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Patient Question:

I have thick skin and want Cosmetic Rhinoplasty to improve the appearance of my nose.  I have seen a few surgeons who have told me I have thick skin and surgery will be difficult.  What does Dr Solomon recommend for patients with Thick Skin requesting cosmetic rhinoplasty?

Dr. Solomon’s Answer: 

Every patient hoping to undergo rhinoplasty surgery needs to have a comprehensive examination by a Surgeon.  Each patient has a different nose and can expect different results.  Patients with thick skin are particularly challenging as the skin is typically not changed in rhinoplasty surgery only the bone and cartilage is modified.  When modifying the nose in patients with thick skin I tend to explain the limitations of each case. That being said there usually is room to improve almost any nose even in patients with thick skin.  In my practice I deal with this problem by reducing the fatty tissue and the cartilage that makes up the tip of the nose.  I also often strengthen the tip cartilage with a cartilage strut taken from the patient’s nasal septum or in some cases use medpore implants to strengthen the tip.   A tip graft made of cartilage from the septum,  ear or rib also may be necessary to rebuild and strengthen the nasal tip. The stronger the tip the better chance that the skin will shrink on the tip over time and allow for increased nasal tip definition.

Up until recently this was the only option for thick skin nasal tips.  Now we have the new ultra pulse C02 Fractionated Laser which allows us to laser the nasal tip skin safely and improve the skin quality on the nose.  This is usually done in the Solomon Nasal and Facial Surgery Clinic about a month after the Cosmetic rhinoplasty surgery.  This is an innovative and new technique and the results so far have been very impressive.  The Ultrapulse Fractonated Laser helps reduce pore size and enhance the quality of the nasal skin giving a better Rhinoplasty result.

Dr. Solomon Facial Cosmetic and Reconstructive Surgeon practicing in Toronto and Thornhill Ontario Canada.

View Ultrapulse Laser video