Skin is a very important parameter affecting the surgical outcome in nasal surgeries.
The skin is a sort of cover draping over the main structural elements of the nose, and it is an unchangeable part of the nose.
Making the nose achieve a beautiful shape post-surgery is only possible by accepting this characteristic of the skin.
What needs to be applied in patients with thick skin is correctly shaping the underlying skeleton to make the nasal skin look good, without aiming for an overly small nasal tip.
Often the cartilages inside the nose are sufficient during this process, but sometimes it may also be necessary to harvest a rib cartilage graft from the patient to make this support strong.
Realistic Expectations: The skin is an unchangeable part of the nose. Therefore, in patients with very thick skin, even if the nose is shortened and the hump is removed, the nasal tip cannot be excessively reduced. Expecting an extremely small "Barbie/Hazelnut nose", which is possible for thin-skinned patients, is unfortunately not realistic for patients with thick skin.