Nuances of the nasal tip: rhinoplasty of the thin-skinned nose.

Rhinoplasty in the thin-skinned patient presents a unique set of challenges to achieve desired results. Preoperative recognition of thin skin is imperative to direct the operative plan and to achieve excellent results. Once identified, meticulous care must be implemented in sculpting the underlying cartilaginous framework. The skin may also benefit from techniques to thicken the skin through the use of cartilage and fascial grafts. This article will discuss recognition of the thin-skinned nose, avoiding pitfalls, techniques to optimize structural support, camouflage grafting techniques, and options available to thicken the nasal skin.