So three months ago, after decades of thinking and planning, I finally went under the knife for a rhinoplasty. Read on for all the details about my nose journey, from the initial consultation to the (almost) final results.
What is involved in designing a new nose?
Once I was ready to move forward, I contacted a renowned board-certified plastic surgeon Adam Caulker, MD, FACS, for consultation. However, I only told my boyfriend, sister, and sister-in-law about my upcoming appointment just in case my aesthetic goals weren’t achievable or if I decided that a nose job wasn’t the right choice for me after all.
Keeping rhinoplasty patients’ expectations in check is sometimes a challenge, says Dr. Kolker, especially given how many variables can affect the final outcome. As he explains, “There are times when people have an absurd image in their head of what they want and it’s just not possible based on their sense of harmony and proportion between the nose and the face.” Similar to art and design, the top and bottom halves of the nose need to stay balanced while also supporting the internal structure so you can, you know, breathe.
Dr. Kolker adds that rhinoplasty is one of the most artistically and scientifically complex procedures performed by plastic surgeons. “There is so much three-dimensionality … and there are so many different elements to deal with,” he says, citing the structural support of cartilage and bone, the soft tissue inside the nose and the overlying skin. Basically, if you want to improve the size or shape of your nose, it’s not as simple as, say, asking for a certain size breast implant—the nose still requires peak functionality.
There is also the added factor of how a patient responds to surgery. As Kimberly LeeMD, a board-certified facial plastic and reconstructive surgeon in Los Angeles, explains, “Balancing both functionality and aesthetics can sometimes be difficult with rhinoplasty [since] it is difficult to predict the healing process and the formation of scar tissue … which can alter the initial outcome.’ And since it can take up to 12 months for swelling to go down and final results to occur, it’s important that rhinoplasty patients clearly communicate their goals with their surgeon of choice before entering the operating room.
Rhinoplasty preparatory surgery
As for my wish list of changes, I sat down with Dr. Kolker in his Manhattan office for about 20 minutes and I talked about the overall shape of my nose from the bridge to the tip and nostrils. He asked me what angles I liked and didn’t like, asked for examples of photos of other people’s noses that I admired, and then took pictures of my face straight on, sideways, three-quarters turned, and a “worm’s eye view,” a.k.a. with my head tilted backwards to see my nostrils. He then used a photo-morphing program to draw a possible final result, placing it side-by-side with my original photo, and talked about the changes to my nose, some of which were so small I couldn’t even tell what had happened — except that I liked the result.
