Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-08T21:40:18.667Z Has data issue: false hasContentIssue false
  • English
  • Français

A comprehensive approach to rhinoplasty for thick-skinned patients

Published online by Cambridge University Press:  07 December 2023

Brajendra Baser ,
Sreena Dev Open the ORCID record for Sreena Dev [Opens in a new window]  and
Shangorav Mukhopadhyay
Brajendra Baser
Affiliation:
Department of ENT, Jaslok Hospital, Mumbai, Department of ENT, Sri Aurobindo Institute of Medical Sciences, Indore, and Department of ENT, Akash Hospital, Indore, India
Sreena Dev*
Affiliation:
Sreena Dev, Department of ENT, Akash Hospital, Indore, India
Shangorav Mukhopadhyay
Affiliation:
Shangorav Mukhopadhyay, Department of ENT, Sri Aurobindo Institute of Medical Science, Indore, India
*
Corresponding author: Sreena Dev; Email: Sreenadev27@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study aimed to propose a systematic approach for managing thick-skinned rhinoplasty patients.

Methods

A retrospective review of the treatment of 26 thick-skinned patients with aesthetic and/or functional problems over a period of three years from January 2018 to January 2021 with a follow up for one year. A presurgical evaluation of skin was carried out initially. Skin thickness due to sebaceous overactivity was treated with retinoic acid derivatives, and skin thickness due to increased adipose tissue or hypertrophic fibrofatty layers was treated surgically. Open rhinoplasty was performed in all patients and a strong osseocartilaginous framework was created with the skin stretched as much as the aesthetic tolerance allowed.

Results

Post-operative outcomes were based on subjective assessment, photographic evaluation and the Rhinoplasty Outcome Evaluation questionnaire, which indicated significant patient satisfaction.

Conclusion

Using this systemic approach for treating thick-skinned rhinoplasty patients, predictable results with improved aesthetic satisfaction in patients were achieved.

Keywords

Rhinoplastyisotretinointriamcinolonesubcutaneous tissue
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 5 , May 2024 , pp. 512 - 519
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Sreena Dev takes responsibility for the integrity of the content of the paper

References

Guyuron, B, Lee, M. An effective algorithm for management of noses with thick skin. Aesthetic Plast Surg 2017;41:381–710.1007/s00266-017-0779-1CrossRefGoogle ScholarPubMed
Lam, SM, Williams, EF. Anatomic considerations in aesthetic rhinoplasty. Facial Plast Surg 2002;18:209–1410.1055/s-2002-36488CrossRefGoogle ScholarPubMed
Davis, RE, Hrisomalos, EN. Surgical management of the thick-skinned nose. Facial Plast Surg 2018;34:22–8Google ScholarPubMed
Nagarkar, P, Pezeshk, RA, Rohrich, RJ. The Indian nose. Plastic Reconstr Surg 2016;138:836e–43e10.1097/PRS.0000000000002687CrossRefGoogle ScholarPubMed
Cobo, R, Vitery, L. Isotretinoin use in thick-skinned rhinoplasty patients. Facial Plast Surg 2016;32:656–61Google ScholarPubMed
Yahyavi, S, Jahandideh, H, Izadi, M, Paknejad, H, Kordbache, N, Taherzade, S. Analysis of the effects of isotretinoin on rhinoplasty patients. Aesthet Surg J 2020;40:657–6510.1093/asj/sjaa219CrossRefGoogle ScholarPubMed
Cobo, R, Camacho, JG, Orrego, J. Integrated management of the thick-skinned rhinoplasty patient. Facial Plast Surg 2018;34:003–8Google ScholarPubMed
Rees, TD. An aid to the treatment of supratip swelling after rhinoplasty. Laryngoscope 1971;81:308–1110.1288/00005537-197102000-00011CrossRefGoogle Scholar
Chu, E, Davis, RE. SMAS debulking for management of the thick-skinned nose. JAMA Facial Plast Surg 2015;17:305–610.1001/jamafacial.2015.0361CrossRefGoogle ScholarPubMed
Coskun, N, Yavuz, A, Dikici, MB, Sindel, T, Islamoglu, K, Sindel, M. Three-dimensional measurements of the nasal interdomal fat pad. Aesthetic Plast Surg 2008;32:262–510.1007/s00266-007-9038-1CrossRefGoogle ScholarPubMed
Copcu, E, Metin, K, Çulhaci, N, Ozkok, S. The new anatomical viewpoint of the nose: the interdomal fat pad. Aesthetic Plast Surg 2003;27:116–1910.1007/s00266-002-0067-5CrossRefGoogle ScholarPubMed
Cobo, R. Rhinoplasty in the Mestizo nose. Facial Plast Surg Clin North Am 2014;22:395–41510.1016/j.fsc.2014.04.011CrossRefGoogle ScholarPubMed
Cobo, R. Rhinoplasty in Latino patients. Clin Plast Surg 2016;43:237–5410.1016/j.cps.2015.09.003CrossRefGoogle ScholarPubMed
Perkins, S, Patel, A. Endonasal suture techniques in tip rhinoplasty. Facial Plast Surg Clin North Am 2009;17:41–5410.1016/j.fsc.2008.10.004CrossRefGoogle ScholarPubMed
Ozucer, B, Yildirim, YS, Veyseller, B, Tugrul, S, Eren, SB, Aksoy, F et al. Effect of post rhinoplasty taping on postoperative edema and nasal draping: a randomized clinical trial. JAMA Facial Plast Surg 2016;18:157–6310.1001/jamafacial.2015.1944CrossRefGoogle Scholar
Nemati, S, Golcha, J, Iranfar, K, Alizadeh, A. Frequency of acne vulgaris and its exacerbation in the facial and periorbital area after septorhinoplasty. Am J Otolaryngol 2013;34:378–8110.1016/j.amjoto.2013.01.012CrossRefGoogle ScholarPubMed
Kosins, AM, Obagi, ZE. Managing the difficult soft tissue envelope in facial and rhinoplasty surgery. Aesthet Surg J 2017;37:143–5710.1093/asj/sjw160CrossRefGoogle ScholarPubMed