Wigley Catrin, Sutton Jonathan, Eynon-Lewis Nicholas, Uppal Rajan
Royal Free Hospitals, London, UK.
Portsmouth Hospitals NHS Trust, UK.
JPRAS Open. 2025 May 30;45:260-270. doi: 10.1016/j.jpra.2025.05.010. eCollection 2025 Sep.
Performing rhinoplasty in patients with a thick skin often presents as a challenge. This article describes an assessment tool to (1) classify patients according to the of their skin and (2) to demonstrate the of this classification for the benefit of patients before Rhinoplasty.
166 patients underwent open rhinoplasty and were graded according to the Nasal Skin Thickness Scale (NSTS). Those patients graded as having thicker skin were selected for an acid peel before surgery. Preoperative and 6-month postoperative rhinoplasty outcome evaluation (ROE) score were collected to assess outcomes as these are a validated patient reported outcome measure. Pearson chi-square test was used to determine statistically significance of the postoperative groups.
All patients with thick skin (grade 3) or above were offered a preoperative skin acid peel. A total of 42 patients received this peel. There was a mean improvement of 6.4 of the nose outcomes in patients who had peel. The mean nose improvement in patients receiving the peel was 6.6 ( < 0.001). This indicates a marginal improvement of outcome in patients who had an acid peel before rhinoplasty.
This nasal skin thickness scale provides a simple framework for classifying nasal skin thickness. Skin thickness helps us identify patients who would benefit from optimisation of their skin before surgery to get the best results. In this case optimisation of the skin was undertaken with chemical peels. The acid peel helped shrink the skin and improve outcomes after rhinoplasty. This classification helps select patients who have thick skin and can be warned about swelling, lack of definition and the possible need for preconditioning.
对皮肤较厚的患者进行隆鼻手术往往具有挑战性。本文介绍一种评估工具，用于（1）根据患者皮肤的 对其进行分类，以及（2）为隆鼻手术前的患者展示这种分类的 ，以使其受益。
166例患者接受了开放式隆鼻手术，并根据鼻皮肤厚度量表（NSTS）进行分级。将那些被评为皮肤较厚的患者在手术前选择进行果酸换肤。收集术前和术后6个月的隆鼻手术效果评估（ROE）评分，以评估手术效果，因为这些是经过验证的患者报告的手术效果指标。使用Pearson卡方检验来确定术后组间的统计学显著性。
所有皮肤较厚（3级及以上）的患者都接受了术前皮肤果酸换肤。共有42例患者接受了这种换肤。接受换肤的患者鼻部效果平均改善了6.4。接受换肤的患者鼻部平均改善为6.6（<0.001）。这表明在隆鼻手术前进行果酸换肤的患者效果有轻微改善。
这种鼻皮肤厚度量表为鼻皮肤厚度分类提供了一个简单的框架。皮肤厚度有助于我们识别那些在手术前优化皮肤会受益的患者，从而获得最佳效果。在这种情况下，通过化学换肤对皮肤进行了优化。果酸换肤有助于缩小皮肤并改善隆鼻手术后的效果。这种分类有助于选择皮肤较厚的患者，并可以就肿胀、缺乏立体感以及可能需要预处理等情况对他们进行告知。
