Fourth Quarter 2010, Volume 24, Number 2

Teenage rhinoplasty. Is your teen a good candidate? What you


Reducing the impact of stress on your skin

Teenage rhinoplasty. Is your teen a good candidate? What you

Ask the Surgeon / Health Tip / What’s New

Medical advances benefit the consumer

Rhinoplasty (nose surgery) is the number one requested surgical procedure by teenagers. Embarrassment, awkwardness, and unworthiness may be attributed to their most distinct facial feature—their nose. Rhinoplasty may be a solution; but your first steps should be to get educated about why your teen wants the procedure, what is involved, and who can perform it.

Rhinoplasty can be a physically and emotionally satisfying operation for teenagers when their motivations and expectations are realistic. If your teenager is contemplating rhinoplasty, make sure you discuss why he or she is interested. The teen should be self-motivated to improve his or her appearance to feel better about himself or herself. It should not be about pleasing his or her parents or looking like a Hollywood star.

What does your teen expect after the procedure? Rhinoplasty will not be the panacea to the angst of teenage life. It will, however, improve the nose aesthetically, creating better harmony with other facial features. This often helps self-confidence.

One of the most important factors to consider is who you will trust your teen’s procedure to perform. Review a facial plastic surgeon’s credentials, training, experience, and practice to ensure that your teenager is receiving the highest quality of surgery and care.

Some teenagers may not realize the practical implications of having surgery. Depending on the extent of the surgery, the teen may miss one to two weeks of school; you may want to schedule the surgery around an extended vacation time. While a teen will heal quicker than an adult and their elastic skin may show results sooner, the final results may take one year. Activities will be limited initially.

Take the time to discuss all of these aspects with your teen before making the initial appointment with your facial plastic surgeon. Your support and assistance in going through the process are crucial for success.

The consultation appointment is an excellent time to discuss with an expert if getting a rhinoplasty is right for your teen. Get to know your surgeon, the practice, and those that will be participating in your care. This will help you and your teen feel more comfortable and assured in the decision to have surgery.

The facial plastic surgeon will perform a thorough medical exam and discuss your teen’s medical history. Skin type, ethnic background, and age will also be discussed. Before the nose is altered, a young patient must reach full growth—usually age 14 or 15. Exceptions can be made on a case-by-case basis, especially if the surgery is to improve breathing. Additionally, the surgeon will explain the procedure, anesthesia, surgical facility, risks, alternatives, pre- and post-operative routine, and recovery.

Don’t be afraid to ask questions. Encourage your teenager to bring a list of questions and to keep asking until he or she feels completely at ease about the treatment plan.

The definition of rhinoplasty is, literally, shaping the nose. First, incisions are made and the bone and cartilage support system of the nose is accessed. The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, certain amounts of underlying bone and cartilage are removed, added to, or rearranged to provide a newly shaped structure. For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size. The angle of the nose in relation to the upper lip can also be altered to correct a distortion.

The tissues are then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be placed.

Immediately after surgery, a small splint will be placed on the nose to protect it and to keep the structure stable for at least five to eight days. If packing is placed inside the nose during surgery, it is removed the morning following the surgery. The surgeon will advise your teen to avoid blowing the nose for seven days after surgery. In the immediate days following surgery, there may be bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and discomfort. Absorbable sutures are usually used that do not have to be removed. Nasal dressing and splints are usually removed six or seven days after.

It is imperative that the patient follow the surgeon’s directions, especially instructions to keep the head elevated for a certain period after surgery. Some activities will be prohibited in the weeks after the procedure. Sun exposure, exertion, and risk of injury must be avoided.