The stigma that used to surround plastic surgery is slowly dissipating as it gains a wide recognition for the value that it provides. Formerly associated with vanity, it is now regarded as an instrument for improving quality of life.  At the same time, plastic surgery is, after all, surgery. More often than not it is an invasive surgery, and should be approached with due seriousness. Rhinoplasty is among the most popular facial plastic surgeries, and it’s important to understand what it implies for the patient. 

It has to solve a problem. 

Rhinoplasty, and ethical plastic surgery in general, is not a practice that promotes surgical interventions that do not solve clearly defined problems. A desire, for example, to bear resemblance to a famous person is not uncommon, but it often comes with unreasonable expectations and demands, which cause more problems than they solve. On the other hand, if a person feels deeply insecure about their face, and thus avoids participating in life in all the ways they wish to do, then plastic surgery can be considered a matter of psychological health. It’s the reason why sometimes plastic surgeons are jokingly referred to as “therapists with scalpels”. When a potential rhinoplasty patient comes in with a desire to make changes that are unlikely to be perfectible by the naked eye, or are so radical they will do harm to the proportions of their face, an ethical surgeon will politely deny surgery to that patient. 

Even the best surgery is not magic. 

As the quality of customer service advances, and we internalize agreeableness as the standard for its quality, it might come as a shock to us when we are denied service, even when we are willing to pay. The mantra “the customer is always right” does not apply to plastic surgery. An ethical plastic surgeon will be perfectly comfortable saying “no” if they believe its in your best interests, and will not accept a patient who wants a surgery for the wrong reasons, or who expects more than what is possible. Of course, there is a great deal of effort made by the industry to help the patient clarify their aesthetic goals and achieve them with maximum accuracy, but even the most advanced software can’t account for every nuance. Elasticity and thickness of skin, subcutaneous tissue, and scarring – these are all highly individual factors, that cannot be predicted by neither software nor even the surgeon. And while most nasal corrections are highly successful, only an irresponsible surgeon would give a 100% guarantee of any outcome.  

Rhinoplasty is not for the impatient.  

Rhinoplasty normally involves skeletal restructuring, so the visual changes appear immediate. But initial changes should not be mistaken for final results. The nasal splint that is placed on the restructured nose comes off in a week, along with the sutures. In about two weeks, the patient can expect a complete “social recovery” where the visual signs of surgery, such as bruising and swelling, will practically disappear. This can create a false sense of the nose being nearly healed, and the patient may begin evaluating their “new” nose in the mirror. However, at that point much of the tissue is still inflamed and will remain so for months. It takes about a year for the tissue to fully settle into its final shape, making reasonable assessment of the results possible. On the bright side, the healing period is usually completely painless. 

It won’t be obvious to those who don’t already know.  

In successful rhinoplasty, it is only the improved aesthetics of the nose that give away a surgeon’s involvement. Even in the case of an open rhinoplasty, the scar is small and inconspicuously located between the nostrils, identifiable only at the kind of close inspection that is not appropriate in ordinary daily interaction. Ultimately, rhinoplasty removes daily psychological discomfort associated with one of the most prominent facial features, and is worth considering for those that really need it.