Supermodel Bella Hadid, 25, recently revealed to Vogue, with an air of regret, that despite her previous plastic surgery denials, she did indeed have a nose job. “I wish I had kept the nose of my ancestors,” she told the magazine. “I think I would have grown into it.”
Celebrity admissions rarely raise eyebrows nowadays—but the fact that Bella was just 14 years old at the time of her rhinoplasty surgery sparked a sort of public outcry across social media, with fans questioning the ethics of her surgeon and the intentions of her parents, former model and reality star Yolanda Hadid and real estate developer Mohamed Hadid.
Rhinoplasty was the number one cosmetic surgical procedure performed in 2020, according to the American Society of Plastic Surgeons. And “nearly half of all plastic surgeries performed on teenagers are rhinoplasties, making it the most common pediatric plastic surgery procedure,” adds Dr. Babak Azizzadeh, a board-certified facial plastic surgeon in Beverly Hills, California.
TikTok is awash in teenage nose job montages and rhinoplasty reveals—yet the proper age at which to operate on minors is still a hot-button issue in plastic surgery. While the conversation is incredibly nuanced—traversing gray areas of anatomical and emotional readiness, psychosocial well-being, parent-teen dynamics, future ramifications, and more—plastic surgeons generally encourage girls to wait until they’re at least 15, and boys 16, before undergoing surgery (there are myriad caveats and exceptions, of course). Ahead, rhinoplasty experts weigh in on the complexities of the underage nose job and the personal age limits they’ve each set.
“14 years old is usually too young”
“I rarely operate on anyone under the age of 18. Minors can be operated on, with parental consent—but either way, 14 years old is usually too young for a rhinoplasty, because the body is not fully developed, therefore, the nose isn’t fully developed.
“With that said, girls are usually more physically developed [than boys] by 14, and all surgeons can and should evaluate on a case-by-case basis. A bone-age study can be completed through an X-ray of the prospective patient’s left hand, wrist, and fingers. If the bone-age study indicates that the bones are not fully developed, a surgeon will typically advise the patient to wait a few years before proceeding with surgery.” —Dr. Gary Motykie, a board-certified plastic surgeon in West Hollywood, California
“I think sometimes […] doing a conservative rhinoplasty in teenage patients is acceptable”
“Traditionally, there has been a small age difference [between genders] when it comes to the minimum age for rhinoplasty, due to the difference in physical maturity rates. For girls, it is usually 15–16 and for boys, about 16–17. Obviously, older is preferable, but sometimes your hand is forced, usually because of low self-esteem, bullying, or nasal obstruction or trauma.
“The problem with performing a rhinoplasty in someone who is not yet ‘done growing’ is that the nose you create may change in undesirable ways as their bones and cartilage continue to develop and/or may not match what their adult face ultimately becomes. Because of these factors, the younger you perform a rhinoplasty, the higher the likelihood of eventually needing a revision surgery. The rate is 5–15%, according to the literature. While anatomy is certainly something to take into consideration, emotional maturity is just as important.
“Times are changing, and we are becoming an increasingly visual society. We take more photos of ourselves than we ever have before—and cell phones have been shown to distort our appearance via a fish-eye effect from the lenses. Seeing these images of ourselves—despite whether they are an accurate reflection of reality—can really impact self-confidence, especially in younger, more impressionable patients. Because of this, I think sometimes making an exception and doing a conservative rhinoplasty in teenage patients is acceptable.” —Dr. Sinehan Bayrak, a board-certified facial plastic surgeon in Philadelphia
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“It is technically very safe to do surgery at [15]”
“I will offer rhinoplasty at age 15 at the youngest. This is the age at which girls achieve skeletal facial maturity. For boys, it’s usually one year later. It is technically very safe to do surgery at this age. However, it is extremely important to evaluate the emotional maturity of the patient as well as their relationship with their parent(s)/guardian prior to proceeding with surgery. Red flags that I always look for in this patient population are immaturity, arguing with one or both of their parents in front of the surgeon, parents and the patient disagreeing about treatment plan or goals, and/or parents or patient disagreeing about performing the surgery in general.
“All of my patients, including teenagers, get my personal cell phone number. I encourage patients and parents to text me with any questions or goal pictures from my website. It’s extremely important in this age of digital medicine to remember that any patient under 18 must have a parent in the chat whenever they text me or message me on Instagram. I will never respond if a parent is not included in the group message.” —Dr. Richard G. Reish, a board-certified plastic surgeon in New York City
“Controversy exists regarding the exact timing of human nasal development”
“While there is a lack of consensus on the appropriate timing of cosmetic rhinoplasty, most surgeons recommend it be performed no earlier than the completion of puberty, which is 15+ for girls—or two years after starting menstruation—and 16+ for boys.
“Females tend to exhibit maximal nasal growth velocity between ages 8 to 12 and males around age 13—but controversy exists regarding the exact timing of human nasal development. When determining if rhinoplasty makes sense for children and early teens, we have to consider not only the theoretical risks of altering facial and nasal development but also the lack of emotional maturity, informed-consent issues, the complexity of the child-parent dynamic, and the fact that young patients may not know what look they desire.
