure he knows what he's doing.He never said I had excess cartilage but when I expressed concern for the nasal skin, he said mine is pretty thin.My nose is extremely oily-so is my whole family (Latin descent) and its very porous. How do I know if my skin is thick or if it's cartilage?

Doctor Answers 8

Thick skin or excess cartilage

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Only an expert in rhinoplasty surgery can tell what is going on through a physical examination of the skin of the nose. Dark skinned individuals tend to have thick, oily, olive complexion skin. Very thick oily skin tends to be difficult to work with in the healing process after the rhinoplasty procedure and in many instances requires cortisone shots to help manage any fluid retention or scar tissue formation that occurs at the super tip area of the nose.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Oily Skin is usually thick as well

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Hi Ivy:

I clicked on your pictures and it does appear that you have oily thick skin and a wide alar base. That is all that I can see from your photos.  Thick skin does not preclude getting a good result from rhinoplasty but it can limit it from being an excellent result.  Alar base reduction helps to reduce the width of the nasal base.

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 45 reviews

Effect of Thick Skin in Rhinoplasty Surgery

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Hi IvyK,

Skin thickness plays an important role in rhinoplasty surgery. Thick skin tends to swell for a longer period of time, and tends to hide subtle contours of the nose after reshaping. Thick skin patients may have a more rounded nose after rhinoplasty, as compared to thin skin patients. To improve rhinoplasty results in thick skin patients, plastic surgeons may remove extra tissue deep in the skin, inject steroids, and/or add cartilage grafts to the tip area.

Photographs of your nose would help. Only after a comprehensive evaluation can a rhinoplasty surgeon help determine your skin thickness effect on potential rhinoplasty surgery. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

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Thick skin in the nasal tip

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The thickness of the skin is important in planning rhinoplasty as thick skin will contour less well and challenge the refinements made in the shape of the tip. It is true that patients with thick nasal skin tend to have very thin supporting nasal cartilages and tip cartilage graft are often necessary to obtain good results. The opposite is not often true, that thin skin means thick or 'excess' cartilage. The shape of the cartilage underneath will show through well however and make tip grafts unnecessary.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Thick versus thin skin

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Unlike thin skin, thick skin generally hides the contours of the underlying cartilage. Thick skin does tend to be oilier and limits the amount of refinement one can obtain in the tip of the nose.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Rhinoplasty - thin skin and cartilage

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Ivy - I wouldn't lose confidence in your surgeon over this discussion - so don't worry!  Assessing whether skin is thick or thin is something that us plastic surgeons can tell from experience.  If you have skin on the thinner side, then he will probably be able to shape your tip well.  One think I do to help my patients have a better understanding of what I'm specifically doing in surgery is to show them a diagram of the cartilage and bones of the nose, and draw where I'm planning to remove it.  Maybe this would help you to understand the plan better.

Dr. Cat Begovic

Thin skin in rhinoplasty

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Ivy, if your surgeon says your skin is thin, it probably is. I'm sure that what you see as enlarged is most likely cartilage and/or bone, which is what we routinely address in rhinoplasty. If your see very well-defined contours on your nose, this is probably the case. While a lot is made about thick skin not showing all of the subtle refinements after rhinoplasty, very thin skin can reveal every little irregularity or asymmetry. Your surgeon should let you know if this is a problem for him to deal with. If you are really unsure, get a second opinion.

Verne Weisberg, MD
Portland Plastic Surgeon
4.6 out of 5 stars 18 reviews

Nasal tip thickness

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You are correct that if your skin is very thick, you may not get the definition you are looking for.  Thicker skin is often oilier.  If you do not see the definition of your cartilage under the skin, then it is probably thick.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.