A Nose By Any Other Name…

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Iggy Azalea

Schnoz, beak, conk… whatever you call it, our noses are a rather important element of what makes us, well, us. Aside from being the ‘guardian to our lungs’ and enabling us to smell and taste, aesthetically-speaking they also play a huge role in our perception of facial attractiveness (although we personally rather like a ‘characterful’ nose).   When Iggy Azalea finally confirmed Hollywood’s worst kept secret and admitted to having had a nose job (as she said, ‘denying it would be lame’) we decided to see exactly what was involved – with a little help from some top Rhinoplasty surgeons.                                                                                                                        

Rhinoplasty is not a one-size-fits-all type of procedure. From refining the tip of your nose, smoothing a prominent bump, reducing the overall size to lengthening upturned tips to reveal less nostril, it relies on someone knowing exactly what will suit your face and what will compliment the rest of your features. “In the past if you had rhinoplasty you would get a scoop nose, especially if you were in Los Angeles,” says Dr Julian de Silva who averages seven to eight nose jobs a week. “It’s the nose that curves up like a Disney Princess which can look cute and suits some women in their mid-twenties but generally after that it just looks like you’ve had surgery. In the UK people tend to want to look more natural with a straight nose or a very slight curve.”                                                                                                                                  

And it seems more of us are wanting nose jobs than ever before.“There has certainly been an increase in the number of patients interested in a rhinoplasty,” says Dr Tim Woolford, expert cosmetic surgeon and ear nose and throat consultant  at the Spire Manchester Hospital. “I think there are many reasons for this, one of which is that it is now seen as far more acceptable to seek cosmetic improvement and any taboo in this area has largely passed. In the past a rhinoplasty was generally a procedure performed on younger people, however I now have patients of all ages including those middle aged and above who wish to undergo a rhinoplasty.”

Lydia Badia, consultant surgeon who specializes in rhinology at 150 Harley Street agrees; “At Rhinoplasty London we’ve definitely seen an increase in patients wishing to change the aesthetics of the nose ranging in age from 17 to 65 although unfortunately we have also seen an increase in patients needing revision surgery.” The reason for this increase? “It's most likely related to social media pressure and the ‘selfie’ boom,” says Dr Badia. “There is a distortion in a selfie similar to fish-eye lens which can make the nose seem bigger.” The most popular celebrity nose people request? “Kim Kardashian”

What is rhinoplasty?
“First of all it’s important to recognise that no two rhinoplasties are exactly the same and I always make the point to my trainees that there is no such thing as an easy rhinoplasty,” says Dr Woolford. “Patients seek surgery for a number of reasons, the most common of which are removal of a bump on the nose or a reduction in the size.  Often the nasal tip requires refinement, and another common concern is that the nose droops or is too long, particularly during smiling.  If the nose is crooked we can try to make it straighter, and of course it's important to remember nasal function.  In many cases surgery is performed both to improve the nasal airway as well as the shape.”

What happens during the procedure?
“The operation takes place under general anaesthesia and typically takes between two and three hours,” says Dr Badia.
“There are essentially two types of rhinoplasty; an endonasal or closed rhinoplasty and an open or external rhinoplasty,” says Dr Woolford. “In endonasal rhinoplasty all the incisions to lift up the skin are made inside the nose, whereas with an open rhinoplasty there is a short incision made between the nostrils and the skin is released and then lifted up. There are pros and cons to each type of rhinoplasty but it is the experience and skill of the surgeon which is important rather than the approach.  The small scar from an open approach almost always heals very nicely and is generally barely visible.  Having looked at my long-term results over a number of years now I generally favour an open approach as I feel able to achieve a more natural and balanced look for my patients.”

Anything to be aware of before going under the knife?
“As in all types of surgery it’s important to select a surgeon who has experience and specialises in this particular procedure,” says Dr Woolford.  “It is vital that patients receive a balanced view about rhinoplasty, being told what is not possible as well as what can be achieved.  In reality, a nice noticeable improvement is possible, however the result will certainly not be perfect.  It is very important that the patient meets their surgeon in person before the day of the surgery. I always see patients on two occasions, including reviewing their photographs together to make absolutely sure surgery feels like the right thing to do.  There are complications associated with a rhinoplasty and although fortunately these are very rare, the possibility that something could go wrong must be honestly discussed with patients.  Even in the most experienced hands a small number of patients require a second operation and again reputable surgeons will be very honest and open about this.  My advice to patients is that if they feel they are being rushed or put under pressure to go ahead with a rhinoplasty by a particular surgeon or clinic they would be wise to reconsider.”

What is the typical downtime?
“Most patients spend one night in hospital, although rhinoplasty is often  now performed as a day case,” says Dr Woolford. “Generally a moulded shield is worn over the nose to protect it for a week or so.  In the open approach I use tiny stitches which dissolve and brush off  after about 10 days. Most people take a couple of weeks off work by which time any bruising has settled and the nose is far less swollen.  I tell patients that this will certainly not be the final result, however they will be ‘presentable’. It is important to stress however that you have to be patient if you have a rhinoplasty and the result cannot be judged for a number of months.  In reality a lot of patients are not sure about things at a couple of months, but are much happier at 4-6 months – you need to be a ‘patient patient’ if you have a rhinoplasty!”

Can anyone have it?
“Rhinoplasty is certainly not a procedure that anyone should have,” says Dr Woolford. “Because it requires a general anaesthetic, patients do of course have to be in good general health to ensure that the anaesthetic is safe. As I said earlier, it is absolutely crucial that patients undergoing rhinoplasty have realistic expectations about what can be achieved.  There is no doubt that surgery can be a very positive experience, however for some individuals who are unrealistic or will focus on minor imperfections the opposite is true.  I see a number of patients where I recommend against a rhinoplasty because I feel either that surgery is not justified, or that I will not be able to achieve results which will make the particular patient happy.  This is the same for all reputable rhinoplasty surgeons.” Something mirrored by Dr Badia; “Certain people such as those with body dysmorphia should not even consider surgery without having therapy prior to any aesthetic surgical procedure. People who abuse substances such as cocaine should also steer clear of surgery until they have been clean for a minimum of three months as the risk of undesirable healing would be too high.”

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