Can I achieve a refined nasal tip and softer profile through rhinoplasty with thick skin? (photo)

Hello,The thickness of your skin will only affect the length of the healing process. You would still benefit from a tip plasty procedure and narrowing of the nasal bones like the example you provided. By doing this via a scarless (closed) approach, there are no external cuts ever on your nose.  This prevents the dreaded complication of external scarring at the base of the nose, which even if rare, if it occurs, is devastating.  Through a scarless approach you can accomplish almost everything needed to be done to the nose with no scarring, less healing time, less bruising, and less swelling. All the best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. You may also benefit from a cephalic rotation of your tip to turn
up your tip slightly and a conservative dorsal hump reduction.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Dear Emm, patients with thick skin are less likely to achieve a perfect slim tip. But a certified facial plastic surgeon can help you proceed for a nicer and more thin tip working on your cartilages and fat under your skin. The nose is a good candidate for cosmetic rhinoplasty. Best regards

Individuals with thick skin are less likely to achieve a greater degree of tip refinement, but this does not mean that they can't still achieve significant improvement in nasal tip definition. In other words, I suspect that you could achieve significant refinement with traditional rhinoplasty techniques despite the thicker nasal skin, although I suspect that seeing such a large degree of tip refinement as illustrated might be challenging and difficult to predict with certainty by any surgeon. The reason why surgeons are unable to predict outcomes with as much certainty with rhinoplasty than other procedures, is because the nose tends to heal with many other factors in play outside of the surgeon's direct control, and thick nasal tip skin is one such big factor. Improving the definition of the nasal tip in individuals with thick nasal skin involves performing multiple suture-techniques on the nasal cartilage as well refinement of the alar cartilages by trimming excess width (known as cephalic trimming). Additional techniques would also need to be employed to rotate the nasal tip, release the depressor septi muscle, and remove the dorsal nasal hump. Despite this, expectations are critical to rhinoplasty, both from the surgeon's and patient's standpoint, and it's essential to be on the same page with your surgeon with regard to realistic results. In the end, your surgeon's expectations will matter the most. Best of luck!