A revision rhinoplasty on thick skin poses certain challenges. First and foremost, the overlying skin makes it difficult, or sometimes impossible, to show a high level of refinement.
Nonetheless, most patients can still expect a great deal of improvement after a revision rhinoplasty or corrective nose job.
To achieve good results, primary and revision rhinoplasties should ensure that the overlying skin can “shrink wrap” around the altered bony and cartilaginous framework. For this reason, over-reduction and over-narrowing will not provide any real benefits to patients with thick nasal skin.
Leading Beverly Hills plastic surgeon Dr. Karan Dhir warns that a thick nasal skin will not redrape well over the altered framework after an over-aggressive surgical maneuver, leading to an amorphous-looking tip.
Having a thick skin also results in longer recovery and more postop swelling and bruising. But regardless of skin thickness, most patients will look socially presentable at 2-3 weeks since the external swelling tends to dissipate quicker as compared with the internal swelling.
Despite the challenges brought on by thick skin, it is good at concealing minor irregularities that could easily show through a markedly thin skin.
Aside from skin thickness, the number of nose surgeries can also influence the length of recovery. In general, a person who has had multiple revisions should expect longer healing period.
Revision rhinoplasty on thick skin is inherently challenging because the baseline of the nose has already been altered, and the presence of scar tissue makes the skin harder to work with.
Aside from careful placement of incisions, steroid injections after a revision surgery can also minimize scarring. In addition, this treatment is known to control the amount of swelling especially at the tip, leading to quicker recovery.
A good revision rhinoplastic doctor will make every effort to avoid additional scarring, which can alter the way the nose heals and settles.
To achieve good definition and preserve the structural integrity of the nose, adding cartilage grafts—which are natural tissues from donor sites such as the septum (wall between the nostrils), ribs, and bowl of the ear—is common in revision rhinoplasty.
Preserving the structural integrity of the nose also ensures that the results can last a lifetime, look natural relative to the rest of the facial features, and less susceptible to the effects of aging, which are the main goals of any sensible surgeon.