dear all, This is my second question over here,as i had a nose job in 2009,i had a crooked nose before the surgery due to accident on my nasal bones,the doctor seemed to grind some sharp corners off my nose but my nose still looks weird,i wanted to ask you how much correction can done on thick and oily skin since i already had a nose done,how much straight my nose can become,and should i have it done from a same surgeon,is there any surgeon who do it for free?
Thick Skin - Limitations for Revision Rhinoplasty?
Doctor Answers 6
Revision rhinoplasty with thick skin
Without seeing your profile views it is difficult to make an accurate assessment. Thicker skin does limit how sculpted a nose can become but symmetry should be no more difficult (in fact easier) than in thinner skins
Thick skin-limitation to surgery?
Yes, the thickness of your skin has an important impact on the surgical outcome. If your skin is very thin, then every little detail, good or bad, is apparent as the skin can't mask the changes to the underlying structure. So on one hand, there can be excellent definition, but on the other hand, every irregularity is seen. With thicker skin the structural changes underneath can't be well appreciated. Also the thick skin can't redrape well and if the nose has been reduced too much, the skin remains arched over the underlying cartilage causing a poor result.
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Rhinoplasty in Patient with Thick Skin
Rhinoplasty in a patient with thick skin requires special techniques - the underlying sructures can be changed, but we cannot thin the skin. The crooked nose is also diffficult to correct. Having said that, your nose can be significantly improved when the surgery is done by an experienced revision rhinolasty surgeon.
Rhinoplasty Results in people with thick skin
The benefits of thick skin are that it wrinkles less and it hides minor imperfections of the structures under the skin. In rhinoplasty in thick skinned individuals, the surgeon's challenge is to be certain that detailed structural work is visible. All desired results can be obtained with more exaggerated changes to the underlying structure of the nose. For example, implants may be necessary to achieve definition. As for whether you should allow the same surgeon to reoperate? Since chosing the right surgeon is everything, make sure you can see 'before' and 'after' photos or meet others with problems simliar to yours. This way you can be certain that the desired aesthetic result will be to your liking. If not, choose another surgeon!
Repair of the crocked nose is very complex. It will require work on the boney pyramid and septum with possible spreader grafts or complete -L - graft to the nasal septum to straighten the nose. If the septum is used already you may need a rib cartilage graft with repositionning the septum. It is a lot of work.