Do Doctors Usually Refuse Your Request for a Nose Job?

The simple answer to your question is "yes".  Some patients are not appropriate candidates for physiologic issues (active heart problems), for psychological reasons (unreasonable expectations, body dysmorphia), and for anatomical reasons (good nasal aesthetics that cannot be improved on).  However, it is up to the Rhinoplasty Surgeon to make the decision on whether to proceed or not.  A number of poor celebrity Rhinoplasty results bear witness to the fact that an individual will probably find a Surgeon to do their procedure, regardless of the quality of the indications.

Your consultation appointment is typically your
one-on-one time with the surgeon to determine whether or not a nose job is a
viable option to consider. During this time, you should stress any concerns and
ask any questions about the surgery, and should relate all medical conditions
to your doctor. Together, you will be able to determine whether or not a
rhinoplasty is in your future, and can construct a plan that best suits your
goals and needs. It is, still, possible that your surgeon “refuses” your
request for the surgery based on medical or personal considerations. A good,
respectable surgeon will always be honest about if a nose job is right for you,
and will be sure to produce the most natural results should you decide to move
forward. 

It is very difficult to answer your question without seeing your pictures – you should consider posting images showing your areas of concern.  Perhaps the surgeon may feel that the problem is not as severe as you perceive to be

Based on your verbiage, you may be a candidate for nose job surgery. Feel free to repost your question with photos.

I may avoid performing nose job surgery for the following reasons:

1) I may not feel comfortable performing the operation.

2)The risks of surgery do not outweigh a non-surgical approach.

3) The patient would be a better candidate for a Non-Surgical Rhinoplasty.

4) The patient has unrealistic expectations.

5) A parent, spouse or significant-other is against surgery.

6) I sense the patient may not be happy after surgery.

That being said, most patients with crooked long noses that have bumps are candidates for Rhinoplasty surgery. You may wish to get a second opinion from another reputable, experienced rhinoplasty surgeon.

Hope this helps.

Dr. Joseph

Jen

Based on your description, you sound like a good candidate for a rhinoplasty - however photographs would be very helpful.  There are several reasons why a good plastic surgeon might refuse to perform a rhinoplasty.  The patient's age is important - some surgeons just don't feel comfortable with younger patients.  The severity of the deformity is another reason - if the deformities are minor a doctor may recommend against a rhinoplasty.  The patient's emotional state or stability - the rhinoplasty surgeon my feel the patient has unrealistic expectations or is emotionally unstable.  Finally, not all facial plastic surgeons or plastic surgeons are comfortable performing rhinoplasty.  In my experience, there are only a few of us who really enjoy, specialize and make rhinoplasty a major part of our practice.  If you have not done so already, consider getting a second opinion.

In cases where expectations cannot be met or underlying medical issues are of great concern, a doctor should refuse to perform surgery on a patient. 

The main goal of any cosmetic surgery, including a nose job, is to improve the patient’s self-image and self-confidence. Of course, a sincere surgeon will be completely honest during his or her evaluation of whether or not to proceed with your nose job. He or she should be on the same page as you are, working to make your vision a reality while comforting and encouraging you at every step along the way. Generally speaking, if you are hoping to change the size, shape, or form of your nose through surgery, your surgeon should be willing to work toward this common goal within reasonable range.

If the patient has enough issues with the nose that can be improved with elective surgery, has realistic expectations, and is emotionally and physically ready for the surgery, then it is acceptable to undergo the rhinoplasty procedure.  On occasion when a patient has medical or psychological issues, a surgeon will deny the patient surgery if they do not think the patient is fit to undergo the procedure.

I think the first thing you should do is go for a consultation. If the surgeon thinks that he can improve your nasal issues then he will probably suggest surgical options to achieve your goals.  Good luck.

Not everyone is a good candidate for a rhinoplasty. The #1 ethos is to do no harm. So if you have medical problems that would make an cosmetic elective surgery risky then it is not worth it in my opinion. I only recommend surgery if the patient seems to understand and accept the limitations of the procedure. The more minimal the changes desired, the less likely the patient's needs the surgery or will be happy with the result. Ultimately if a patient has reasonable expectations then it should be able to be done. Preoperative imaging can help to make sure you and your surgeon have the same thought process in mind.