Nose Job Myths Explained

One of the top cosmetic surgical procedures for the past several years according to the American Society for Plastic Surgery has been rhinoplasty, with approximately 220,000 people undergoing the procedure in the US last year. Despite its popularity, however, there are a number of common misconceptions about this procedure. Having seen patients requesting rhinoplasty many times a day, I thought this may be a good opportunity to dispel some of the misconceptions many of my patients present with. 

1. Anyone who performs plastic surgery can perform my rhinoplasty

This one is critical! Many patients assume that anyone who performs plastic surgery can perform rhinoplasty. The nose is one of the most complex and misunderstood areas of anatomy, especially in the facial region. Board-certified Facial Plastic Surgeons are required to perform extensive numbers of rhinoplasty before achieving certification. Some Plastic Surgeons also have been trained specifically to focus on the intricate aspects of facial and nasal anatomy. It is critical that you inquire about board certification for facial plastic surgery, or at least the number of rhinoplasties your surgeon has performed prior to undergoing this procedure. Revision rhinoplasty, though relatively common, is not easy and you never want to plan to have a revision if everything is done well the first time.

2. Rhinoplasty is a simple operation

This is a common misconception, especially for those patients who present desiring what they consider a small “bump” to be removed, or a wide nasal tip to be narrowed. One of the reasons rhinoplasty is such a complex procedure is that each millimeter of change in one area could lead to dramatic changes in form and function in another region. Reducing a hump on the bridge on the side view may lead to an appearance of excessive width on front view. This necessitates small cuts to be made in the bone to balance the front view with the side view. That doesn’t mean that some cases aren’t straightforward—they can be, but many cases require maneuvers to be made in areas other than exactly where you may desire change just to ensure a good cosmetic outcome.

3. Rhinoplasty cannot be covered by insurance

In some cases, this may be true. If every portion of the surgery requested in purely for cosmetic changes, insurance likely will not cover the surgery. However, in many cases, patients present with functional issues that can be addressed simultaneously. Significantly deviated septums, post-traumatic changes, significant breathing difficulty that has not been helped with conservative medications or interventions can all be addressed during nasal surgery. If this is the case, and insurance approves these interventions, certain portions of your nasal surgery, anesthesia fees and operating room fees may be covered. Not every office handles this the same way. Make sure you ask about your options when considering functional work and insurance coverage possibilities during your 

consultation.

4. Rhinoplasty is an expensive procedure

As stated before, in some cases of functional, breathing or traumatic concerns, insurance approval can be sought to reduce or even cover the costs associated with rhinoplasty. The average cost for rhinoplasty in the US is about $4500. In addition to the fee for the surgery itself, however, are facility fees and operating room fees for the instruments, surgery center, and anesthesia, leading to a total cost that can range up to $9000. If your procedure is purely cosmetic, many offices participate in plans that allow financing for cosmetic interventions. Make sure to inquire about these options with the coordinator at your surgeons’ office. 

5. My nose will look fake after rhinoplasty

In decades past, most rhinoplasty patients underwent the same few maneuvers to achieve a smaller, more petite nose. As the science and art of rhinoplasty has advanced, so has our understanding of the many anatomic and ethnic variations that exist in this meticulous procedure. The rhinoplasty surgeon of today understands that each individual has characteristics they wish to preserve, as well as areas they wish to improve upon. Not every patient wants a scooped nasal bridge or small nasal tip. Most consultations for rhinoplasty will allow enough time to discuss exactly what the changes are you wish to undergo. Some offices even provide options for computer imaging to allow the discussion of preferences to be hashed out in exact detail. Our goal is always to achieve a natural looking nose that disappears into the background of your face, not one that stands out.

6. I can ask for any nose I want

This misconception goes right along with the one before. Nasal anatomy is extremely complex. Each patient presents with unique anatomy as well as unique ethnic characteristics that are important to preserve. The fault of early rhinoplasty surgeons was an attempt to convert each nose to the same template. This leads to complications in breathing and structure over the years, not to mention a nose that may not fit your overall appearance. 

It is vital to share with your surgeon exactly what areas of your nose are bothersome or concerning to you. The best chance for success is to have an open and honest dialogue regarding your concerns. This also means that your surgeon may have recommendations about how to balance your desires with your current facial structure and shape. Be open to this discussion, because your surgeon has the overarching goal of allowing your new nose to blend into the background of your current facial aesthetic.

7. Rhinoplasty is a painful procedure

I counsel my patients that rhinoplasty recovery may feel similar to recovering from a bad cold. During the procedure, most surgeons prefer patients to be placed under general anesthesia. This allows the highest level of safety by allowing the anesthesiologist to control your airway and keep a close eye on all your vital signs. You will be completely asleep and unable to feel any discomfort. Once you are awake, prescription pain medications will be given to you to minimize discomfort. That being said, a moderate amount of congestion, some eye swelling and possible bruising around the eyes is common for about 7-10 days. Most patients do well with pain medication and staying away from strenuous activity for about 2 weeks. At one week post-surgery, most patients are feeling little more than congestion, and can return to work. 

8. I will have breathing problems after rhinoplasty

Breathing problems after rhinoplasty can occur. There is a small risk in any elective cosmetic procedure that revision may need to take place, however most of the time these are minor procedures with minimal recovery time. The properly trained rhinoplasty surgeon will take functional concerns into account even if your surgery is strictly cosmetic. The advantage of undergoing surgery with a board-certified Facial Plastic surgeon or plastic surgeon with extensive experience in rhinoplasty is that we have been trained to make desired cosmetic changes while still understanding the supportive and functional aspects of the complex anatomy of the nose. A nose that has been narrowed too significantly, a tip that has been pinched to allow excessive refinement or a bridge that has been reduced dramatically without instilling needed support will very quickly develop breathing issues. When those aspects are anticipated and prevented, the desired changes can be achieved safely and with lasting results.

9. Only women get rhinoplasty

Although the majority of the 220,000 patients undergoing rhinoplasty last year were female, approximately 25% of the cohort was male. Male patients often desire both functional and cosmetic improvements, especially reducing a hump, making a nasal tip less boxy or bulbous or narrowing the bridge. Having a consultation with a surgeon well-versed in rhinoplasty will also ensure that as a male patient, your nose will continue to balance your overall masculine aesthetic. 

We hope the discussion above will help dispel some of the most common misconceptions about rhinoplasty. Ultimately, when patients are well-prepared for the surgery and recovery, nasal surgery carries a high satisfaction rate. Make sure that you take the time to ask questions about your concerns, priorities and desires prior to undergoing nasal surgery, and listen to the advice and recommendations of your surgeon. Ensure your rhinoplasty surgeon is board-certified in Facial Plastic Surgery or has a significant number of rhinoplasties under his or her belt before undergoing your procedure and know that you are in good hands after all the research you have done! Best of luck!