It is the operation protocol of thick-skinned noses, which we can call the most difficult nose surgeries for plastic surgeons, and the beautification process after it. It is very valuable to talk to the patient in detail and inform the person beforehand. While most patients know that surgery is a problem in thick-skinned noses, some patients are disappointed after meeting with the plastic surgeon. What is valuable here is that the patient knows that he cannot have a very small and thin nose, but a nose that suits his face can be made.
Plastic Surgery Specialists give form to the bone and cartilage tissues that basically form the nasal skeleton in nose surgeries. Then, he wants the nose skin to fully cover this skeleton and take the form of the mold below. Because even the smallest asymmetry will be obvious from the outside. In patients with thick nasal skin, most of the asymmetry and deformations of the underlying bone and cartilage tissue are masked and inconspicuous. The disadvantage of the thick-skinned nose structure for the surgeon is that he can see the underlying bone and cartilage tissue only when opened during surgery.
As the skin thickness rises above a critical level, it becomes such that the nasal skeleton is personally formed by the skin layer. No process to the bone and cartilage roof causes a change in the nose. When viewed from the outside, the nose can be seen as a lump of flesh. This type of nose is also known as bulbous nose. In bulbous nose structure, unlike the skin on the outside, the cartilage tissue is wide but extremely thin and weak for more than one time. This situation is also challenging for the surgeon who tries to give a permanent form to the cartilage during the surgery.
Another application that can be done in thick-skinned rhinoplasty is stripping the subcutaneous tissue under the skin. The most valuable reason for the thickness is the layer formed by the loose connective tissue, adipose tissue and muscle layer in the subcutaneous tissue. During the nose surgery, the nasal skin is removed by stripping the bone and cartilage tissue. After giving the necessary form to the skeleton, it is possible to achieve at least 50% thinning of the skin by stripping the subcutaneous tissue from the skin along the entire skin and very carefully. In this type of noses, it is extremely valuable to increase the resistance of the cartilage skeleton by adding ample reinforcements, especially while giving form to the cartilage tissue.
In thick-skinned rhinoplasty, the problem cannot be completely eliminated by thinning the nose skin, it is valuable to remove excess tissue while thinning the skin and to fit it into the bone tissue without leaving any bulk. Another valuable point that should not be forgotten is that since edema formation will be more in thick-skinned noses, it will take 1 year for the nose to fully take shape.
If a thick-skinned rhinoplasty is to be done, especially for skin thinning, it is very valuable for the patient to quit smoking 15 days before the surgery, if they are using it for post-operative beautification. If the patient is working, he can return to work exactly 7 days later.