Is 14 Years Old Too Young for Rhinoplasty?

Question

I am a female fourteen year old, and have already reached puberty well over a year. If I did get rhinoplasty, I would only want a tip reduction from my bulbous nasal tip.

	Since I do not need to alter any bones in my nose, is my age too young for this procedure? I want it because I want to love my body, and I know I would be emotionally matured for the surgery.

Randy Wong, MD · Answer

The age limits on teenage rhinoplasty are arbitrarily set to insure maturity of physical and mental emotional development. I know a few adult patients who have not reached this goal. As a minor, your parents will have to take responsibility and consequences of the results. I hear that you really want to proceed. Ask yourself "what if it doesn't come out the way I want it?"

Marc DuPéré, MD · Answer

I know in Canada, most surgeons would not operate until the age of 16, some will even wait until age 18. The person's maturity, both physical and emotional, is crucial for any body/face-enhancing procedures. Rhinoplasty has a significant emotional component and I would recommend you wait a few more years prior to undergoing such a procedure.

Toby Mayer, MD · Answer

If your nose looks mature and you have stopped growing 14 years old is old enough for a rhinoplasty.

Julian De Silva, MD · Answer

Having a nose that is out of character
with your face because it is too large, bulbous, large hump can be a difficult
issue during growing up and a source of lowered esteem and confidence. Although
surgery to re-shape the nose with rhinoplasty can improve the appearance of the
nose it is important that other factors are considered:
Teenage years are one of the most challenging periods
in our lives. As we develop from childhood to adulthood, our physical
appearance takes center stage. Although teenage insecurities are a normal part
of adolescence, if a young person’s self-esteem is adversely affected by
unsatisfactory facial features, such as the shape or size of one’s nose, then
rhinoplasty may provide a solution. Physical growth of the nose is complete towards 13 to
16 years old for girls and 15 to 17 years old for boys. Adolescents should only
seek nasal reconstructive surgery when their noses have reached their full
size. Most boys mature later than girls, and this explains why their procedures
typically take place later.Psychology and maturity are important, as are the ability to
understand the concepts of surgery with rhinoplasty. Teenagers must determine
their reason for surgery and evaluate the benefits and drawbacks.Consultation and discussion over objectives from rhinoplasty,
understanding of the surgery as well as expectations from surgery are important
throughout the decision-making process. The teenager needs to be sufficiently
mature to cope with the recovery period, which may involve bleeding, bruising, discomfort
and swelling.

Shepherd G. Pryor, MD · Answer

The textbook answer would be to wait until you are 15. However, if you have a more mature facial appearance one could presume that you have very little mid facial growth that is left to mature.  The fact that no work would be done on the bones of your nose to remove a hump or narrow it would let you fall into a reasonable safe category at your age.  The reason the recommendations exist on age is for this reason...as you want to avoid restricting the bony growth of the mid-face. 
	
	But there is no rush!!  At any point moving forward you can have the procedure done and have an excellent result if you seek a consult with a Board Certified Facial Plastic Surgeon who routinely performs rhinoplasty.  Sit down and have an honest discussion with your parents to see if everyone is in agreement and then move forward accordingly.
	
	Good luck!

Mario J. Imola, MD, DDS · Answer

Dear Coco:  As you can see from the different answers, there appears to be 2 viewpoints on the minimum age that one can perform rhinoplasty.  My belief is that the correct answer is with the the group of surgeons who believe that the real answer depends on the individual:  ie. it is not based on chronological age (the number of years)  but rather on physiological age (the amount of growth that has been completed).

	If physiologic age is near completion then I feel it is OK to proceed with rhinoplasty.  Growth can be complete anywhere from 13 to 16 years of age for girls and 15 to 18 years of age for boys.  I have performed rhinoplasty safely and successfully in people within these age ranges.

	In order to determine physiologic age, 2 pieces of information are very useful:

	
		Individual growth charts.  Careful monthly records of height , clothing size and shoe size will indicate whether growth has plateaued or not.
	
		X-rays of the hands and wrists will show whether growth plates are closed.


	Other factors that should be taken into account are:

	
		What are the reasons that the young individual wants to have rhinoplasty.  Is he or she being realistic?  Does the patient want rhinoplasty or do the parents want rhinoplasty for their child?
	
		How severe is the deformity?
	
		Are there severe functional problems such as nasal obstruction?


	When all of these issues have been considered, one can then decide what the best time to perform rhinoplasty in the given child.

	Sincerely, Mario J. Imola, MD, DDS.

Steven Wallach, MD · Answer

In my opinion, 14 is a bit too young to have a rhinoplasty. More than likely you have not reached full adult body maturity and should wait in general until you are at least 15/16 for a girl and 17/18 for a guy. Of course you would need your parents' approval.

Erel Laufer, MD · Answer

In most instances female noses are fairly mature at age 14 and I do proceed with rhinoplasty.

Marcus L. Peterson, MD · Answer

Hi Coco,

	Even if you do not do anything to the bones the bones may change as you get older.  I would recommend waiting until you are fully mature from your bony skeleton point of view.  I feel the age for women is 16 years old where I am comfortable in manipulating the nose and knowing it is stable.

	Best Wishes

	Dr. Peterson

Peter E. Johnson, MD · Answer

At age 14, your nasal shape is well established and rhinoplasty is possible, though facial maturity and emotional maturity are more certain by age 16. We notice that for some the face is still rather convex as the chin is underdeveloped, and the lips and nose in middle school are larger on the face than in high schoolers. You should love your body. Give it care, nurture yourself, and a good time for rhinoplasty will come.
	Best of luck,
	peterejohnsonmd

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