“The decision is complicated by the intricate psychosocial landscape encountered by the modern adolescent. ‘Nasal dysmorphia’ has become a considerable mental burden for some teenagers in the setting of early access to social media and susceptibility to physical and cyberbullying. When there is a severe nasal deformity that has led to bullying, withdrawal, and/or mental wellness problems, early intervention may be a better option—and these children universally appreciate the improvement, regardless of age.” —Dr. Babak Azizzadeh, a board-certified facial plastic surgeon in Beverly Hills, California
“The safe answer for girls is 16”
“First, we have the very objective answer—we will only operate on patients who are physically fully developed, meaning they have completed the growth changes that occur during puberty. For girls, older than 16, 17 for boys. However, there are exceptions. If a girl is 15 but her body changes have been stable for many months, then I may consider surgery as young as 15. However the safe answer for girls is 16. This is purely with the intention that we want the nose to be stable in terms of changing in shape or size prior to surgery.
“Beyond this, we treat every case individually when determining if someone is a good candidate from an emotional perspective. That said, young patients are more challenging, because they are inherently less mature. We need very motivated patients who are free from coercion from their parents. If I feel the patient is on the fence, I insist that they not have surgery and instead wait and see how they feel as they advance in age.” —Dr. Dino Elyassnia, a board-certified plastic surgeon in San Francisco
“15 for females and 16 for males”
“There’s really not a lot of data on this. But we do know that the septum [the cartilage dividing the nose] is in a growth phase potentially through your early teen years. In surgery, we’re stripping blood supply, which can theoretically stunt growth. This is why most surgeons wait to operate until there’s full facial maturity.
“I think 15 for females and 16 for males is a fair bottom line. But when you’re debating 16 versus 15 or 14, it gets really murky. You have to allow a little bit of room for interpretation of what’s appropriate for any individual. There are exceptions and extenuating circumstances.” —Dr. Jason Roostaeian, a board-certified plastic surgeon in Los Angeles
“The transition between high school and college is a very common time for rhinoplasty”
“In girls, the facial skeleton has usually stopped growing by the age of 15. For boys, this is usually later, more like 16 or 17. This usually correlates with having no height or shoe size changes for a year or two. They also need to basically look like adults. There are some 15-year-old girls who look 12, and others that could easily get into a bar. In general, whether girls or boys, if they still look more like a child than an adult, I would advise them to wait, even if they meet the other physical guidelines.
“As far as emotional maturity, that is a somewhat more subjective yardstick. Rhinoplasty patients need to be able to weather the ups and downs of the surgical recovery, tolerate a less than perfect result—which all of them are—and not be likely to look back at their decision as flippant or hasty later in life.
“Finally, lifestyle considerations come into play. Considering this is not an emergency and the patient may have to live with their rhinoplasty results for 60 or more years, if they are in a sport with a high risk of fracture, I would wait until they finish high school, especially if they don’t intend to pursue that sport rigorously in college. Sustaining a significant nasal fracture after a rhinoplasty often requires a full revision rhinoplasty, which is less predictable than [a primary procedure]. The transition between high school and college is a very common time for rhinoplasty, because social circles change greatly at that point. For patients who want to keep their rhinoplasty relatively private, this is an excellent opportunity to have surgery.” —Dr. Laxmeesh Mike Nayak, a board-certified facial plastic surgeon in Frontenac, Missouri
@drkanodia90210 Cast Reveal – 7 days post Closed Scarless Septo-Rhinoplasty #nosejob #rhinoplastybeforeandafter #learnontiktok ♬ Graduate – BLVKSHP
“What’s most important is for the patient to be psychologically prepared”
“Age 14 for Bella was somewhat early for both the nasal growth and emotional growth. In general, a female should be over age 15 and a male, age 17, as they mature later in bony and cartilage growth. Overall, what’s most important is for the patient to be psychologically prepared for this change and to have supportive parents. The most common reason [for teenage rhinoplasty] is peer-to-peer ridicule, bullying, and hence lack of confidence.
“The transformation after rhinoplasty is absolutely remarkable in these young patients. At their seven-day reveal, they often cry and say they finally look as good as they feel on the inside—that they now have the nose that they should have had from birth.” —Dr. Rod J. Rohrich, a board-certified plastic surgeon in Dallas
“One must have good reasons to do rhinoplasty surgery on the pediatric patient, especially if it is during puberty”
“My cutoff is 16 years in girls and 19 in boys. Before these ages, the risk of damaging the growth plates and disrupting normal nasal and facial skeletal growth must be weighed against the benefits of rhinoplasty.
“While I generally advise against routine aesthetic rhinoplasty until the nose has completed its growth after puberty, if there are significant functional or social issues, conservative surgery before puberty is likely safe and it may be best to intervene early to prevent worse deformity and/or psychosocial trauma that can occur with poor self-esteem and bullying.
“If there’s a breathing concern, with or without aesthetic or psychosocial issues, a ‘functional rhinoplasty,’ to improve breathing, can be very helpful. Since surgery is limited to the airway and can be minimally invasive, it does not disturb nasal growth. And it can make a big difference in terms of exercise, sleep, and performance in school.
“The bottom line is that one must have good reasons to do rhinoplasty surgery on the pediatric patient, especially if it is during puberty.” —Dr. Ariel N. Rad, a board-certified plastic surgeon in Washington, D.C.
