RealSelf actual patient comment:

Hello, I just had my first consultation with a doctor. I asked him if an alar base reduction was possible, with some tip refinement. He felt my nose and informed me that my skin around the tip is extremely thick, so making it any smaller will not work. He recommended I see a dermatologist regarding my skin, but I feel that doing so won’t address my main concerns: making my nose look smaller. Any advice? I’m aware of the limitations due to thick skin but this advice was disheartening.

A.In the hands of an expert rhinoplasty surgeon you can achieve your rhinoplasty aesthetic goals. It will likely require an open approach rhinoplasty with the use of your own cartilage to create a refined nose. It is less about thinning your skin, more about creating an underlying cartilage support. The best thing that you can do is consult with a few expert rhinoplasty surgeons and then choose your surgeon most carefully based on their experience, skill, knowledge, and natural artistic vision. A few great rhinoplasty surgeons whom I would recommend are Ari Hyman, MD (Los Angeles), Dean Toriumi, MD (Chicago), and Steven Pearlman, MD(NYC). Good luck and be well.