Download PDF
Facial Plast Surg 2018; 34(01): 003-008
DOI: 10.1055/s-0037-1617445
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Integrated Management of the Thick-Skinned Rhinoplasty Patient

Roxana Cobo
1   Department of Otolaryngology, Centro Médico Imbanaco, Cali, Colombia
,
Juan Gabrie Camacho
2   Department of Otolaryngology, Universidad Militar Nueva Granada, Bogota, Colombia
,
Jorge Orrego
3   Department of Otolaryngology, Universidad Militar Nueva Granada, Bogota, Colombia
› Author Affiliations
Further Information

Publication History

Publication Date:
06 February 2018 (online)

Also available at
    Permissions and Reprints

Abstract

Patients with thick skin are a challenge in facial plastic surgery. Rhinoplasty is still the most frequently performed facial plastic procedure worldwide and it becomes very difficult to obtain optimal consistent results in these patients. A systematic presurgical skin evaluation is performed dividing skin into type I–III depending on the elasticity, oiliness, presence of skin alterations, size of skin pores, and laxity. Depending on the skin type, presurgical, surgical, and postsurgical management of the epidermis and dermis is defined. Preconditioning and treating thick skin can improve postsurgical results and reduce postsurgical unwanted results.

Keywords

thick skin - rhinoplasty - skin evaluation - acne prone
 

  • References

  • 1 Cobo R. Trends in facial plastic surgery in Latin America. Facial Plast Surg 2013; 29 (03) 149-153
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Hafezi F, Naghibzadeh B, Nouhi A. Management of the thick-skinned nose: a more effective approach. Ann Otol Rhinol Laryngol 2006; 115 (06) 444-449
    CrossrefPubMedGoogle Scholar
  • 3 Sugiyama-Nakagiri Y, Sugata K, Hachiya A, Osanai O, Ohuchi A, Kitahara T. Ethnic differences in the structural properties of facial skin. J Dermatol Sci 2009; 53 (02) 135-139
    CrossrefPubMedGoogle Scholar
  • 4 Guyuron B, DeLuca L, Lash R. Supratip deformity: a closer look. Plast Reconstr Surg 2000; 105 (03) 1140-1151 , discussion 1152–1153
    CrossrefPubMedGoogle Scholar
  • 5 Cho GS, Kim JH, Yeo N-K. , et al. Nasal skin thickness measured using computed tomography and its effect on tip surgery outcomes. Otolaryngology Head Neck Surg 2011; 144 (04) 522-7
    CrossrefPubMedGoogle Scholar
  • 6 Tasman AJ, Helbig M. Sonography of nasal tip anatomy and surgical tip refinement. Plast Reconstr Surg 2000; 105 (07) 2573-2579 , discussion 2580–2582
    CrossrefPubMedGoogle Scholar
  • 7 Nemati S, Banan R, Alizadeh A, Leili EK, Kerdari H. Ultrasonographic evaluation of long-term results of nasal tip defatting in rhinoplasty cases. Laryngoscope 2013; 123 (09) 2131-2135
    CrossrefPubMedGoogle Scholar
  • 8 Kosins AM, Obagi ZE. Managing the difficult soft tissue envelope in facial and rhinoplasty surgery. Aesthet Surg J 2017; 37 (02) 143-157
    CrossrefPubMedGoogle Scholar
  • 9 Guyuron B, Lee M. An effective algorithm for management of noses with thick skin. Aesthetic Plast Surg 2017; 41 (02) 381-387
    CrossrefPubMedGoogle Scholar
  • 10 Klatsky SA, Manson PN. Aesthetic rhinoplasty in patients with thick nasal skin. Ann Plast Surg 1983; 11 (01) 10-16
    CrossrefPubMedGoogle Scholar
  • 11 Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol 2015; 8: 371-388
    PubMedGoogle Scholar
  • 12 Pappas A. The relationship of diet and acne: a review. Dermatoendocrinol 2009; 1 (05) 262-267
    CrossrefPubMedGoogle Scholar
  • 13 Cobo R, Vitery L. Isotretinoin use in thick-skinned rhinoplasty patients. Facial Plast Surg 2016; 32 (06) 656-661
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Spring LK, Krakowski AC, Alam M. , et al. Isotretinoin and timing of procedural interventions: a systematic review with consensus recommendations. JAMA Dermatol 2017; 153 (08) 802-809
    CrossrefPubMedGoogle Scholar
  • 15 Zaenglein AL, Pathy AL, Schlosser BJ. , et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2016; 74 (05) 945-973.e33
    CrossrefPubMedGoogle Scholar
  • 16 Chu E, Davis RE. SMAS debulking for management of the thick-skinned nose. JAMA Facial Plast Surg 2015; 17 (04) 305-306
    CrossrefPubMedGoogle Scholar
  • 17 Cobo R. Rhinoplasty in the Mestizo nose. Facial Plast Surg Clin North Am 2014; 22 (03) 395-415
    CrossrefPubMedGoogle Scholar
  • 18 Cobo R. Rhinoplasty in Latino patients. Clin Plast Surg 2016; 43 (01) 237-254
    CrossrefPubMedGoogle Scholar