We Performed Again Thick Skin Revision Rhinoplasty Operation!

Thick skinned revision nose job in Istanbul

Revision rhinoplasty for thick skinned nose

We performed a revision nose aesthetic operation in a patient who had previous surgery and had a history of intensive smoking. According to the patient's history, she continued to smoke 2.5 packs a day in the early postoperative period. During the surgery, we found many deformations and weaknesses in the support cartilage at the tip of the nose. Due to nicotine in the cigarette, blood vessels narrow and tissue blood supply decreases. Other smoking-related side effects include decreased tissue oxygenation due to carbon monoxide, and an increased risk of infection due to particles present in it. Postoperative mucosal healing in the nose can sometimes last longer than 6 weeks. If possible, it is ideal to start smoking after a few weeks after rhinoplasty. In patients who will not stop smoking, surgery may be canceled.

Since the cartilage of the nasal septum in the nose of the patient whom I shared photographs was sufficient, columellar strut graft, cap graft, spreader graft was prepared with cartilages taken from septum and sutured with 4/0 PDS and 5/0 vicryl. A limited amount of bone rasp was performed and bilateral osteotomy was performed to narrow the nasal bone.

The challenges of revision rhinoplasty in thick-skinned noses

The following difficulties may arise during revision rhinoplasty in noses with thick skin characteristics:

- subcutaneous fibrosis may be more than normal and dissection may become more difficult
- care must be taken to avoid dead gaps during operation.
- more cartilage support grafts may be required to support thicker skin than normal
- digital rhinoplasty animation may result in a thicker nasal tip than the pre-operative photograph

You can see very detailed article about thick skinned rhinoplasty algorithm at >> An Effective Algorithm for Management of Noses with Thick Skin

Additional recommendations for edema and bruising after revision rhinoplasty in thick-skinned noses

In addition, following the thick skin revision rhinoplasty operation, the following additional recommendations may be offered to patients to reduce edema that may be pronounced at the tip of the nose:

- sleep time nose tip banding (U-shaped and horizontal tape application, edema at the tip of the nose and supratip area can go faster)
- Salt restriction in the diet for 2-4 months
- planning of cortisone injection from 2 months to the nose in patients with prolonged edema at the tip of the nose

Revision nose aesthetic surgery for thick skinned nose

"Thick skin characteristics" and "revision" in itself two separate difficulties!

Revision rhinoplasty is a surgery like "opening a surprise box" as I have already written. Along with the difficulties of tissue dissection due to altered anatomy and healing tissue, edema and recovery time which can last long after surgery can be seen. Kal Thick skin properties ve and rev revision baş mean two difficulties in itself.

How do you know if your nose skin is thick?

You can easily determine whether the nose skin is thick or not.

Way 1: look closely at the skin of the nose and if you see intense comedones on the skin, it means that the skin is oily and thick.

2nd way: if you use the index finger and thumb to hold the nose skin between the two fingers from top to bottom, if you notice a serious increase in the tip of the nose, this means that the tip of the nose is thick skinned.

I wish you luck in the surgery.

You can find details about revision nose aesthetic surgeries at >> Revision Rhinoplasty in Istanbul

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47