Is Late 40s Too Late for Rhinoplasty?

Dear rhinoplasty patient from San Francisco,
Any age after 18 is appropriate for rhinoplasty. If you’re not happy with your nasal profile, find a board certified surgeon specializing in rhinoplasty. Having a good nose job requires a nose specialist and a skilled surgeon. You also want to take into account whether you feel comfortable with the surgeon, as well as the doctor's experience and other qualifications. Always choose a board certified facial plastic surgeon or a plastic surgeon with experience in rhinoplasty. Be sure to check his before and after pictures to get a feel for the results the doctor has previously produced for other patients.
 

Your age does not preclude rhinoplasty surgery provided you are otherwise healthy. In our experience, if a dorsal hump is removed, the ligaments that span from your bridge to your tip may be lost, and this may lead to droopiness of your tip. In most patients requesting hump removal, tip work may be necessary to add structural support to avoid a droopy nasal tip postoperatively. Hope this helps. Dr Joseph

 The only real rules to follow when considering undergoing a rhinoplasty is to make sure that the patient has reached some degree of physical maturity. Besides this, there are no guidelines that indicate what is too “late” to have your nose operated on. In my opinion, if a rhinoplasty can boost a person’s confidence and can make you feel good about yourself, there should be no age limit on having the surgery. If you are in good overall health and want to make the appropriate changes, I would advise that you find a surgeon in your area and schedule a consultation appointment for an in person evaluation of your condition. 

Hello! Thank you for your question! Age alone is not a contraindication
to a surgical procedure. There are a few medical
comorbidities that contribute to a higher risk during any surgical
procedure including infections, wound complications, delayed wound
healing, bleeding, anesthetic risks, etc. Factors such as diabetes,
hypertension, coronary artery disease, heart problems, lung problems,
etc are more common in the elderly. However, if you are healthy, or
these conditions are well-controlled, you would certainly still be a
candidate for a surgical procedure. If your complaints or desires are
great enough to consider the surgical option, I would seek a
consultation with a plastic surgeon to discuss your complaints and go
over the options as well as risks and benefits of the procedure.You
should obtain medical clearance from your primary care physician that
you
are at an acceptable risk for undergoing a surgical procedure. For
elective or aesthetic procedures, your surgeon may want to get you to a
reasonable health status prior to consideration for a procedure.
Discuss all of
your medical comorbidities and medication with your surgeon prior and
discuss these risks. Also, discuss this with your anesthesiologist as
proper monitoring and medications will be watched closely. This
procedure should still be very safe for you and hope for an
uncomplicated course with an excellent result! Hope that this helps!
Best wishes!

In my opinion, there is no absolute age limitation for rhinoplasty. When I select a patient who is an appropriate candidate for the procedure - I base my decision on the following: is the patient healthy enough to undergo few hours of general anesthesia; is there a change I can make in a positive direction that I can achieve reliability, predictably, and safely; and are the expectations of the patient realistic?

Those are the most important considerations whether or not rhinoplasty is feasible for any individual, not an absolute age requirement. That being said, I’ve preformed surgery on several patients, who were in good health, into their late 60s – even early 70s who’ve met the previous criteria.


As far as part 2 of the question:
Can the profile be improved while preserving the rest of the nose?
A bump on the nose can be smoothed in most cases without a significant change to the rest of the nose. What can happen, however, is that the nose may appear slightly wider along the bridge from the front view of the nose. This is because the nose sits on the face like a triangular pyramid - taking the bump down is removing the narrowest part of the pyramid. While the nasal bones can be repositioned to close at the widest part of that pyramid, the overall geometry of the nose changes to a lower point along that pyramid, causing the nose to appear a little wider from the front view. The other issue is that if there is a significant reduction of a bump this can result in a relative excess of skin. If the skin envelope on a nose is very thick the skin may have trouble settling down on the lower structure of the nose this may manifest as persistent soft tissue swelling or skin thickening which may also cause the appearance of some widening. Also note, reduction of a bump on the bridge will not change the width or appearance of the nostrils and will have minimum affect on the nasal tip.
 

Unless there is a medical reason not to perform an elective surgical procedure on you, you are never too old to straighten your profile and get rid of the "bump" on your nose.  Sometimes it is necessary to perform some other maneuvers after the bump is removed to make sure the "roof" of the nose is "closed."  If getting rid of this bump will make you feel better about yourself, I recommend you see a surgeon experienced in performing rhinoplasty to help address your concerns.