Management and Limitations of Thick Skin in the Secondary Patient.

Roxana Cobo

Journal: Facial plastic surgery clinics of North America 2026;34(2):245-256

PMID: 42091326

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Abstract

Thick skin is a challenge in secondary rhinoplasty, frequently compromising both aesthetic outcomes and the predictability of surgical interventions. This article presents an integrated approach to the management of thick skin in patients undergoing secondary rhinoplasty. The described protocol encompasses preoperative, intraoperative, and postoperative strategies designed to reduce and control swelling, edema, and inflammation as much as possible. It incorporates topical and systemic medical therapies, dietary modifications, structured skin stretching exercises, and surgical techniques including superficial musculoaponeurotic system debulking, skeletal augmentation, structural grafting, and control of dead space formation.

Address: Department of Otolaryngology, Clinica Imbanaco, Carrera 38A #5A-100 cons 222A, Cali, Colombia. Electronic address: [email protected].

DOI: 10.1016/j.fsc.2026.01.006

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MeSH Terms: Humans, Rhinoplasty, Skin, Reoperation, Postoperative Complications