Getting A Nose Job Is Not Always About Vanity
I was born with the same “Jewish nose” as my mom and many before us. As soon as I turned 18, I had it fixed – a graduation gift from my grandmas, the only gift I actually wanted.
Many share this story… getting nose jobs to cope with bumps and hooks and curves they aren’t comfortable with. Rhinoplasty has absolutely gotten a reputation for being about vanity, and in many cases that is what it’s all about. But, there are quite a few other reasons a person may choose to get their nose fixed, and a lot have absolutely nothing to do with vanity.
More than vanity
“Patients often undergo rhinoplasty to correct deformities, address the physical aftermath from an injury, or correct a nose that isn’t structured properly to allow for optimal breathing, ,” says Dr. Antonio Gayoso, a Florida-based plastic surgeon.
Congenital deformities of the nose are often related to a cleft lip and/or palate and require surgery which is often performed on children or teenagers affected by these conditions. Some may need a subsequent re-operation of the nose to correct deformities related to a previous cosmetic rhinoplasty.
Additionally, lifestyle choices like the abuse of cocaine can lead to destruction of the nasal septum and cartilage causing the nose to collapse, requiring rhinoplasty. “This is exceptionally difficult to reconstruct,” explains Dr. Gayoso. “I also see a lot of patients with severely deviated septums who struggle to breathe. These patients aren’t undergoing rhinoplasty for purely aesthetic purposes. That just happens to be an additional perk,” he continues.
It’s true that patients asking for rhinoplasties usually have a cosmetic concern. However, cosmetic surgery and reconstructive surgery aren't black and white terms. “For example, patients with cleft lips have an associated cleft lip nose. When those patients are teens, years after they've had their lips repaired, they often have a rhinoplasty to improve the appearance of the cleft lip nose. Rhinoplasty surgery is also performed after a trauma once the bones have set. If the septum is deviated, causing the nose to lean to one side, then a rhinoplasty is combined with a septoplasty,” says Santa Rosa based plastic surgeon, Dr. Heather Furnas
Different procedures for different results
Functional nasal surgery usually involves the septum, the wall that divides the two nasal passages, explains Dr. Furnas. A deviated septum can cause breathing difficulties. “A hole in the septum is often seen in patients with a history of cocaine use. A septoplasty can also improve the shape. A rhinoplasty can do more than make a normal nose look pretty - it can change a disproportionally large and distracting feature to more normal proportions, balancing the face. Often the goals of what we consider reconstructive surgery and what we consider cosmetic surgery are really the same. It's a matter of degree and etiology. If a bump is post-traumatic, it might be considered reconstructive. If not, it's considered cosmetic,” says Dr. Furnas.
“Every rhinoplasty, whether cosmetic or reconstructive, is highly individualized, and the surgeon will choose from various tools and techniques to achieve the result,” says Dr. Gayoso. “Most reconstructive rhinoplasties will require more invasive and more elaborate techniques than cosmetic rhinoplasties. The degree of difficulty is usually higher due to pre-existing scar tissue related to injury or previous surgery. In the case of congenital deformities there may be a lack of tissue available to create a normal shape. This holds true for the cocaine nose as well. However, the line between reconstructive and cosmetic rhinoplasty has been blurred over time because many reconstructive techniques are now used in cosmetic rhinoplasty, Dr. Gayoso says. “The doctor must diagnose the anatomic problem in the nose and then formulate the solution. This general process is essential in any rhinoplasty surgery,” says Dr. Gayoso.
Still largely cosmetic
“In my own practice the rhinoplasties I do are for aesthetic reasons. The term "beauty" might be marginalizing the difference the surgery can make. Some people with large noses and small faces have suffered through years of teasing or simply being ignored. When they feel normal or attractive, the self-confidence can have a huge impact on their lives. Some of my patients say they think of their nose all the time. That's a huge distraction in one's life. After surgery, they feel liberated and confident,” says Dr. Furnas.
If you are considering a rhinoplasty, consult with a plastic surgeon certified by the American Board of Plastic Surgery (ABPS) who has experience performing the procedure. Use the ‘Find a Plastic Surgeon’ tool to find a board-certified plastic surgeon in your area.