Some patients have inquired about scar tissue formation after rhinoplasty and revision rhinoplasty. Specifically, they ask if the nose permanently becomes bigger because of scar tissue development under the skin following nasal reshaping? In most cases, the nose will not enlarge significantly following rhinoplasty or revision rhinoplasty. In fact, in most cases the nose will trend toward shrinkage as the months and years go on. There are, however, instances where rhinoplasty and revision rhinoplasty patients will experience some degree of enlargement of the nose. In my experience this is more common in those patients with very thick skin, such as ethnic rhinoplasty candidates. The area just above the tip, called the supratip, is particularly susceptible to excess, unwanted scar tissue formation. If noted, fortunately steroid injections can be quite successful in managing this in the office. Overall, though, most experienced rhinoplasty and revision rhinoplasty experts will take into account the skin type and anticipated postoperative scarring during the actual procedure so that these variables have little to no impact in the final outcome.