Rhinoplasty is usually perceived as being a young person’s facial surgery… and for the most part it is. The majority of elective nasal reshaping surgery is done on male and female patients between the ages of 18 to 35 years old. But on the further end of the spectrum is the ‘senior rhinoplasty’ patient. Probably representing 5% or less of aesthetic rhinoplasty surgeries, they offer some unique considerations both anatomically and psychologically.
In the First Online edition of the December 2017 issue of the European Journal of Plastic Surgery, an article was published entitled ‘Rhinoplasty in elderly patients: analysis of outcomes and patient’s satisfaction following 20 years experiences’. In this paper the authors looked at the necessity of rhinoplasty in elderly patients, to determine the perception of patients before and after surgery and compare the older patients with younger patients. In a retrospective manner the total number of patients studied was 125 of which 25 of them had their results compared to a control group of younger patients.
Through a pool of over 1700 rhinoplasty patients over a twenty year period, 125 were found to be oder than 65 years. (7.3%) The average age was 68 years old with a near even distribution between men and women. Most of these were done through an open approach. (71%) Most rhinoplasties were augmentation (86%) rather than reductive, When comparing older vs. younger patients the greatest difference as that older patients were almost exclusively focused on the tip of the nose.
It should probably be no surprise that as one ages the tip of the nose changes. While often referred to the nose growing as we age, it does not really grow. Rather the cartilage weakens and sags and the tip of the nose drops a bit. When measured from a straight line from the top of the nose to the tip, it has indeed lengthened. It is this droopy tip that most older patients want improved or lifted. To do requires adding cartilage support to the tip to derotate it and have it stay up.
Dr. Barry Eppley
Indianapolis, Indiana