How young is too young for nose surgery? According to statistics published by the American Society of Plastic Surgeons, more than 63,000 cosmetic surgery procedures were performed on patients between the ages of 13 and 19 in 2013, and of those nearly half (more than 30,000) were procedures to reshape the nose. While some have argued that cosmetic plastic surgery procedures, like nasal surgery, or cosmetic rhinoplasty, are not appropriate for adolescents, the truth is that such procedures can and often do provide a variety of benefits. When performed by a skilled plastic surgeon, with extensive experience dealing with the subtleties of facial anatomy, adolescent rhinoplasty can be a safe and effective way to resolve congenital disorders or trauma to the nose while greatly improving nasal function and appearance.
Rhinoplasty procedures can be of particular benefit to younger patients because they address both functional and cosmetic issues at the same time. An adolescent’s self-esteem can be greatly influenced by physical appearance, and as a main focal point of the face, the nose is a key component in establishing harmonious facial balance. Moreover, several different congenital disorders can affect a patients’ ability to breathe in addition to impacting aesthetic appearance. Cleft lip and palate deformities, as well as physical trauma, can displace the cartilage of the nose, causing the interior wall, or septum, to deviate and restrict air flow.
Many plastic surgeons are hesitant to perform rhinoplasty on younger patients, as surgical procedures performed before the nose is fully grown can potentially hinder the nose’s ongoing development. However, the nose has completed approximately 90 percent of its total growth by age 14, and a thorough understanding of the anatomical structure and developmental characteristics of the face can help tremendously in predicting the ultimate outcome. During all rhinoplasty procedures that I perform, I prefer an open approach that allows visualization of the entire nasal anatomy and, if necessary, easy access to the septum and internal nasal valve. This level of exposure allows me to achieve a higher degree of precision with every maneuver, largely eliminating late shifting of structures of graft displacement, and increasing the predictability of the procedure.
As my colleagues and I point out in our chapter, “Primary Aesthetic Rhinoplasty in Adolescents”1 (published in Principles and Practice of Pediatric Surgery), adolescence is a critical period of development both physically and mentally, and self-image can play a vital role in long term happiness and well-being. Where form and function are adversely affected by nasal deformities, adolescent rhinoplasty can result in extremely gratifying plastic surgery results. In all cases, however, any adolescent prospective patient should have an honest, open discussion with their parents about their concerns and aesthetic goals. From there, a thorough preoperative evaluation and discussion of expectations, along with computerized imaging to help avoid the misunderstandings that lead to postoperative disappointment, is an absolutely essential first step before undergoing any cosmetic plastic surgery procedure. Following a step-by-step approach, with an emphasis on a conservative but thorough evaluation of the patient’s aesthetic and functional needs, is the key to achieving the best possible surgical outcome.
If you have questions about how best to address your own individual facial concerns, or if you are interested in any of the facial plastic surgery procedures I perform, please contact my office, to schedule a consultation. Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.
- Burstein, F.D., Bauer, M.D., Bruce S.: “Primary Aesthetic Rhinoplasty in Adolescents: Indications and Techniques.” Principles and Practice of Pediatric Surgery. Quality Medical Publishing, Inc. St. Louis, MO., Vol 2, 34:945-966, 2008.