Need help with my thin skin - can I safely augment radix or dorsum for masculine nose?

Question

After several rhinoplasties I am left with a very thin skin, thin columella and a shrink-wrapped look. I need this to be reversed, maybe with fascia, rib and ear graft? Also very important, it shrunk soo much that my upper lip/philtrum. I have alot of fibrotic scar tissue inside my nose as well that I've been told can be removed permanently. It's too small to fit my face especially front profile, can I safely augment radix or dorsum for masculine nose or necrosis guarantee for stretching skin?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a dorsal augmentation with diced cartilage wrapped in fascia. There are many additional maneuvers which could also be performed to improve nostril symmetry. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Alejandro Nogueira, MD · Answer

Sir please better photos needed (all profiles and obliques, also underneath nostrils); as a general concept your skin does not seem to me overly thin, indeed it is too operated and next rhinoplasty has to be executed by someone with solid experience, talent and passion for complex revisions.

Superficial temporales fascia (not the deep one) contains a smooth sheet of tendinous layer to smoothen irregularities and a deep layer of millefeuille cake collagen acting like spongeous clay filling the cracks, dents and all the irregularities, so this can be an optional technique for you too.

Need help with my thin skin - can I safely augment radix or dorsum for masculine nose?

Answers (2)

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