The new nose: Insights on the growing popularity of rhinoplasty procedures

There is no doubt that rhinoplasty, also more informally known as a "nose job," is high on the list of the most popular plastic surgery procedures. This procedure involves changing the size and shape of the nose through surgical intervention.

However, it's not only an aesthetic procedure. Many rhinoplasties also focus on invisible structural corrections to improve breathing and are often paired with other procedures like septoplasty, which corrects the nasal septum.

To gather more insights on the growing popularity of modern rhinoplasty procedures and upcoming advancements in the field, we reached out to two renowned ASPS Member Surgeons – Omar Hussain, MD, FACS, and Lara Devgan, MD.

The modern rhinoplasty procedure

A rhinoplasty isn't just a procedure that simply addresses an aesthetic change within the nose. It is now often used to correct hidden airflow issues.

"Most patients have an issue affecting their breathing due to their septum," said Hussain. "They are either born with it or acquire a blockage after trauma."

While correcting breathing issues with structural repairs is an important part of many rhinoplasties, there are still plenty of patients seeking it for a more personal reason.

"Many patients, both young and old, seek rhinoplasties for multiple personal and aesthetic reasons, the most common being improving facial balance and symmetry, refining the nasal tip, minimizing a dorsal hump and narrowing the alar base," said Devgan. "In some instances, patients with previous nasal fractures come in with crooked noses that need straightening."

Aesthetic corrections are also popular, as the nose is one of the most prominent aspects of facial beauty.

"The nose is a paradoxical feature that is at its best when it is utterly neutral, so often when I am thinking about the aesthetics of the nose, I am actually focusing on the overall global proportions of the face – the light reflex of the cheekbones, the shadow of the jawline and the balance of the chin," said Devgan. "The nose bears on all of these in some way."

Oftentimes, before surgical rhinoplasty is considered, many specialists will look to nonsurgical techniques to address the issue at hand.

"If the issue is a mild asymmetry, a small amount of fat or filler can be injected to correct it," said Hussain.

There are many different maneuvers and techniques to accomplish the look a patient desires when considering surgical options for rhinoplasty.

"Surgically, there are open versus closed rhinoplasties as two categories describing whether surgery is being performed through incisions that are hidden inside the nose or whether there will be an external scar," said Hussain.

In addition to an open or closed rhinoplasty, there are other maneuvers that will differentiate the type of rhinoplasty. This can range from "tip work" that aims to change the position, size and appearance of the nasal tip to dorsum grafting and removal of extra skin. One additional set of procedures is "osteotomies," which, according to Hussain, "are performed when we need to break bone to change the size or height of the top third of the nose."

The exciting future of rhinoplasty

In looking toward the future of rhinoplasty, there are many innovations on the horizon, from new techniques that decrease the length of surgeries to new tools that minimize scars and complications.

"An exciting hot topic today is 'preservation rhinoplasty' in which anatomic appearance of the top of the nose is 'preserved' by performing surgery beneath to lower the dorsum (top) of the nose versus taking it apart to lower it and reconstruct it," said Hussain.

In other words, this technique works to preserve the appearance of the nose and minimize scars by working beneath the nose rather than opening it up entirely.

Another hot topic today is the increasing popularity of nonsurgical rhinoplasty.

"This is due to patients not having enough downtown to undergo surgery, and many want to trial a change prior to signing up for a surgical commitment," said Devgan. "The nonsurgical rhinoplasty uses a filler in order to fill in areas of the nose to create a certain look and shape, or to make a correction of the physical appearance of the bone structure of the nose."

In looking at innovations within tools, there is one particular option that is proving to be very promising within the rhinoplasty field – the piezo-saw. According to Hussain, these tools are used to "perform very safe and precise cuts in the bone or ribs to avoid bleeding and other complications."

Maximizing your rhinoplasty results

As with any cosmetic procedure, there are means and methods to maximize your recovery and achieve the results that you've been dreaming of. Here are some of our top tips and advice to consider.

Go for a board-certified plastic surgeon

Your first step in achieving your dream results is to find the right surgeon who is board certified by the American Board of Plastic Surgery.

"There's a reason board certification exists," said Hussain. "You'd never fly in a plane that didn't pass inspections."

Look for a specialist

Just like any other field of medicine, plastic surgeons tend to have procedures they concentrate on.

"Try to go to surgeons that specialize in the procedure, and it comprises a large volume of their practice," said Hussain.

Look for a surgeon who has a lot of experience with rhinoplasty so you can be assured they are well-versed and able to accomplish exactly what you want.

Remember that you are unique

It's important to remember your end goals and your unique appearance when considering the right surgeon to perform your rhinoplasty.

"I always remind my patients that each of them has a different, unique anatomical structure," said Devgan. "Based on that, all noses are not meant to look the same. It is important to approach cosmetic procedures with a well-informed and realistic mindset, as well as an understanding that we are rehabilitating a building but using the same bricks, meaning that baseline anatomy and starting point will determine the degrees of freedom we have in achieving an aesthetic outcome."

Make sure you feel heard

You should feel like the surgeon and their team are listening to you and what you need when you find the perfect surgeon and meet with them to discuss your goals.

"When you're at your consult, make sure you feel like you are seen and heard," said Hussain.

After all, this team and surgeon will be responsible for accompanying you along the journey to your end results!

Don't cut corners on your recovery

It may feel like the majority of your results are achieved during the procedure itself, but how you recover will actually determine your success. Prepare ahead of time and commit to following all directions from your surgeon.

"I tell my patients to think of it like a European vacation," said Hussain. "Don't cut corners on things like hyperbaric oxygen therapy postop, staying in an aftercare facility, red light therapy, IV therapy, peptides and time off from work around your surgery. You want to be relaxed and healing in a positive, stress-free environment. It all makes a difference."

On top of all these postop routines and therapies, it's also important to simply allow your body time to recover and heal.

"In terms of postoperative care, I tell all my patients that recovery is a one- to two-year journey," said Devgan. "Swelling will come and go for the first postop year; it is so important to be patient while you are healing."

More than just a nose job

Far more than a simple "nose job," a modern rhinoplasty involves not only restructuring the nose but also addressing issues that might not be visible to the naked eye to allow patients to breathe more easily and feel more confident in their day-to-day lives.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.