Can Thick Skin Prevent A Good Rhinoplasty Result?
Q: Dr. Eppley, I am interested in a rhinoplasty. I have consulted with a plastic surgeon who said I had thick skin and results would be minimal. I can accept this, however, I do believe that at least suturing the tip cartilage together would minimize the width. My goal is a narrower nose in general, but particular attention to the tip. Perhaps narrow the bone structure? I have always kind of wiggled my nose down which elongated it and made the tip smaller and less noticeable. Of course it manipulated my upper lip. Is it possible to take a pie shape of skin out of the side of each nostril to bring it down and narrow it? I do always seem to have a congested nose. If I pull outwards beneath my eyes I can breathe significantly better. My profile is acceptable. I appreciate your consultation greatly!
A: By your description, it sounds like a rhinoplasty that includes tip width reduction by cartilage reduction and suturing, nostril narrowing and possible middle vault spreader grafts (although this would widen the middle third of your nose) and/or inferior turbinate reduction would help improve your nasal appearance and function. While it is true that thick skin does not a limiting effect on rhinoplasty results, I would not say that the results would necessarily be ‘minimal’ and that the desired tip changes seem achievable.
Dr. Barry Eppley