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“A nose which varies from the ideal of straightness to a hook or snub may still be of good shape and agreeable to the eye; but if the excess be very great, all symmetry is lost…”

This is Dr. Tae Ho Kim, plastic and reconstructive surgeon with the NYGPS. The partial quote above by the Greek philosopher Aristotle was actually making a political point, but I’ll take the liberty of applying it to cosmetic surgery today. A person whose nose is not “perfect” according to current standards may still look and feel quite attractive. It’s not the nose in itself, but the symmetry and balance of the face overall that determines what is perceived as aesthetically pleasing. Some people are quite happy with their looks regardless, but for others their nose is a source of upset that they’d like to fix and for them, rhinoplasty may be a good option.

Rhinoplasty is a cosmetic plastic surgery procedure to reshape a person’s nose, otherwise known as a “nose job.” Rhinoplasty is one of the top five most performed cosmetic surgery procedures in the U.S., with about 243,000 done in 2012. But just because it’s done often doesn’t mean it’s easy to do! In fact, the anatomy of the nose is very intricate and complicated.

I have a special interest in rhinoplasty as a natural result of the reconstructive surgery I specialize in to repair the faces of babies and children with congenital facial deformities, such as cleft lip and palate. The idea of fixing these congenital deformities is to restore symmetry and balance to the face, and it’s much the same with rhinoplasty. A nose that is overly large, crooked or bumpy bothers patients seeking rhinoplasty because it results in imbalance, and the nose, along with the eyes and lips, is the most prominent feature of the face.

Patients of all ages seek rhinoplasty, from teens to young adults to people well into their 50’s. It’s best to wait until at least the age of age 14 or 15 before having a rhinoplasty, depending on the size and shape of the nose.

Rhinoplasty is performed either as an open or a closed technique.  The main difference is that the open technique requires a small incision in the mid-columella, the bottom part of the nose that divides the right and left nostrils. I prefer using the open method because it enables me to clearly view all the important structures to define the nasal tip and ensure a more complete reshaping.

I would advise someone considering a rhinoplasty to have an evaluation by a plastic surgeon with a great deal of experience in the procedure, as rhinoplasty is a very difficult operation to do well consistently. For my patients, I spend time discussing exactly what he or she likes and dislikes about their nose. I then go over each part of the nose and explain what is aesthetic or not, such as symmetry, width, shape, proper proportions and overall balance with the face.

The type of nose we ultimately shape is based on this detailed assessment, and the goal is to make the nose look attractive but also natural within the person’s face. I also make sure that a patient has a realistic understanding of what is and is not possible. For instance, if a person has a very large nose and wants one that is like Michael Jackson’s, I would advise that person against a rhinoplasty.

In my experience, people who have a good result from a rhinoplasty ultimately feel better and more confident about themselves. Finding an experienced plastic surgeon and having a clear understanding of what to expect from surgery and results is key to rhinoplasty success.

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