Everyone deserves to have the nose that they want. But shouldn’t it be the nose that their face wants too? Every face has certain proportions and dimensions that often make the nose stand out because it doesn’t quite fit – this is what usually drives one to seek a rhinoplasty. But exchanging one nose that doesn’t match nicely with the face for a “prettier” nose but which still doesn’t really match isn’t such a good idea. The best rhinoplasties result in a nose that looks nicer and fits better. A new nose which makes you still look like you – only better and in better overall proportion to your face. A nose that doesn’t scream out “I had surgery” because it is actually in better harmony with your face than the nose you had beforehand.
Generally, this will be a nose that has been sculpted to have improved aesthetics but doesn’t look like it is a nose which should belong to someone else. Do you really want to hear “Hey, nice nose job!” or would you prefer “You look nice – what did you do?”? Women will often realize during their consultation that the new characteristics they seek for their nose are really all about making their nose look more feminine. Unfortunately, it seems that many women have inherited a male-like nose (i.e. it looks more like Dad’s than Mom’s!). For a woman, the sculpting of the nose to look more feminine is another important strategy to bring it more into alignment with the rest of the face. For a man, the ideal reshaping of the nose will simultaneously maintain (or assert) its masculinity.
A “nose job” procedure sounds like it should hurt, but it really doesn’t. Really! Most patients believe that a rhinoplasty has got to be a painful procedure. They delay their consultation while dreading a recovery they actually know very little about. The truth is that a rhinoplasty is one of the least uncomfortable procedures in all of plastic surgery! Patients frequently seem surprised by this fact but quickly learn after their procedure that they truly have very little discomfort.
Stuffiness of the nose can be around for a while as the inside of the nose swells even more than what you might see on the outside but this is more “annoying” than it is painful. Speaking of which, due to advances in rhinoplasty techniques, the bruising and swelling is typically far less than what most people expect too. In under a week, most of the tell-tale signs that a procedure was performed will be gone – and it is likely that you will still have most of your pain pills left!
Do not watch any videos of a rhinoplasty or you will never have it done. Even though it doesn’t really hurt all that much afterward, it is probably wise for you to not watch any explicit videos of this procedure and wrongfully conclude otherwise. Watching things that you really weren’t meant to watch might dissuade you from following up on your dream…and for all the wrong reasons. The surgical techniques which are used, while sophisticated and artistic, do involve some maneuvers that might make you cringe a bit here and there.
For that matter, the same could probably be said for almost every surgical operation that there is, not just this one. Psychologically, patients who expect more pain and obsess about it (especially after watching things that are best left unwatched) will literally talk themselves into having more pain. Imagine – the reason it hurts more and your worst fears seem to be coming true are simply because you believed that they would. An old saying says that while your doctor cannot talk you out of your pain, you can certainly talk yourself into it!
“Packing” is essentially a thing of the past. This is another one of those still common but totally misplaced fears patients often express about a rhinoplasty. The idea of having the nose “packed” with about 8 yards of gauze per nostril that days later has to be removed with all the subtlety of starting a lawnmower – that would scare anybody. This all goes back to the old days, some 20 years ago or more, where packing of the nose after a rhinoplasty was routine.
The packing removal was literally the most painful part of the recovery. Modern plastic surgeons questioned the science behind this standard routine and for the most part it has been abandoned. For a cosmetic rhinoplasty, many plastic surgeons will use a small piece of a non-adherent type of packing that is removed shortly after your procedure, before you go home, not left in for days. More complex nasal procedures, reconstructions, or those involving the sinuses might require packing left in for longer.
Why does it seem like so many of the celebrities have their noses done and “re-done”? About 10% of patients having rhinoplasties will ultimately need or want at least some type of touch-up for their nose. This statistic has held true for many years. Why? Some patients will heal or scar (yes, there is scar tissue which can form under or in the skin in unkind ways) such that the result is not as good as it should have been and a revision, not a total overhaul, will be of benefit. Sometimes parts of the cartilage framework that support the nose will twist or bend in a wayward way as it recovers.
Unexpected and unpredicted, but in need of some minor surgical modification to be righted. A surgical solution is not always needed though – a good number of imperfections can be corrected with special injectable treatments in quick fashion in the office. It is actually only a small percentage of patients who wanted their nose to look a certain way and just didn’t get it, or worse. Unfortunately, it is somewhat of a standard Hollywood happenstance that a result is deemed good today, but then needs to go in a whole new and more aggressive direction next year. This sort of thing is often seen with breast implants and face lifts as well.
Dr. Lyle Back is originally from New York City, receiving his medical and surgical training at Rutgers Medical School, Cooper Hospital – University Medical Center, and Ohio State. He is Board Certified in General Surgery (ABS) and Plastic Surgery (ABPS). He is a Fellow of the American College of Surgeons (ACS), the American Academy of Cosmetic Surgery (AACS), and a longstanding member of the premier American Society of Plastic Surgeons (ASPS). He served as a Professor of Plastic Surgery at Temple University and St. Christopher’s Hospital for Children and performed reconstructive surgery with “Operation Smile” in Vietnam. He specializes in the full range of the most modern and state of the art facial cosmetic surgery procedures and non-surgical cosmetic enhancement techniques available today.