The Difficulties of "Nasal Tip Narrowing " in Thick Skinned Nose
Nasal tip reduction can be much more difficult and complex in patients with thick nasal skin than in patients with thin skin.
As easy as in the animation above, I wouldn't actually have to write them here. For the patients with thick nasal skin, the following features should be kept in mind in terms of both the way of surgery and the healing characteristics of the nose tip aesthetic surgery:
In patients with thick nasal skin, the cartilage should not be reduced too much in order to narrow the tip of the nose. If the cartilages bearing the skin are weakened, it is possible that the wings may collapse or the tip of the nose will sag after the procedure. For this reason, it is more preferable to reduce the skin pain (subcutaneous tissue removal by two-level dissection) or to try to show the nose more finely by additional cartilage grafts.
• In patients with thick nasal tip skin, instead of a nasal tip shrinkage in the form of removal of cartilaginous nostrils to reduce nostrils, insertion of cartilage grafts that allow the tip of the nasal tip to be seen more narrower from the anterior view, or can be placed.
• How is thick nasal skin? (How to tell the thick skinned nose - what is a thick skinned nose? - What is a thick skinned nose? - How to understand the thick skin) - You can use two methods to understand whether the skin of the nose is thick or thick: 1. When you look closely, or, if there is a significant thickness difference between the nose of the nose and the tip of the nose, from the top of the nose with two fingers by touching it as option 2; The thick skin structure of the tip of the nose is understandable. Generally, in patients with thick nasal skin, the tip of the nose is more rounded (bulbous nose).
• In patients with thick nasal skins, it is not easy to understand the shade of the corners and angles of the cartilage due to the thick and blunt wrap of the skin surrounding the tip of the nose. For this reason, it is very difficult (like one of the difficulties of ethnic nose aesthetics) to simulate the shape of European-origin noses in many African patients.
• Healing process in thick-skinned noses : In patients with thick nasal skin, the amount of swelling that may occur after the tip of the nose and the recovery period of the edema may be much longer and more than the patients with thin nasal skin. In general, patients with thick skin can last up to 2 years.
• Various herbal products and massage oils can be used in patients with thick skin structure to reduce swelling and shorten recovery time after nose tip aesthetics surgery. In addition, there are also clinics that provide subcutaneous cortisone injection. I do not prefer cortisone injection due to the risk of skin atrophy, rarely blindness and color changes.
• In order to narrow the nasal tip, you can find photos of many patients who have undergone nose tip surgery and whose nose tip is larger than the old ones. In patients with African origin and who have been operated abroad, healing properties sometimes be so different than thin skinned patients.
• In patients with very thick skin, it may be very difficult to obtain a thin and delicate nasal tip. In the same way, it may be necessary to provide the nasal tip support by supporting the cartilage much more than the patients with normal nasal skin.
• I have always written the difficult and challenging features of the thick nasal skin, but it has no good features? ... Thick skin hides better defect than thin skin and camouflages asymmetric bone protrusions by closing the skin under the nasal skin much better despite long recovery time.
• In patients with thick nasal tip skin, Alar Base Resection, which is generally used for narrowing the tip of the nose, should be performed in a limited manner and the patient's nostril diameter should not be reduced much.
• Laser nasal skin thinning: Although the nose aesthetics and nose aesthetics surgery, the nose surface to accelerate the progression of the operation of the laser can be tried to use. Laser thinning of the nasal skin during the operation is controversial:
• There are so many questions about the thick and oily skin structure ... realself.com, which is a respected online platform, has more than 600 questions and answers related to the thick nose skin and nose aesthetics >> Rhinoplasty Thick Skin Doctor Answers, Q&A, Tips - RealSelf
Actually, one of these questions is quite nice ... "Since oil and thick skin structure, acne treatment and oily skin structure used in patients with vitamin A drugs, before the nose is used for a long time before surgery , can not thin the skin and make the result more beautiful? " The general consensus is that "the side effects of the drugs in this group should be considered, the surgery is supposed to be expected for 6-12 months after the discontinuation of the fatty tissue, even some authors argue that it is 18 months". In addition, it is advisable to apply creams containing limited amounts of vitamin a to pre-operative and post-operative nose-tip area.
As a result, the thick nasal skin seems to be a factor that makes work harder for physicians and patients who are interested in rhinoplasty for a long time.
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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
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