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Should you or shouldn’t you — if you are a teenager (or the parent of one) you may be wrestling with the question of whether a nose job or other facial plastic surgery is right for you, and if teenagers should get such surgery at all.
This is a highly emotional and personal issue, but you know yourself best. If a misshapen nose or ears that stick out make you feel miserable about yourself, it is important to know you can do something about them. For some teenagers, changing their looks literally gives them a new attitude, a new self- image, a new perspective on life. It goes well beyond aesthetics, and is not considered cosmetic surgery.
With today’s computer technology, you can even get a preview of the “new you” before you make any decisions about undergoing surgery, and modern surgical techniques mean a much shorter recovery period than ever before. After just two weeks you can pretty much get back to normal, or rather a new, much more confident normal!
First, let’s look at the facts. Most of the time teenagers are talking about wanting rhinoplasty, commonly called nose jobs. Occasionally they’ll need otoplasty for very prominent ears, and chin augmentation for receding chins.
Those in favor of plastic surgery realize that it can go far in enhancing one’s self- image during the formative years, at a time when self- confidence and social acceptance can be very important. Others feel that it is too early for teenagers to be having any purely elective surgery. Personally, I have seen so many teenagers come out of their shells, particularly after operating on a particularly large or misshapen nose. I support this procedure for a properly motivated teen.
Our face defines who we are, how others see us and who we see. The nose is the most prominent feature on the face. An important scientific study on physical attractiveness and peer perception states that “physical attractiveness may be an important personal characteristic primarily during adolescence…when social acceptance by a peer group is a particular salient issue.” (Dion KK, Bersheid, E. Physical attractiveness and peer perception among children. Sociometry journal 1974 vol. 3). Following cosmetic surgery, adolescents can gain self satisfaction from changes in their appearance which is beyond what would otherwise occur with natural development (Sills KH, et al. Plastic and Reconstructive Surgery Journal Vol .109, 2002).
Adolescents are under a lot of social pressure for acceptance. Some teens have endured ridicule or bullying and have put up a wall of self-isolation due to lack of self-confidence from a large nose or protruding ears. Fixing these physical problems often transforms the future for these kids who gain a whole new self-image, and a brighter future.
We also understand that teenagers may be embarrassed about the concept of having cosmetic surgery. We reassure them that this is a confidential consultation and that we plan to answer any and all concerns that both patient and parents have. Consultations usually last around 45 minutes or more. It is important to emphasize that we strive to create a natural nose. No one wants a scooped, pinched nose. Even parents can be reluctant since their generation was subjected to cookie-cutter, overdone noses. Today’s nose should fit the face, which the vast majority of our rhinoplasties do.
With the use of the latest technology in 3-D computer imaging, we can give both teens and their parents a realistic preview of the expected result. Teenagers are very visual. Seeing the potential outcome and discussing “looks” right for them can help alleviate their apprehensions. Rhinoplasty should not look “fixed” or completely change you from who you are. It should enhance the other attractive features that you have yet might be overpowered. The addition of 3-D imaging makes it even easier to see how great the patient will look after the procedure.
We help assuage one of the biggest obstacles — reluctant parents who saw too many “overdone” noses. Today’s nose job looks natural and properly fits the face. One of the most common and gratifying comments I get from former patients is that they saw old friends from camp or school and the remarks were: “You look great, did you lose weight? Change your hair?” NOT, oh, you had a nosejob.
Your consultation usually lasts up to 45 minutes or more. You spend a lot of time with Dr. Pearlman and have the chance to ask all the questions you want. During the consultation, we review healing time and how fast they can get back to school or embark on their summer activities. Timing is important since surgery is often considered before summer activities or going back to school. Other popular times are Christmas vacation, winter and spring breaks. The minimum time I prefer is 2 weeks before going back to school. By that time, the swelling is down enough so that the nose often looks like the original and gets gradually smaller over the ensuing month. Some actually go back to school in less time but may show some bruising. Patients are cautioned that they can’t participate in gym for 2 months (most girls love this and ask for more) and need to be careful about hitting the nose; today every teenage girl hugs and kisses their friends who they haven’t seen in two whole weeks!
Finally, the big question is what age should we consider rhinoplasty? The general teaching, going back decades, has been that girls can have rhinoplasty as soon as 15 years of age and boys by 16. This is when they are almost fully grown. What is more important than physical growth is the age at which a teenager can make a mature responsible decision to undergo surgery. Given changes in society, this age is getting younger and younger. What I do during the consultation is gauge the teen’s level of maturity and motivations for surgery. If they’re not mentally ready, I insist we wait. No one should rush into surgery, but no one should be afraid of it either.
Please visit our sections on otoplasty, a procedure that is safe and appropriate for teens and children down to the age of 6.
Answers to frequently asked questions about the procedure
Eyelids can look "tired" from a number of reasons. The more common ones are bags under the lower eyelids, excess skin of the upper and/or lower eyelids and drooping of the eyebrows. You don't have any of these.
Your eyelids slant downward towards the sides; the corner where the upper and lower eyelids meet (called the canthus) is lower towards your ears than near your nose. There are a number of surgical techniques that can be used to raise the lateral canthus. Sometimes, there may be some hollowness of the bone of the eye socket as well. This is also treatable. Seek out a surgeon who is versed in this procedure for a more definitive discussion.
A: A rhinoplasty will last for the rest of your life. However, even a nose that has undergone a rhinoplasty ages like the rest of your face and body. As we age, the nose begins to droop. After a rhinoplasty they will age from where they were after the procedure. The procedures we do for an aging nose is often more subtler than a formal rhinoplasty.
A mini-facelift of today was the maxi-facelift of 2 decades ago. Mini or maxi, best to discuss with your doctor. There are many definitions of what a mini-facelift is. For some it's a shorter incision, for other doctors its less work on the muscle called the SMAS. The technique depends more on the doctor's skill and your anatomy. For a patient in their early 40's, you often don't need the same deep plane facelift that someone in their 50's or above might need. Most of these procedures address your jowls.
A: Performing both a quality septoplasty and rhinoplasty is dependent on the individual's training and experience. Generally, facial plastic surgeons start with ENT training before they move on to facial plastic surgery. Although they are not formally trained, many plastic surgeons can also be experience and qualified to perform septoplasty procedures. The main focal point should be how much training they have received and how much experience do they have performing the procedures together and separately. There are subtle signs that could indicate if the proposed surgeon is right for you: