A Nose Job by Any Other Name

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Iggy Azalea confessed to putting her nose under the knife, and with rhinoplasty on the rise we investigate what’s involved (STOP! warning: it’s not to be sniffed at)

Conk, beak, snout, snoot… whatever you want to call it, our noses are a relatively important element of what makes us who we are. Quite apart from being the ‘gatekeeper to our lungs’ and enabling us to taste and smell, aesthetically-speaking they play a massive role in our perception of attractiveness (although most would personally like a ‘characterful’ snout). When Iggy Azalea finally verified Hollywood’s worst kept secret and confirmed to having had a nose job (she admitted, ‘denying it would be lame’) we decided to find out exactly what was involved – with help from some of the top Rhinoplasty surgeons.

This procedure – Rhinoplasty or Nose Job – is not a one size fits all type of surgery. From smoothing a prominent bump, reducing the overall size and refining the tip of your nose to lengthening upturned tips to minimise nostrils, it relies on an expert to know exactly what will suit your features and what will complement the rest of your face. “Previously if you had rhinoplasty you could get a scoop nose, more so if you were in Los Angeles,” says Dr Julian. “The nose curves up like a Disney cartoon princess, which may look cute on women in their mid-twenties but generally, anything after that looks like you’ve had surgery. Mostly in the UK patients tend to want to look natural with a straight nose or very slight curve.”

And, so it seems, lots of us are wanting nose jobs, far more than ever before. “There has most definitely been an increase in the amount of patients interested in a rhinoplasty,” says Dr Tim Woolford, consultant cosmetic surgeon, ear, nose and throat consultant. “There could be many reasons for this, of which, one it is now seen as far more acceptable to seek cosmetic enhancement and any taboo in this area has largely passed. In the past a rhinoplasty was typically a procedure performed on young people, however, now patients of all ages including the middle aged and above, are wishing to undergo a rhinoplasty.”

Lydia, consultant plastic surgeon who specializes in rhinology agrees; “We have definitely seen an increase in clients who wish to change the aesthetics of their nose, ages ranging from 17 to 65 although, unfortunately we have seen an increase in patients needing revision surgery.” And the reason for this increase? “It’s more than likely related to social media pressure and the ‘selfie’ boom,” says the doctor. “There is a distortion in a selfie similar to the fish-eye lens which can seem to make the nose seem bigger.” The most popular celebrity nose request? ‘Kim Kardashian’

What is rhinoplasty?“
Firstly it’s important to recognise that there are no two rhinoplasties that are exactly the same and so I always stress to my trainees that there is never an easy rhinoplasty,” says Dr Woolford. “Clients seek surgery for any number of reasons, the most common being removal of a lump on the nose or to reduce its size. Sometimes the nasal tip requires refinement, and one other frequent concern is that the nose is too long or droops, particularly during smiling. If the nose is crooked we can endeavour to make it straighter, and it’s also important to look at the nasal function. In a lot of cases, surgery is done to both improve the nasal airway, as well as the shape.”

What happens during the Surgery?“
The operation is performed under general anaesthetic and typically takes around two and three hours,” says Dr Badia.“ Essentially, there are two types of rhinoplasty; an endonasal (closed rhinoplasty) and an open or external rhinoplasty,” says Dr Woolford. “In endonasal rhinoplasty all the incisions to the skin are made inside the nose, however with an open rhinoplasty, the incision is made between the nostrils and the skin is released then lifted up. There are pros and cons to each type but it is the skill and experience of the surgeon which is more important than the approach. The tiny scar from an open approach will usually heal nicely and is almost invisible. Looking at my long-term results over a few years, I generally favour the open approach as I seem able to achieve a more natural and balanced look for my clients.”

Any factors to be aware of before going under the scalpel?“
As with all types of surgery it’s especially important to select a surgeon who has experience and specialises in this particular procedure,” says Dr Woolford. “It is essential that clients receive a balanced view about rhinoplasty, being informed of what is not possible as well as what can be achieved. In reality, a good noticeable improvement is probable, however the results will never be perfect. It is also very important that the client meets their surgeon in person prior to the surgery. I always see clients twice, including reviewing their photos together to be absolutely sure surgery is the right thing to do. There are common complications associated with a rhinoplasty and although these are very rare, the possibility that something could and may go wrong must be discussed with clients. Even in experienced hands a small number of clients require a second op and reputable surgeons would be open and honest. The advice to clients, go slowly and if they feel rushed or put under pressure to go ahead by a particular surgeon or clinic they would be extremely wise to reconsider.”

What’s the typical downtime?“
Most patients spend at least one night in hospital, although a nose job is often performed as a day case now,” says Dr Woolford. “Generally a moulded shield is worn over the nose to give it protection for a week or so. In the open procedure I use tiny stitches which will dissolve and brush off after around 10 days. Many people take a fortnight off work by which time any bruising has settled and the nose is much less swollen. I always tell patients that this will certainly not be the final result, however they will, more often than not, be ‘presentable’. It is important to stress though that patience with a nose job is essential, results cannot be judged for a number of months. In reality many patients are still not sure within the first 2 months, but are much happier at 4-6 months – you’ll need to be a very ‘patient patient’ if you have a nose job!”

Can anyone have it?“
Rhinoplasty is certainly not a procedure that anyone should have,” says Dr Woolford. “As it requires a general, clients must be in good health to ensure that the anaesthetic is safe. As I mentioned earlier, it is crucial that clients undergoing rhinoplasty, have realistic expectations about what can be achieved. There is no doubt that this procedure can be a very positive experience, however for some individuals who are unrealistic and focus on minor imperfections the opposite is true. I see quite a few patients where I recommend against a nose job as I feel either that surgery is not justified, or that I will not be able to achieve the results which will make that particular patient happy. This is the same for most reputable rhinoplasty surgeons.” Something mirrored by Dr Badia; “Certain people like those with body dysmorphia should not consider surgery without having therapy prior to any aesthetic procedure. Also people who abuse substances such as heroin, should steer clear of surgery until they have been clean for at least three months as the risk of undesirable healing will be too high.”


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London Plastic Surgeon