The most difficult nasal surgery for plastic surgeons is the surgical protocol of thick-skinned noses, which we can call the most difficult nasal surgeries, and the recovery process afterwards. While most patients know that surgery is difficult in thick-skinned noses, some patients are disappointed after meeting with the plastic surgeon. The important thing here is that the patient knows that the patient cannot have a very small and thin nose, but a nose that suits the face shape can be made.
What is Thick-Skinned Rhinoplasty?
The most difficult nose surgeries for plastic surgeons are the surgical protocol and the recovery process after the thick-skinned noses, which is a type of nose. It is very important to talk to the patient in detail and inform the patient beforehand. While most patients know that surgery is difficult in thick-skinned noses, some patients are disappointed after meeting with the plastic surgeon. The important thing here is that the patient knows that the patient cannot have a very small and thin nose, but a nose that suits the face shape can be made.
Plastic Surgery Specialists mainly shape the bone and cartilage tissues that make up the nasal skeleton in nose surgeries. Then, they want the nasal skin to fully cover this skeleton and take the shape of the underlying mould. If rhinoplasty is to be performed in patients with prominent thin nasal skin, it is necessary to be very careful when shaping the bone and cartilage tissue. Because even the slightest asymmetry will be obvious from the outside. In patients with thick nasal skin, most of the asymmetries and deformations of the underlying bone and cartilage tissue are masked and inconspicuous. The disadvantage of the thick-skinned nasal structure for the surgeon is that he sees the underlying bone and cartilage tissue only when he opens it during surgery.
As the skin thickness increases above a critical level, it becomes such that the nasal skeleton is formed by the skin layer itself. No procedure performed on the bone and cartilage roof causes a change in the shape of the nose. The nose can be observed as a pile of meat when viewed from the outside. This type of nose is also called bulbous nose in general. In the bulbous nose structure, unlike the skin outside, the cartilage tissue is often large but extremely thin and weak. This is a situation that also challenges the surgeon who tries to give a permanent shape to the cartilage during surgery.
Another application that can be performed in thick-skinned rhinoplasty is the stripping of the subcutaneous tissue under the skin. The most important cause of thickness is the layer of loose connective tissue, adipose tissue and muscle layer in the subcutaneous tissue. During rhinoplasty, the nasal skin is lifted by peeling off the bone and cartilage tissue. After the necessary shape is given to the skeleton, it is possible to achieve at least 50% thinning of the skin by scraping the subcutaneous tissue from the skin very carefully and along the entire skin. In such noses, it is extremely important to increase the resilience of the cartilage skeleton by placing plenty of supports, especially when shaping the cartilage tissue.
In thick-skinned rhinoplasty, the problem cannot be completely solved by thinning the nasal skin, it is important to remove excess tissue while thinning the skin and to fit the bone tissue without leaving abundance. Another important point that should not be forgotten is that it will take 1 year for the nose to take full shape, as the formation of oedema will be high in thick-skinned noses.
It is very important for postoperative recovery that the patient quits smoking 15 days before the thick-skinned rhinoplasty surgery, especially if the skin is to be thinned. If the patient is working, he can return to work exactly 7 days later.
