skin thickness rhinoplasty

The shape of the nose depends on the bone and cartilage skeleton and the skin that drapes over it. Rhinoplasty is the surgical intervention that modifies the underlying bone and cartilage architecture.

Also known as a nose job, rhinoplasty is one of the more difficult cosmetic surgical procedures to perform. Every nose is different and everyone has different goals. The thickness of the nasal skin is one factor that affects the outcome and must be considered in the surgeon’s operative plan.

One simple way to think of the nasal skin is as a blanket that lies over the framework of bone and cartilage. If the blanket is too thick, it may conceal the underlying features, making the nose appear less elegant. If the skin is too thin, then every irregularity and asymmetry (which every nose has) is visible beneath it.

The result after rhinoplasty depends on the interaction between the underlying bone-cartilage structure and the overlying skin blanket. 

Is thin skin good?

The good news about thin skin is that the surgical modifications in the underlying skeleton will be seen through this thin coverage. The downside, as mentioned above, is that any irregularity or asymmetry is more visible.

For plastic surgeons, the primary challenge presented by thin nasal skin is to create as smooth a nasal bridge and as symmetrical a nasal tip as possible.  Occasionally it is necessary in thin-skinned patients to transplant a thin layer of additional tissue to provide slightly thicker coverage of the underlying bone and cartilage.

How Thick Skin Affects Rhinoplasty Results

Many people have thick nasal skin, which contributes to a broader nasal tip and thicker nostril rims. If the skin is very thick, as is sometimes the case in patients of Eastern European or African descent, nasal tip refinement a challenge. The skin’s firmness prevents it from taking on the shape of the tip cartilages. In thick-skinned patients, it is often necessary for the surgeon to exaggerate the underlying architecture so the details are apparent through the thicker skin coverage. On the other hand, thicker skin will disguise any imperfections in the underlying framework and can be an advantage if it is not too thick.

The recovery from nasal surgery takes longer in thicker skin patients because the swelling may last longer. The final outcome in the nasal tip in patients with thicker nasal skin requires 1-2 years and sometimes necessitates steroid injection to encourage a reduction in the swelling.

Recovery from Rhinoplasty

As a general rule, about two-thirds of the swelling after aesthetic nasal surgery is gone after a month but the last third, usually in the nasal tip, requires about a year. The thicker the skin the more that final result may be delayed.

Final Thoughts

When it comes to a nose job, both thick and thin nasal skins present advantages and disadvantages. While delicate skin heals faster after rhinoplasty, it offers little camouflage. On the other hand, while thick skin provides a better disguise, it makes it more difficult for the surgeon to create ideal refinement and the post-operative swelling may take more time to fade. The ideal skin thickness is, of course, not too thin and not too thick!

Consult a Plastic Surgeon with Expertise in Aesthetic Nasal Surgery

Be sure to consult an expert and board-certified plastic surgeon to examine your nasal skin thickness and determine your candidacy for a nose job.

Dr. Charles Thorne is an experienced plastic surgeon with over three decades of experience in the subspecialty of aesthetic surgery of the nose including primary and secondary (revision) rhinoplasty. 

Schedule an online appointment with Dr. Thorne to discuss your concerns and see if you are a candidate for rhinoplasty.

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