New York, N.Y.
Last week I discussed the scientific background for who and why we can and should offer rhinoplasty to teenagers with big noses. I will now discuss the more personal aspect of caring for these sensitive individuals. Teenagers are under a lot of social pressure as they are finding themselves, establishing social skills and interacting with peer groups. It is easy for an outsider to criticize cosmetic surgery as unnecessary, but for a teen who has endured ridicule from the outside or put up a wall of self isolation due to lack of self confidence from a large nose, it can be a huge issue, no pun intended. Rhinoplasty is not about popularity but more about social acceptance.
All too often the consultation starts with the teenager staring at the floor because they are shy about their looks, yet they also 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.
Computer imaging is an excellent tool as well for the consultation. Teenagers are very visual. Seeing potential results and discussing what we both feel looks right for them can help alleviate their apprehensions. We review healing time and how fast they can get back to school or embark on their summer activities. 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. Patients are cautioned that they can’t participate in gym for 2 months (most 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.
What can result? The transformation I have seen is often amazing. Teens come back with new attitudes; chins lifted up, improved eye contact and they smile a lot more. The psychological changes often outdo the physical changes we made through rhinoplasty. For the teenagers who already were outgoing and social, it only serves to support their already well established self confidence.