Happiness for rhinoplasty patients is achieved when expectations are met, or even better when they are exceeded. It is therefore so important that patients have realistic expectations. This ideal state can only be reached if the surgeon understands what the patient wants and helps the patient understand what can be achieved for their nose, what the limitations are and what the risks are. Only then can the patient know what to expect and if it is what they are hoping for.
I think this is especially true for teenagers wanting rhinoplasty. The opportunity to have surgery may be a present, perhaps offered at the ideal time after leaving school and moving on to a first job or university and a new group of friends. Such an opportunity is associated with all the excitement that a gift can bring. Furthermore, expectations may be inflated due to pressure in the body conscious, beauty driven world of celebrities and media manipulation. A sense of entitlement may be present in some teenagers and there may be areas of emotional upset that the teenager thinks can be resolved by achieving a new nasal shape. Of course this may not be the case.
I think it is also true that teenagers may not appreciate that rhinoplasty is serious surgery and that the operation is considered probably the most difficult of all the cosmetic facial plastic surgery operations. I have seen many patients who rushed into rhinoplasty in their teens without researching the operation first and who later greatly regretted their rush into surgery and its results.
I also think that surgery should err on the side of conservatism in teenagers. Surgery should certainly not be performed before the age of 16 as the nose is likely to still be growing up until this age. Skin also tends to be thicker in teenagers so greater refinement of the nasal shape may occur with age anyway. It is important that surgery is predictable in the long run and so rhinoplasty should concentrate on reshaping and maintaining support rather than removing too much tissue in pursuit of a little nose that lacks balance and harmony. Good qualities in a nose should be recognised and maintained and a standard approach based solely on removing tissue should be avoided.
None of us can predict fashion change either. The small Barbie doll noses of the 1960’s are not considered fashionable now so again I think it is better to err on the side of conservative rather than radical surgery.
To compliment our rhinoplasty surgery I have put together a rhinoplasty discovery programme™. The components of this programme are all about providing patients, absolutely including teenagers, with all the information they need to understand what they want for their nose and what is possible. We also think it is extremely important that patients are fully informed of the risks of surgery. Only then are they able to make a decision with the help of their family and friends and with our honest advice and support as to whether they would like to proceed with surgery.