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Rhinoplasty: Still Tricky After All These Years

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Rhinoplasty is one of the oldest plastic surgery procedures, if not the oldest. In fact, the written record dates back hundreds of years B.C. to ancient India, where physicians developed techniques to restore form and function to those who had their noses cut off as punishment for crimes.

Interest in nose surgery waxed and waned over the ensuing centuries. The age of modern rhinoplasty is said to have begun in the 1700’s, when surgeons in Europe refined the procedure for both aesthetic and reconstructive purposes.

You might think that after hundreds of years of experimentation, rhinoplasty would be a procedure that delivers satisfaction to most patients. In fact, it’s not too unusual for someone to be unhappy with their results.

If you’re considering nose surgery, how can to increase your chances of a great outcome? The answer to these questions rests partly with you, the patient, and partly with your surgeon.

First, the determination needs to be made that you’re seeking surgery for the right reasons. An Italian physician performed a fascinating study on the psychological side of rhinoplasty in 2007. He noted that the procedure was consistently one of the most popular among men and women, and that it was the procedure most requested by patients with body dysmorphic disorder. In other words, physicians were likely to encounter patients with skewed views of their physical selves often in consultation.

The actual focus of this researcher’s study was to find out how well surgeons handled the psychological aspects of rhinoplasty. He found that in many cases, the doctor did not conduct preoperative interviews that allowed them to evaluate patient suitability and readiness. What this means to you is that you need to take the responsibility of thinking extra hard about your goals for rhinoplasty. Is it mainly your nose that bothers you, or are you unhappy with many of your body features, dwelling on negative thoughts about your physique often? If you succeed in getting the nose you’ve always wanted, do you think your nose will be changed or your life?

Equally important to realize is that rhinoplasty continues to be a delicate operation—one that requires skill and experience. It also demands the application of science and a good sense of aesthetics to achieve a change that makes your nose a better fit for your face.

If you’re considering nose surgery, you already know the central role your nose plays in your overall looks. Here, tiny fractions of centimeters can make a big difference in your appearance. Bones and cartilage make up the nose, and both may need to be modified to achieve a natural look. Then there’s that other pesky consideration, breathing. Even if improved breathing is not a motivator for your, you definitely don’t want to suffer impaired breathing afterward.

For all these reasons, many plastic surgeons will advise you to seek out a physician who is highly experienced in rhinoplasty. Some will even steer you away from a general plastic surgeon to one who’s educated specifically in facial plastic surgery.

You should consider surgeons that have experience with all kinds of noses: Caucasian, Asian, African American, male and female. Ask how many nose jobs the surgeon has performed and how many they perform each year. To be a specialist, rhinoplasty should be among the top few procedures your doctor performs.

Make sure he or she has experience in both closed (inside the nostrils) and open (lifting the skin) procedures. Find out how the surgeon decides which approach is best for a given patient.

Surgeons you consider should be happy to show you quite a few before and after photos. These days many physicians also offer computer imaging to give you an idea what you can expect from nose surgery.

Finally, ask about the surgeon’s revision rate. If he or she has a few patients who have sought more surgery, that’s understandable. But the overall revision rate should be low. Ideally, your prospective surgeon will perform revisions for other surgeons. And, he or she should be happy to tell you their revision policy just in case you’re not satisfied with your result.

To sum it all up, you’re not looking for a surgeon who performs nose jobs as one of the many procedures he or she does. You are looking for someone who truly enjoys performing rhinoplasty surgery. A surgeon who sees the procedure as challenging and embraces each job. Someone who is proud of the fact that they reshape hundreds (or at least many dozens) of noses each year for satisfied men and women.

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Cathy Enns
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.