Problems For Nose Reduction In Patients With Thick Skin Structure During Rhinoplasty Operation

Problems Related to Reducing Nasal Volume in Thick Skinned Noses

Rhinoplasty for thick skinned nose, Big nose aesthetics,

Rhinoplasty operation is the reshaping of the nose, reshaping the bone, cartilage and subcutaneous tissues that make up the nose and making aesthetic and functional changes in the nose. Surgical removal of cartilage and bone tissue is usually easy, especially in patients with "big nose" who have excess cartilage and bone tissue. However, in patients with thick skin and subcutaneous tissue and oily skin, is it possible to thin this skin permanently by surgical means?

It is possible to resect various parts of the nasal skin and to make the skin on the nose more taut, and to reduce the volume of the nose. For example, in the simplest way, the volume of the nose can be reduced by removing the skin and subcutaneous tissue such as "alar base recection", which can be done to reduce the nose wings and nostrils. Here, the most challenging problem for surgeons is that it is not easy to permanently thin or shape the fatty and thick skin structure, which is a genetic condition, by laser or surgery. Especially in noses with ethnic and thick skin features, performing rhinoplasty operation with open technique, bilevel skin dissection and underskin tissue removal can be beneficial in thinning the nose tip skin. However, in order to prevent the reproduction of the subcutaneous tissue (there is no method to stop it for sure), the use of natural edema and bruise removal gel, herbal oral supplements that can slow down the functioning of fibroblast cells, the use of pressure on the nose during sleep, regular nasal massage, drinking green tea, salt. restriction and nasal massage may be beneficial.

Patients with some thick skin characteristics think that the nasal skin can be easily shaved with laser and thinning. In cases where there is abnormal production in the nasal skin such as rhinophyma, it may be appropriate to apply an alzer to thin the nasal skin; It should be kept in mind that unnecessary laser application in patients with thick skin features may cause burns and deformations in the nasal skin. In ethnic noses with very thick skin features, if the expectation of surgical results is a nose with very thin, small and sharp edges, thick skin features should be investigated and the recommendations of the examining surgeon should be considered in order not to experience serious disappointment after the operation.

Bilevel skin dissection and underskkin tissue removal can provide thinning of the nasal skin during rhinoplasty operation, but it should be kept in mind that the nasal skin features are determined by genetic transfer from the patient's mother or father, and it is not possible to thin or shape thick skin easily.

Especially in patients with African American Nose Features, the fact that a large part of the large and large nose structure is associated with the skin thickness may cause a wide and round appearance at the tip of the nose, causing intense camouflage effect of the skin after surgery. It may not be easy to shrink a nose in patients with thick skin structure.

So how can you understand if your nose is thick or not?

There are two ways to understand whether your nasal skin is thick or thin:

1.Look soon if there is too much comedones on the nose, there is an oily and thick skin structure

2.Control from top to bottom, holding the skin of the nose in the midline between your index and thumb. Especially if you have an increase in thickness that starts in the supratip area and becomes pronounced downwards, your nasal skin is quite thick.

Patients with very thick skin features, showing photo animations as a "favorite nose shape" by reducing the nasal volumes before the operation may cause disappointment after the operation. It is the best option to pay attention to the recommendations of your surgeon who examined you.

Expectations of patients with very thick skin that can be "just a dream" after rhinoplasty

Maybe if you want a very thin or sharp-edged nose tip, if you have thick nose tip skin, you should definitely consider the following before surgery:

- In patients with very thick skin structure, a more swollen or rounded appearance may appear at the tip of the nose, unlike your expectation, due to the high post-operative camouflage effect and edema.

- In patients with thick skin features, sometimes years may be required for the edema to disappear, or this edema may be permanent. Please do not rely on "simple rhinoplasty digital simulation programs". This is a "living tissue change" and determining the result requires the care of the patient, the healing characteristics, the knowledge and experience of the surgeon, and a little "luck". Keep in mind that there may be 10-15% risk of revision in every rhinoplasty operation. In patients with thick skin features and revision rhinoplasty operation, the recovery period may be longer; near-round subcutaneous edema may occur in the nose for a long time


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

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E-Mail: muratenoz@gmail.com 
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