Is It Possible to Thin the Skin on the Nose?

Question

I've had thick skin on my nose since forever. I am looking into getting a nose job and I know the issues with thick skin involved in nose jobs. It also wouldn't hurt if I could have more minor issues like blackheads and excess oil dissipate, as well as thinning skin solution. Is there anything I can do to thin the skin on my nose? I have heard in the past that topical prescription corticosteroids naturally thin skin with long-term usage. Would doing this give my nose a better starting point for surgery? Can any dermatologist help me out?

Philip S. Schoenfeld, MD, FACS · Answer

You can thin the skin during rhinoplasty. This is done by conservatively defatting the skin primarily along the dorsum and around the nasal tip. The procedure is performed during your rhinoplasty and from below the skin. The surgeon cannot be over aggressive in this procedure as the potential complications from over thinning the skin can be catastrophic.  It sounds as if you have had acne problems, too. 
I would suggest a good skin care regimen and possibly topical or oral antibiotics for these problems. I would not suggest any long term use of topical steroid creams to help with these problems, however, your surgeon may elect to inject your nose with steroids following surgery in order to prevent scar tissue from building up and causing thickening of the skin around your tip.

Jonathan Kulbersh, MD · Answer

There are ways to thin the nose a bit during rhinoplasty. However, the surgeon must use extreme care not to overcorrect the area or you will end up with an undesirable result. I recommend scheduling a consultation with a few board-certified facial plastic surgeons who have extensive experience and expertise in rhinoplasty techniques. A qualified surgeon will know how to customize your treatment plan to ensure the best possible outcome. If you would like to address your acne prior to surgery, a laser resurfacing treatment could be an effective option.

Michael R. Macdonald, MD · Answer

The skin can be thinned during rhinoplasty, but it sounds like you might benefit from laser resurfacing to minimize the blackheads too.  If texture on the nose is an issue, laser resurfacing can help.  Meet with a Board Certified Facial plastic surgeon to discuss.  Be well!

Ali Sajjadian, MD, FACS · Answer

The skin of the nose can be made thinner by removing the fat from under the skin. Some patients have excess soft tissue. The procedure should be done conservatively as to avoid skin loss or other complications. Even though I have done a great number of these procedures, it can be done safely with great result.

	Hope this helps.

Enrique Etxeberria, MD · Answer

Obviously it can be done... but I do not recommend it. When there is excessive soft tissue in the nose -specially in the tip area- we can remove part of this thicknes (during an open rhinoplasty) from below the skin in order to defat the cutaneous layer. Wth this manouver we can get a slight thining of the soft tissue layer (20-30% aproximately). But this is a highly risk manouver; there are many potential complications with this surgical step with no easy solutions. These include:

	
		Irregularities
	
		Vascular supply compromise
	
		Sensitive alterations (numbness,...)
	
		Skin loss, necrosis
	
		Adherences
	
		External notice of nasal osteo-cartilaginous framework
	
		....


	Definitely it's a very risky choice. In my personal opinion, this manouver must be avoided in almost all cases (99.9%).

	But nothing is an "axiom" in Surgery. Discuss with your board certified plastic surgeon thoroughly this possibility. And be sure to select a very experienced plastic surgeon (in nose surgery)!

Is It Possible to Thin the Skin on the Nose?

Answers (5)