There are some physical characteristics that make a surgical reshaping of the nose more difficult. If you were born with exceptionally thick facial skin and seek a smaller nose, your skin may not have the flexibility to adjust to the new bone profile. Very thin skin is likely supple enough, but may not be sufficiently opaque to cover the subdermal marks of surgery, such as bone grafts. Rhinoplasty revisions present additional challenges, as there is likely to be scar tissue from the earlier surgery.