Background: With its central position on the face, it is no surprise that the nose is often a major focus of a teen’s attention. The constant exposure to social media, a developing self-image and peer pressure to be attractive and popular can have a teen preoccupied with their appearance. The nose can often become a focus of this attention as a flaw that ‘needs’ to be corrected. Thus many teens turn to rhinoplasty to improve the shape of their nose. This is validated as numerous plastic surgery societies rate the number one cosmetic procedure among teens is that of rhinoplasty.
The most common reasons that teens decide to undergo rhinoplasty are varied. These can include a bump on the bridge of the nose, reshaping the tip of the nose, straightening a crooked nose, or improving breathing through the nose. Often times the overall goal is to make a nose a smaller and more proportionate to their face.
In teen rhinoplasty the question is often at what age can the surgery be done. How soon is too soon? Historically rhinoplasty was not thought to be done before most of facial growth was complete. This would be the age of 14 or 15 for girls and 16 for boys. However there is no compelling medical evidence that manipulating the nasal bones or external nasal cartilages earlier has an adverse effect on their growth. While septal cartilage has a significant influence on nasal development, there is little need for surgical resection of the septum before the teen years.
When it comes to the influence of age on rhinoplasty, there are no absolute rules and each patient should be evaluated individually. An equally important issue is that of a teen’s emotional maturity and whether they have realistic expectations of the result and the recovery involved after the procedure.
Case Study: This 13 year-old teen female did not like the shape of her nose. She was bothered by the large bump on the bridge and the tip which was broad and not defined. She wanted to have it reshaped even though she was very young. Her mother was supportive of her desire for an early teenage rhinoplasty surgery.
Under general anesthesia, an open rhinoplasty was performed. The dorsal hump was reduced and osteotomies done to close the small open roof. The tip cartilages were reduced in size, narrowed and rotated slightly upward. Her results at one year after surgery showed a better nasal shape and proportions.
Teen rhinoplasty can be safely performed early after puberty. The key qualifications are realistic expectations and parental consent/support. The bone and cartilages of the nose are not adversely affected by surgical manipulation even if they are yet not completely grown. Extensive septal work or resection should be minimized in the still growing nose.
Case Highlights:
1) Teenage rhinoplasty can be very effective at improving the shape of a nose and the teens concern about it.
2) The timing of teen rhinoplasty is influenced by their age, degree of nasal deformity, having realistic expectations and parental support.
3) In the right teen, very early rhinoplasty can be safely done.
Dr. Barry Eppley
Indianapolis, Indiana