A rhinoplasty can be performed on patients with thick skin, but there may be some limitations. Rhinoplasty is performed by lifting the skin, adjusting the underlying muscle and cartilage, and then pulling the skin back into place. However, the skin must be taut in the final step, which can be more difficult to do on patients with more elastic, thick skin. In these cases, there may be a need for additional thinning of the underlying tissue.