Thick Skin - Limitations for Revision Rhinoplasty?

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?

Doctor Answers 6

Revision rhinoplasty with thick skin

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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

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Thick skin-limitation to surgery?

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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.  

Revision Rhinoplasty

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Your nose can definitely be improved by Revision Rhinoplasty in the hands of a skilled surgeon. Thick skin is not a problem for surgery it is just something that needs to be addressed in the surgical plan. As far as the same surgeon performing your Revision Rhinoplasty, this is a personal choice. I would suggest a few secondary consultations for multiple opinions. I am not aware of very many surgeons who would perform the surgery for no charge except your original surgeon.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Rhinoplasty in Patient with Thick Skin

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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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty Results in people with thick skin

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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!

Michelle R. Yagoda, MD
New York Facial Plastic Surgeon

Crocked Nose

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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.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.