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Issue Date: July 2006 Issue


A New Nose

Restructure through rhinoplasty

The “less is more” approach to reshaping a nose is replacing outdated requests for a ski-slope look, Twiggy-thin bridge or Jessica Hahn-style pointy tip. “We’ve gotten away from the pointy tips that were common in the 1970s and even the 1980s,” says Dr. Richard Gentile, who says a fair number of teenagers and an increasing number of men seek services at Facial Plastics & Aesthetic Laser Center in Boardman, Fairlawn and Warren.

“Aesthetics are important, but function is just as important,” Gentile emphasizes. If you shave off too much of the schnoz, patients could suffer from breathing problems since noses naturally grow thinner as we age.

But Gentile doesn’t have to worry about recreating this manufactured look; proportion is in, skinny is out, and most patients understand that they can’t start from scratch. “If you have a triple-X-sized nose, it will never be a small-sized nose,” Gentile says, adding that most patients relate to the portfolio of patient before-and-afters he shows them during consultations. He generally refers to a picture of someone who reminds him of the pre-operative individual.

“I will say, ‘you remind me of this patient,’ and then I gauge their reaction,” he says. “Sometimes they’ll say, ‘That nose isn’t narrow enough,’ but most of the time, they are in agreement that the ‘after’ is a good result. From that, I can get an idea of what we can do.”

Gentile says most patients don’t seek an extreme makeover, rather an improvement on what they already have. In fact, because many men and women must return to professional work environments, they prefer that results are less dramatic — a marked improvement, but not so obvious that their procedure becomes watercooler gossip.

“Patients don’t want to look so different that when they see someone they know on the street, the person looks at them and says, ‘Nice nose job,’ ” Gentile remarks.

Gentile says patients request nose jobs for a variety of reasons. Some have lived unhappily with a hump for years. Others want to improve their profile, thin down the bridge or reshape a crooked line. A certain population seeks reconstructive surgery to alleviate breathing problems, and many men and teenagers visit Gentile after an injury.

Dr. Steven Goldman, of Beachwood Plastic Surgery and Laser Center, says the benefits of rhinoplasty are twofold for many patients, who sincerely state functional “repair” reasons for the surgery. “But maybe what pushed them to get their nose fixed for breathing was they wanted to get the hump fixed, too,” he suggests.

Goldman says his patients sometimes refer to celebrity noses like Jennifer Lopez or Keira Knightley when they describe their ideal end result. “People who go into surgery don’t want me to leave them with a little hump,” he says, citing Jessica Simpson’s pretty-but-imperfect nose, which appeals to patients who can’t achieve a model finish. “You don’t want to leave patients with a ski slope either,” he adds.

Regardless of preference, patients who have broad nose structures and thicker skin will never leave a plastic surgeon’s office with a petite, tiny-tipped nose. “Most patients understand that what they have already is what we can work with,” Goldman says.

This is a relief for Gentile, who prefers to err on the conservative side. “Fortunately, they never bring in pictures of Michael Jackson,” he jokes.

[Rhinoplasty is the second most popular surgical procedure, according to the American Society of Plastic Surgeons 2005 statistics.  more than 298,000 people had nose reshaping procedures in 2005. (www.plasticsurgery.org)]

Procedure Pointers:
Sizing —
Proportion to facial structure is a key factor in analyzing whether a nose is attractive. That said, patients with larger structure before surgery shouldn’t aim to shrink their nose to a size too small for the face. (Dividing the face in horizontal, equal thirds, the nose should be positioned in the middle-third of the face.)

Before — First, ensure that your plastic surgeon is certified by The Board of Plastic Surgery (www.plasticsurgery.org). During your consultation, ask to see before-and-after pictures of past patients, Gentile says. He relies on computer imaging to produce postop pictures to ensure realistic expectations.

After — Swelling and bruising in the under-eye area will persist a week following surgery, and during this time, the doctor will prescribe pain medication to alleviate soreness. Some patients experience swelling for several weeks; most people can return to work within one to two weeks. The nose will heal completely in 12 to 16 months.


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