By Allure Magazine

Interest in plastic surgery is at an all-time high, but stigma and misinformation still surround the industry and its patients. Welcome to Life in Plastic, a new series by Allure that aims to break down cosmetic procedures and provide all the information you’ll need to make whatever decision is right for your body — no judgment, just the facts. Here, we’re covering everything you need to know about rhinoplasty.

Considering a permanent way to transform the size, shape, or appearance of your nose? You’re not alone. In fact, the 2017 Plastic Surgery Statistics Report by the American Society of Plastic Surgeons lists the procedure as the third most popular cosmetic surgery, with 218,924 recipients. If you’re considering joining them, here’s everything you need to know about rhinoplasty — initial consultation to post-op.

The Consultation

Commonly referred to as a nose job, rhinoplasty is a procedure that “sculpts the shape of the nose externally for cosmetics, and internally for breathing,” says Deepak Raj Dugar, a board-certified plastic surgeon in Beverly Hills. The goal, he says, is to give a “natural look to the nose, as if it was never touched, that balances the patient’s face perfectly.”

The first step in the rhinoplasty process for prospective patients begins in the office of a board-certified plastic surgeon for a thorough consultation. Following paperwork and initial photographs, the surgeon chats with the patient about any cosmetic concerns and “studies the inside of their nose for breathing issues,” says Dugar. “I then morph the patient’s photos on the iPad directly to show them the intended goals of surgery.”

Patients may also be shown other patients’ before-and-after photos for noses that are similar to their own size and shape. “If they are a good candidate, I let them know. If they aren’t, I also let them know,” says Dugar. “It’s the most honest 30 minutes of their life.”

Interest in plastic surgery is at an all-time high, but stigma and misinformation still surround the industry and its patients. Welcome to Life in Plastic, a new series by Allure that aims to break down cosmetic procedures and provide all the information you’ll need to make whatever decision is right for your body — no judgment, just the facts. Here, we’re covering everything you need to know about rhinoplasty.

Considering a permanent way to transform the size, shape, or appearance of your nose? You’re not alone. In fact, the 2017 Plastic Surgery Statistics Report by the American Society of Plastic Surgeons lists the procedure as the third most popular cosmetic surgery, with 218,924 recipients. If you’re considering joining them, here’s everything you need to know about rhinoplasty — initial consultation to post-op.

The Consultation

Commonly referred to as a nose job, rhinoplasty is a procedure that “sculpts the shape of the nose externally for cosmetics, and internally for breathing,” says Deepak Raj Dugar, a board-certified plastic surgeon in Beverly Hills. The goal, he says, is to give a “natural look to the nose, as if it was never touched, that balances the patient’s face perfectly.”

The first step in the rhinoplasty process for prospective patients begins in the office of a board-certified plastic surgeon for a thorough consultation. Following paperwork and initial photographs, the surgeon chats with the patient about any cosmetic concerns and “studies the inside of their nose for breathing issues,” says Dugar. “I then morph the patient’s photos on the iPad directly to show them the intended goals of surgery.”

Patients may also be shown other patients’ before-and-after photos for noses that are similar to their own size and shape. “If they are a good candidate, I let them know. If they aren’t, I also let them know,” says Dugar. “It’s the most honest 30 minutes of their life.”

The Procedure

Rhinoplasty is typically performed on an outpatient basis and can be done in one of two ways: open or closed. Both approaches involve incisions being made within the internal nostril region, but the open rhinoplasty approach adds an external incision (a few millimeters) on the undersurface of the columella (i.e. the tissue that divides the nostrils), says Kolker.

That external cut leaves a permanent scar, says Dugar. The skin of the nose is then “undraped” (similar to opening the hood of the car, says Dugar) so that the inner structures of the nose become visible. “This allows you to do massive changes to the nose and take things apart more readily and reconstruct the nose,” says Dugar. “This is necessary for botched or revision [previously operated on] noses, or noses with very difficult anatomy.”

With closed rhinoplasty, “all of the incisions are made inside the nose, which means no external cuts and no risk of scarring,” Dugar says. It is through these internal incisions that the nose is then shaped and sculpted for subtle changes. “We don’t alter the face, yet we soften and improve the overall balance,” he says of the procedure.

Ultimately, the plastic surgeon will select the most appropriate rhinoplasty incisions based on the specific structural modifications required for the patient, according to Kolker.

Risks

When considering rhinoplasty, or any other cosmetic and elective procedure for that matter, there are risks to keep in mind. Gary Breslow, a board-certified plastic surgeon in New Jersey, explains rhinoplasty is not without risks, although it is considered a very safe procedure. “The biggest risk of rhinoplasty is a poor outcome, which is why rhinoplasties have the highest revision rate of any plastic surgery procedure performed,” he tells Allure.

Poor outcome might mean that the cosmetic appearance is not what was desired, and sometimes it might even be worse than pre-procedure. Breslow gives some examples. “Cartilage grafts are often used in cosmetic procedures, and these grafts may move and become visible,” he says. “Rhinoplasty to correct a crooked nose runs the risk of not straightening the nose completely,” he says. “Because cartilage has ‘memory,’ there is also the risk of the nose becoming crooked again over time.”