How Young is Too Young For a Nose Job?


Beth Longware Duff, Medical Editor

Beth Longware Duff is an experienced writer and reporter whose work on a wide variety of topics has been published in numerous newspapers and magazines. Her health and medical writing credits include nationally distributed videos for the March of Dimes Birth Defects Foundation, and she is the recipient of numerous awards including an American Cancer Society Media Award and a New England Press Association Award for Health Reporting. She holds a degree in Communications from Ithaca College.

July 15 2008

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Rhinoplasty and Age
Ah, the nose! It has the distinction of being one of the most defining features of the face. When it's nicely shaped and proportional, it can bring all the other features of the face into focus. But when it's too short, too long, or just too TOO, it can be a distraction and overshadow everything else, unbalancing the face.

Rhinoplasty – surgery that reshapes the nose – can deal with any number of issues. It can reduce an overly prominent nose or straighten a crooked one, remove bumps, improve a hanging or enlarged tip, reduce asymmetries (when one side of the nose looks different from the other), relieve breathing problems caused by a deviated septum, and correct birth defects or the results of trauma.
Given the versatility of the procedure, it's not surprising that rhinoplasty is one of the most popular plastic surgery operations in the United States. It generally takes an hour or two to complete as outpatient surgery, it's permanent, and most patients are back at work in 7 to 10 days. In 2007, rhinoplasty ranked sixth among surgical cosmetic procedures, with well over 151,000 performed, according to statistics from the American Society for Aesthetic Plastic Surgery.

The vast majority (92%) of those surgeries were performed on patients between the ages of 19 and 64, which might raise the question: Is one ever too young or too old for rhinoplasty?
The easy answer first: there is no upper age limit for rhinoplasty as long as the patient is physically and mentally healthy. That means no uncontrolled active diseases or chronic conditions like asthma, diabetes, cardiovascular disease, or high blood pressure. Surgeons also look for patients who have realistic expectations of what the procedure can do for them and are capable of navigating the sometimes rocky shoals of postsurgical recovery. Older patients may take longer to heal, and their skin may not be as elastic as that of a younger patient, but they usually have the patience and life experience required to get them through the surgery and recovery period.

At the other end of the age spectrum, the rule of thumb is that rhinoplasty should be postponed until children have reached what's known as physical maturity; in lay terms, they've gone through puberty and have stopped growing. One way to determine if a teen has achieved physical maturity is to compare his or her height to that of the parents. If the patient is as tall as their tallest parent, they (and their nose) have probably stopped growing.

Physical maturity differs in girls and boys. The magic age is 15 for girls and 18 for boys, although this can vary from individual to individual. Rushing the process and operating on the nose before it has reached its final state could result in disappointment. It makes it more difficult for the plastic surgeon to anticipate the final result because he or she is altering something that's still in transition. The concern is that the proportional nose achieved through rhinoplasty could morph into something less attractive if it changes significantly after surgery.

The exception to the rule for delaying rhinoplasty occurs when the surgery is corrective rather than strictly cosmetic. If nasal function has been compromised by a structural defect or traumatic injury, rhinoplasty could be appropriate at an earlier age. However, surgeons will generally advise the patient and his or her parents that future growth could affect the corrections, necessitating follow-up surgery.

As is the case with surgery in general and plastic surgery in particular, each patient must be evaluated individually prior to a procedure to determine if they are medically sound and mentally prepared to deal with what lies ahead. Younger patients who have completed their growth but are less mature may not be ready to deal with the psychological impact of cosmetic surgery. An honest assessment of their situation may result in the decision to postpone rhinoplasty for a year or more until the emotional maturation process catches up with the physical growth process.