Q: Dr. Eppley, I have a follow-up question pertaining to something you had mentioned at my rhinoplasty consultation the other day.  So you said I have very thick nasal skin.  I’m reading that thick skin often does not shrink as well as thinner skin so it might not conform properly to the reduced nasal size.   Also that it leads to scar tissue buildup in those open areas where the skin did not shrink sufficiently, resulting in a squishy, shapeless nose.  Should I be at all concerned about my thick skin or would you consider it a non issue?  Thanks much.

A: The well known issue with thicker nasal skin is how much it will shrink down to reflect any changes to the underlying bone or cartilage that has been modified. This is really only a concern in the nasal tip where the skin is the thickest. As long as the nasal tip cartilages are not aggressively reduced (which is not needed in your case) then the concern of the amorphous (shapeless) nose is not an issue. I mention it in every rhinoplasty patient who has thick nasal skin of the tip, whether it is male or female, to temper any expectation that they are going to get a small or thin-shaped nasal tip as thicker nasal skin will prevent that from being a realistic result.

Dr. Barry Eppley

Indianapolis, Indiana