Can my nose pores be reduced? When should I do it? (Photo)

Question

I plan to get a rhinoplasty early 2018. My nose has larger pores (see photos) on it that I'd like to have cleared up/made smaller permanently. 1) Is this possible? If so, what would be the best treatment? 2) Should I do this before or after the rhinoplasty?

Steven M. Denenberg, MD · Answer

The pore size and appearance is determined by skin element that are so far underneath the surface, that if you try to get down there and change them, it could create scarring instead of improvement.About the nose, be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon. You should only have surgery if you are able to make yourself very confident in your surgeon's skills. 
From what I see in your photo, you seem to have a wide tip, and I'm estimating that the profile view would show that the tip sits lower than you might ideally like. That makes sense: when the tip cartilages are strong enough to make the tip wide, they are usually strong enough to hold the nose out forward from the face more than we might like, and they tend to hold the tip down as well. If that's true for you then your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
I usually make computer morphs when I'm answering questions like this, to show the changes that are possible for a nose with a rhinoplasty, but unfortunately the one photo you submitted isn't good enough for making morphs. At the *very* bottom of the "Learn more" page is a link to instructions on taking and sending photos that are comprehensive and useful for an online consultation like this, in case you'd like a more complete evaluation.

Daniel Butz, MD · Answer

Shrinking your pores permanently isn't feasible but there are options to reduce their appearance. 
Topical Retin-A medications can reduce the pore size by increasing cell turnover and unclogging the pores. This improves the skin condition overall but does require you to be on it consistently. You also have to watch out for sun sensitivity and slowly taper up on the medication to decrease your risk of redness and flaking. I usually recommend starting with the lowest strength, at 0.025% cream. 
Accutane can also reduce pore size but is a oral medication that can have a number of side effects. There are newer studies that show it can shrink the overall nasal skin envelop and improve rhinoplasty outcomes. 
Lastly, you can use laser resurfacing, which will reduce pore size and increase collagen production. This does require some downtime to allow the skin to heal after the treatment. 
I think it's best to improve the skin condition before your Rhinoplasty and then continue with retin-a treatments afterwards to maintain your results. 
Good Luck.

Andres G. Sarraga, MD, FACS · Answer

Large pores on the nose can be reduced using either laser resurfacing (best) or microneedling. If you are planning to have rhinoplasty done next year I would do that part first and then consider treatment for the pores 3-6 months after surgery.
Also consider facials with extractions until then.
You may need multiple treatments for the pores but patients are happy with results.

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