Rhinoplasty On Thick Skinned Noses

The shape of the nose is mostly dependent on the shape and structure of the underlying skeleton. Therefore, rhinoplasty surgeries are mostly aimed at shaping the underlying bone and cartilage structures. The connective tissue, fat tissue and skin are located on the nasal skeleton. The final result of a rhinoplasty surgery is dependent on the interaction between the skin and bone/cartilage structures. Therefore the changes that can be made on the skin enveloping the nose are limited as creating any visible scars on the nose would not be wanted. Thick nasal skin has limiting effects especially in surgeries where the nose size is to be reduced. Patients with thick nasal skin may have large nasal tips and thick and wide nostrils. Very thick nasal skin can create difficulties for the surgeon to perform the surgery. The amount and duration of swelling after a rhinoplasty surgery can be prolonged in thick skinned patients.

It is possible to mention some surgical approaches for rhinoplasty surgeries performed in thick nasal skinned patients. In such surgeries, tissue grafts can be used, nose size reduction can be performed more conservatively, and the layer underneath the nasal skin can be thinned.

Tissue grafts (cartilage) are often used to create better definition at the tip of the nose. A well-structured nasal tip will help the nasal skin adapt to the new nasal structure.

A more conservative reduction of the nasal tissues may be preferred in rhinoplasty surgeries performed on thick skinned patients. Because thick nasal skin tends not to contract very well and may take more time to adapt to the newly formed nasal structure. This means that the aesthetic objectives need to be balanced with physical structural requirements. If too much bone and cartilage is removed, a formless nasal shape may occur. It is important to maintain sufficient nasal supporting architecture when reshaping the nose. A slightly larger nose with a good shape and definition can be more preferable than a small, formless nose with little definition.

Thinning of the nasal skin is also an approach that can be used in rhinoplasty surgeries performed on thick skinned noses. Patients with thick nasal skin often have a layer of fat and connective tissue that contribute to the feeling of thickness below their skin. This layer can be thinned with suitable techniques in suitable patients. While this appraoch can support the ability of the skin to contract and adapt to the new skeletal structure, it can also create better definition in the nose.