Thick Skin Nose Aesthetics Photos
Below, you can find photos of a female patient with very thick skin, before the rhinoplasty operation, 1 month after the operation and 5 months after the operation.
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There are studies emphasizing that by administering oral isotretinoin tablets and monitoring liver enzymes, the fatty subcutaneous tissue in the nasal skin can be reduced and the skin thinned. In patients with thick and oily skin structure, a round or ball-like swollen nasal tip may occur due to unexpected unfavorable healing responses, abnormal skin swelling and excessive camouflage effect of the skin. Recovery may be slower and may take longer in these patients.
In the photos above, it is noticed that the nose is getting thinner and there is still edema in the nose despite the 5th month.
In these patients, open technique nose surgery, two-level skin dissection and subcutaneous tissue dissection, subcutaneous tissue removal can be performed. Cartilage support can be preserved as much as possible and care should be taken not to leave any dead space under the skin. There are rhinoplasty surgeons who do not accept nasal aesthetics for patients with thick skin features. The reason for this may be that patient expectations are not likely to match the surgical result, and the simulation result and the surgical result may differ from each other.
The surgical management of a thick-skinned nose
The surgical management of a thick-skinned nose involves various techniques to reshape and refine the nose, taking into consideration the unique characteristics of thick skin. Thick skin can obscure the underlying nasal structures and make it challenging to achieve precise definition and refinement. However, skilled surgeons can use specific approaches to achieve satisfying results. Here are some common surgical techniques used in the management of a thick-skinned nose:
1. Open Rhinoplasty: Open rhinoplasty is a surgical technique that provides direct access to the nasal structures. It involves making an incision across the columella (the tissue between the nostrils) and lifting the skin to gain better visibility and access to the underlying cartilage and bone. This approach allows the surgeon to address the thick skin directly and make more precise adjustments.
2. Cartilage Grafting: Thick skin may not contract as well as thin skin, making it difficult to achieve certain nasal shape changes. Cartilage grafts can be used to provide additional structural support and definition to the nasal tip and bridge. Commonly used grafts include septal cartilage, ear cartilage, or rib cartilage, depending on the availability and the specific needs of the patient.
3. Tip Refinement: Thick skin in the nasal tip can lead to a rounded or bulbous appearance. Tip refinement involves reshaping and repositioning the underlying cartilage to create a more defined and aesthetically pleasing tip.
4. Osteotomies: Osteotomies are controlled bone fractures performed to narrow the nasal bridge and correct any bony irregularities. They are essential in cases where the nasal bones need to be repositioned for better symmetry and harmony with the rest of the nose.
5. Alar Base Reduction: In cases where the nostrils are excessively wide, alar base reduction can be performed to narrow the nasal base. This involves removing a small wedge of tissue at the base of each nostril.
6. Subcutaneous Undermining: During surgery, the surgeon may perform subcutaneous undermining to separate the skin from the underlying tissues. This allows for better re-draping of the thick skin over the newly sculpted nasal framework, resulting in improved definition.
It is crucial to choose a qualified and experienced plastic or facial plastic surgeon who has expertise in dealing with thick-skinned noses. The surgeon should thoroughly assess the patient's nasal anatomy and skin type to develop a customized surgical plan that addresses their specific concerns and provides the best possible outcome.
Keep in mind that the surgical management of a thick-skinned nose can be complex and may require additional time for healing and settling of the final results. Patients should have realistic expectations and be prepared for the recovery process.
Link group where you can find the articles I have written and published about thick-skinned female rhinoplasty on this website >> https://www.ent-istanbul.com/search?q=thick+skinned+female+rhinoplasty
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
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