Posted by Dr. Anil R. Shah
A common question for patients seeking rhinoplasty is to make their nose smaller. So how small can you make the nose?
The rate limiting step on how small you can make the nose is the soft tissue envelope, which is essentially the skin of the nose. A rhinoplasty is designed to reshape the underlying structure of the nose which is bone and cartilage, but it does not remove skin. So, if the surgeon removes too much cartilage and bone, the skin will not have enough support and structure and look shapeless, not to mention the loss of functionality of the nose.
An analogy that can be used here is to think of the nose as a dress and the underlying structure (bone and cartilage) as the body. If person with a larger frame loses a significant amount of weight, there must be enough elasticity in the skin to accomodate for this. Similarly with a rhinoplasty, in order for a llarge reduction in cartilage or bone to work, the skin must be able to adapt to the new shape of the nose. Thicker skin, typically can withstand less significant changes to the nose than thinner skin. Just as you would not want to wear a thick, baggy dress that is 4 sizes too big, nor would you wanr the skin of the nose to not fit its frame. It is more important for the shape of the nose to be proper, rather than focus on the size.
