Rhinoplasty and aging? What determines that the nose will stay “stable” as years go by?

Your questions are good ones. Typically as we age so does the skin of the face including the nose. Nasal cartilages can weaken with time whether one has a rhinoplasty or not. In addition, edges of cartilage can be visible as we age due to thinning of the skin. People with thicker skin on their nose have less problems with visible cartilage edges but can lose some support due to the heaviness of the skin on the reshaped or repositioned cartilage structures. That being said I have had more patients than not maintain their same noses over 20 plus years with the exception of changes in the skin. However, other factors such as changes in skin texture and composition, illness, sun exposure, minor trauma, can increase the likelihood of changes occurring over time.

Thank you for your question. It is important to understand that with the normal ageing process the facial structures along with the nose will change dramatically in size and shape over a life time. Often when someone undergoes surgery they assume that the associated change is a permanent one and will be stable over a lifetime. Although the results of surgery can last a lifetime patients should be aware that there are many factors that will influence post operative change that extend far beyond the surgery itself. Individual factors including genetics, weight gain and loss, tissue quality, post operative healing, trauma and medical conditions can all influence the results of the surgery over a lifetime. Specifically, in regards to the nose the more subtle surgical changes and less restructuring of the nose will be associated with a higher degree of longevity. Bony changes also tend to be more stable over time but cartilaginous change particularly to the tip will be less stable over time. Although cartilage re-shaping is a powerful tool and ideal for the nasal tip, over time cartilage is the least predictable of all nasal tissues. When undergoing rhinoplasty a more conservative approach and natural change is encouraged. All patients should be aware that some change over time is almost guaranteed and in part is a normal ageing process. RegardsDr Guy Watts

Thank you for your questions! All faces and bodies will age and change over time; it’s inevitable! In the years and decades after a rhinoplasty there are subtle tissue contracture forces that act on the nose.  If the structure of the nose was not appropriately supported during the surgery these forces was shift the shape of the nose and can result in asymmetries.  The key is to provide excellent structure to the nose during the surgery and allow the nose to resist long-term contractile forces.  If this is done a nose that has undergone surgery will not necessarily age or change more than a nose that has not been operated on.   

The results of a rhinoplasty will last a lifetime, but the face does age, and the tissue can thin, and the cartilage can grow even.  These are out of the doctor's control.

Rhinoplasty is very stable and after one year the nose will look the same years to come. Facial aging will continue however and few will look in their 70's as they did at 20 or 30. Skin will thicken a bit, the tip will fill out and overall the nose will lengthen somewhat. Rhinoplasty or not, the same changes are likely to occur. If you don't like your present nose rhinoplasty will provide many very good years.

There are some very subtle effects that occur after the initial healing process and the skin shrink wraps over the bony and cartilaginous framework. With the aging process, the ligaments tend to loosen up between the cartilages on the nose. A hanging columella can be easily addressed at the time of surgery or at any time thereafter.

HiGreat question! So lets get to the truth:1) All noses and face will change with time and age.  Your nose is not the same at 70 as it was at 17 regardless of a rhinoplasty or no rhinoplasty.  Same goes for the entire body.  So reasonable expectations is important2) After rhinoplasty, scar tissue forms everywhere in the nose under the skin and scar tissue takes years (many years) to mature and shrink.  The skin envelope also undergoes a process called "shrink wrapping" that puts pressure on the nose.  So all this will put push and pull pressure on the cartilages and grafts and possibly shift them around a bit.3) Even if the nosejob is done perfectly and looks perfect initially, over time some subtle shifting and changes and asymmetries can occur.4)But most often the nosejob is NOT done perfectly and in the beginning swelling is covering up many of these surgical errors and as swelling subsides the asymmetries and mistakes reveal themselves and are subject to move movement and drop or shifting due to lack of support5)So if you want a better nose then see a good surgeon and get a better nose and dont expect it to be perfect or the exact same for the rest of your life.  But you have to choose the best possible surgeon and then keep your fingers crossed and hope you heal well.6)But if any of this scares you then dont bother wasting the money and downtime because you may be disappointed afterwards and the heartache is not worth it.  

Dear Anastasia_Blue,This is a very good question. Your nose will continue to change as you age just like any other organ in your body or face. However, an operated nose (if done correctly) should not change into an unnatural looking nose. It is vitally important that the surgeon do not over-resect your nasal cartilages. This is done everyday unfortunately. In fact many times we add cartilages to strengthen the tip or columella. I would seek a board certified facial plastic surgeon in your area who understands the anatomy and physiology well before jumping into your surgery.  

Anastasia_Blue,The way that rhinoplasty has been performed has changed over the decades. Long-term follow-up on patients revealed that older rhinoplasty techniques, many of which relied on aggressive cartilage excision, could weaken and destabilize the nose over years. Modern techniques including cartilage repositioning and reshaping, as well as placement of non-anatomic supportive grafts, help to provide a durable result over decades.Certain ethnicities are also predisposed to cartilage "sagging" following a rhinoplasty due to the inherent softness of their cartilage. This aspect should be part of the pre-operative consultation for ethnic rhinoplasty, and techniques to support the desired result must be employed.Best wishes!  Harry V. Wright MD, Sarasota, Florida

the nose of course will age as time goes on. There is no evidence to suggest that the nose that is being operated on will age more than one that is unoperated.