Are Rhinoplasties a Procedure of The Past?

For decades, plastic surgery patients have been keen on achieving a “perfect” nose. However, recent articles have suggested that this trend has ended, being that the number of rhinoplasties have seemingly decreased. Dr. Matthew Kaufman gives his expert opinion and weighs in on this alleged change in trend.

Q: A recent article on “The Conversation” alluded to the following statistic: Americans are no longer “obsessed” with fixing their noses, being that the number of rhinoplasties has gone down 43 percent since the year 2000. Why do you think this is?

A: The reduction in the number of rhinoplasties since 2000 may indeed reflect societal “comfort” with ethnic diversity, and in particular nasal shapes and sizes that do not fit one aesthetic standard. However, there are other possible explanations why the survey results may have demonstrated this decrease-  1. The survey may not have been distributed to ALL surgeons that perform rhinoplasty (i.e. Facial Plastic surgeons, Plastic surgeons, Otolaryngology-Head and Neck surgeons (also known as Ear, Nose, and Throat specialists). For example, I am Board Certified in both Plastic Surgery and Otolaryngology-Head and Neck Surgery and perform high volume rhinoplasty but do not recall completing any survey; 2. The survey may not have included those who seek out rhinoplasty primarily for functional improvement (stated another way, nasal surgery that is performed mainly to improve nasal breathing); & 3. The survey may not include rhinoplasties performed after a fracture due to nasal trauma.

Q: The article suggests that cosmetic surgery patients, namely women, might be inclined to invest more in other procedures, such as a procedure that can better their figure (liposuction and body contouring) or skin (injectables or laser treatments). The article mentions that these women are motivated to look younger, thinner and more attractive so that they can secure a better future, and rhinoplasties no longer equate to that. Do you agree or disagree with this opinion?

A: There has most certainly been a major increase in procedures that are considered minimally invasive, such as injectables and laser treatments. Unfortunately, in most cases these are no substitute for rhinoplasty when someone is looking for anything more than a very subtle change to their nose.

Q: What reasons for wanting a rhinoplasty do you commonly see in your practice?

A: The most common reasons for rhinoplasty I see in my practice are for a combination of breathing difficulties and the nose looking too large for the individual’s face. Also to be clear, this issue applies to men and women, and approximately 30-40% of my rhinoplasty patients are men.  I also commonly see patients who are dissatisfied with the results of rhinoplasty performed elsewhere who are seeking out an expert for revision rhinoplasty surgery.

Q:  This article states that in the past, patients sought rhinoplasties to alter their “ethnic” looks – to fit a more common standard of beauty. It mentions the change in the standard of beauty currently; that women are embracing their unique ethnic qualities now perceived to be beautiful and may no longer seek rhinoplasties to revise these features. Have you noticed this trend at all in your practice?

A:  Regarding whether societal perceptions have changed and if women are more comfortable maintaining individual ethnic qualities, I am not sure if that is necessarily true. There may be certain celebrities with specific ethnic qualities that many women see as the new standard (for example, every month someone comes in with a picture of Kim Kardashian and says they want her nose). However, a young woman with a large bump on her nose that disrupts facial balance and offsets desired delicate feminine features is often desperate to have surgery for correction.

I think it is too much of a generalization to conclude that there is no longer a desire for rhinoplasty because everyone is comfortable with their nose regardless of shape or size. To the contrary, it seems that with social media and the constant bombardment of celebrities having plastic surgery to look a certain way, that women and men are more focused on their faces, bodies, AND noses.

Q: Have you ever heard of a patient requesting a “reverse nose job”? Would you recommend this procedure? Why or why not?

A: The term “reverse nose job” is not something I have heard before, however for patients seeking revision rhinoplasty to correct a result that has given them an “operated look”, I attempt to restore a natural, “God-Given” nose that will be more balanced with their face.  The best rhinoplasty is always the one you cannot pinpoint and should look as though the patient was born with that nose.

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About the Author – Dr. Matthew Kaufman, MD, FACS 

Matthew Kaufman, MD, FACSDr. Matthew Kaufman has the rather rare distinction of achieving board certification in both Plastic Surgery and Otolaryngology- Head and Neck Surgery. This gives him the added expertise necessary to deal with complex cosmetic and reconstructive problems of the head, face and neck. In addition, he has advanced expertise in complex revision rhinoplasty and ethnic rhinoplasty (non-Caucasian rhinoplasty). He has done groundbreaking work in the field of reconstructive plastic surgery, and is the only known expert to perform phrenic nerve surgery. Dr. Kaufman is a partner at The Plastic Surgery Center, the largest plastic surgery practice in New Jersey.