This is a question that is still a ‘hot button’ issue among surgeons who have very strong feelings one way or the other. But, the debate thankfully is not quite as big a deal today as it was once was. When rhinoplasty first became very popular in the last century, all of the work was done through the nostrils from the inside. The surgeon tunneled under the skin over the bridge of the nose and made alterations almost blindly. This is called a Closed Rhinoplasty because all of the incisions are enclosed inside the nose. It’s a bit like trying to carve a delicate glass figurine (the nasal cartilage) while working under a blanket (the skin). And, it’s still done almost the very same way today. There are variations where the surgeon makes a couple extra incisions inside your nose and ‘delivers’ the tip cartilages outside your nostril so he or she can see some of the changes being made. But, this procedure provides a slightly distorted view of the anatomy and, sometimes, it may hamper the surgeon’s ability to make precise changes. Read more

We are often asked to perform rhinoplasty in young adolescents. Nasal surgery on children has long been a focus of discussion in the medical literature. As experts in rhinoplasty and nasal surgery, at Profiles we believe that discussion regarding nasal surgery in children has to be divided between functional surgery and cosmetic rhinoplasty.

When dealing with children with functional problems, surgery such as septoplasty can be done as early as necessary in order to restore nasal function and to prevent the consequences that may arise due to misplaced anatomic structures. In these patients, extra care must be taken to preserve as many structural supports and as much septal continuity as possible in order to insure normal nasal growth.

When considering cosmetic surgery of the nose, we generally believe surgery should be delayed until the nose is fully grown. This commonly means rhinoplasty can be done on girls when they have had their period for at least 2 years and in boys when they are at least 14 years old. Another good indicator of nasal growth is the patients’ height compared to their parents. If the patient is as tall as their tallest parent, then they are probably finished growing and so has their nose. Exceptions for younger children are made for those patients who have a significant anatomic deformity and a very strong desire for surgery to correct it.

The problem with operating on patients earlier than these target ages is that the nose may continue to grow in an unpredictable fashion. So, despite creating a balanced nose after the rhinoplasty, the continued nasal growth can distort the proportions that were created.

Finally and perhaps more important than the physical maturity, we also believe that all our adolescent patients must have the emotional maturity to deal with their surgery. It is very important that the patient himself/ herself is interested in having the surgery and that it is not only being done because the parent wants surgery.

With all of this said, we believe that the psychological benefit that rhinoplasty can afford during puberty, a very critical time in emotional development, is significant and should be considered for the right patients.