When preparing for rhinoplasty, one of the most important aspects your plastic surgeon should consider is the thickness of your skin. Skin thickness has a major impact on how your results will end up and what can be achieved with rhinoplasty. Trust your nose to a rhinoplasty expert like Dr. Marcelo Antunes of The Piazza Center in Austin, TX to help you achieve the nose you’ve always wanted.
The thickness of the skin is one of the most critical aspects when planning for rhinoplasty. Patients with thin skin can show even small irregularities on the nasal contour while patients with thicker skin will tend to have a more amorphous contour despite the presence of definition in the underlying structures.
Dr. Antunes frequently tries to illustrate this important point to his patients using the example of a finger under a towel – if the towel is thin, we will be able to see the contour of the tip of the finger. However, if we add a couple more towels, this layer will become “thicker,” one loses the ability to see the contour of the tip of finger that lies underneath.
Patients with medium thickness skin are ideal as their skin will contract to some extent but will camouflage the underlying cartilage and bone better than thin skin.
In patients with thin skin, the nose can be made smaller with a more delicate tip and lower dorsum as the thin skin is more likely to contract and accommodate the underlying nasal framework. However, these patients require the highest level of attention as they are at greater risk for visible or palpable irregularities. On some occasions, Dr. Antunes will use fascia grafts to create a thicker sheet that will create a balance between showing the underlying structures while camouflaging minor irregularities.
In patients with thick skin it is important to keep the nose slightly larger with a increased tip projection and definition and a higher nasal bridge to avoid problems with skin redraping or formation of a polly-beak deformity (when the tip droops below the bridge). A nasal tip will always look narrower and more defined when they are more projected. If a thick-skinned patient has a significant reduction on the nasal framework, the skin has trouble redraping and the nasal tip can look shapeless. This can sometimes be a difficult concept to understand.