Thick skinned rhinoplasty

Thick skinned rhinoplasty

Thick skinned rhinoplasty is a challenging procedure which requires extended knowledge, experience and surgical skills. The disadvantage of this type of skin is more inflammation after the surgery comparing to the thin skin and being able to achieve the final outcome at least after 1,5 to 2 years. Thick skin covers the nose like a thick blanket and hides the underlying structures. Therefore, it requires certain preoperative treatments from the patient’s side and precise surgical approach by the plastic surgeon.

How can you determine thick skin? 

Certainly, an expert can identify which type of skin you have, but there are some tips which will help you out. If you have a bulbous tip, wide alar wings, enlarged pores and oily skin you probably have a thick skin. Thick skinned rhinoplasty is also commonly known as the ethnic rhinoplasty.

Can I achieve a defined and small or ‘Barbie’ nose if I have a thick skin?

Commonly inspired by the “ideal” noses on the internet, patients considering rhinoplasty  dream of having a small and pointy noses. Whereas, thick skinned patients need to realize the limitations caused by the type of their skin, thus recommended to have realistic expectations to avoid any kind disappointments. Since the nose can be reduced as much as the tissues will allow, without compromising the functional issues. Improving and preserving the functionality of the nose and achieving natural results which suit their facial features should be the main goals in rhinoplasty.

How can I optimize the post op results? 

In order to achieve the best possible results after the surgery thick skinned patients have to prepare and improve the quality of the skin as it will be the main indicative of the surgery. Assoc.Prof.Dr.Suleyman TAS has handled numerous thick skinned patients with the Closed Atraumatic Technique. There are two types of treatments recommended by him for the improvement of the skin.
1. For extremely thick skin faster working method- At least 3 sessions of the Ablative Co2 fractional resurfacing laser to peel off the upper layers of the skin this way making it thinner and getting regenerated.
2. For thick skin slower working method- Usage of a dermaroller and vitamin A daily for at least 3-4 months to resurface the upper layer of the skin and to take under the control production of the oil.

The surgical approach 

Especially in reduction cases there is too much excessive skin which has to be redraped skillfully. As the thick skin has a low contraction ability these cases require the removal of the excessive skin and fat tissues commonly known as the alar base reduction. It is performed to catch the harmony between the tip and bridge of the nose, as well as to address the asymmetries between the nostrils and reduce their size. The roof on the tip of the nose has to be designed precisely to avoid any droopy tip appearance after the surgery as the thick skin is a heavy thing.
 
You may see numerous before and after pictures of the thick skinned patients operated by Assoc.Prof.Dr.Suleyman TAS from the following links.

*4 months post op results of a thick skinned patient

References:
1. https://drsuleymantas.com/rhinoplasty-gallery/
2. https://www.blogger.com/u/1/blogger.g?blogID=5412756837385143650#editor/target=post;postID=6129832967299330987;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=22;src=postname
3. https://www.realself.com/dr/suleyman-tas-istanbul-turkey