Performing rhinoplasty on a nose with thick skin can be challenging. Patients frequently desire a smaller more refined nose but as a surgeon, you are limited by the thickness of their skin. Now, the skin can be thinned a little from the underside by removing a fat/fascial layer, but the skin itself cannot be made much thinner during rhinoplasty without damaging the blood supply to the skin and leading to scarring.
The analogy I give rhinoplasty patients with thick skin is that the cartilage and bone of the nose is like a block of marble and we are going to carve a fine statue of it. At the unveiling, we can wrap a thin sheet tightly around the statue and we will be able to still delineate some of the fine details of that statue. However, with thick skin, this is more like wrapping it with a thick blanket or a comforter.
The nose can be made smaller for patient with thick skin during rhinoplasty, however, patients’ expectations need to be discussed as the nose cannot be made as small as someone with thin skin.
Dr. Funk is a top rhinoplasty surgeon in Houston