Teenage Rhinoplasty - Teen Rhinoplasty

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Cosmetic surgery on teens or children is becoming more popular (in 2009 203,000 teens and in 2012 236,000 teens between the ages of 13 and 19 altered their physical appearance) but can be controversial. While adults have appearance altering surgery to stand out or look younger, teens do so to fit in and be more like their average peer.  Not all teens with psychosocial anxiety about a body part have psychological issues, and they should not be dismissed by adults as being too immature to understand their own emotions or automatically be assumed to have primarily psychological problems.

In Australia such surgery is legally restricted. In 2009, breast and nose surgery, liposuction, and Botox on children were banned in Queensland, Australia. Doctors who perform such procedures without medical reason can face up to 2 years in prison. In New South Wales, Australia patients under 18 years of age who are considering cosmetic surgery have undergo a 3-month cooling-off period, followed by consultation with an internist and clinical psychologist before they can have surgery. There are no such regulations in the United States.

Rhinoplasty, nose reshaping surgery, is the most common cosmetic surgery performed on American teens. It is usually performed as same day surgery under general anesthesia. According to the 2010 American Society of Plastic Surgeons report, rhinoplasty made up 45% of all teen plastic surgery procedures. This has been consistent with 44% of teen cosmetic surgeries being rhinoplasty in 2012. Over 30,000 teens a year get nose jobs in the US. The reasons for having the surgery and the specifics of surgery can be much the same as they are for adults:

• Removing a hump on the nose
• Straightening the bridge
• Reshaping the nose's tip
• Increasing or decreasing the size of the nostrils
• Correcting the nose after an injury
• Opening breathing passages
• Making the nose bigger or smaller

But there are additional issues the surgeon has to take into account including:

• is the teenager mature enough and physically old enough to undergo surgery, follow instructions after surgery and wait for complete recovery before judging the result
• are the teenagers motivations for surgery appropriate and are their expectations reasonable
• are the parents supportive and on board

The drooping nasal tip - drooping tip of the nose

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Drooping nasal tip is a term used to describe downward movement of the nasal tip with smiling. More severe forms of this include shortening of the upper lip with the appearance of a horizontal crease and elevation of the outer lower edge of the nostril in the same motion.
Drooping Nasal Tip With Upper Lip Shortening and Horizontal Crease on Smiling
This appearance is created by the actions of the levator labii superioris alaeque nasi and depressor septi nasi muscles.

>Muscles That Cause Drooping Nasal Tip

The treatment is to prevent the actions of the muscles. This is achieved by cutting the depressor septi nasi via an incision in the floor of the nose or the inside of the lip and transecting the outer portion of the tip cartilage with a portion of levator labii superioris alaeque nasi so that it can no longer raise the outer lower edge of the nostril.


The commonly performed trimming of the tip cartilage also helps to rotate the tip upward.

Rhinoplasty
Correction of the Pinched Nasal Tip
Aaron Stone MD - Plastic Surgeon Los Angeles
Aaron Stone MD - twitter

Asian Rhinoplasty - AfroAmerican Rhinoplasty

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There are 3 main types of noses - Caucasian, Asian or Oriental and African. The Asian nose has characteristics between those of the Caucasian and African. Today one increasingly finds mixed features between these groups as well so some individuals can have a Caucasian tip with an African bridge or vice versa. The most visible difference is the more vertical nostril alignment with a longer strip of skin between the nostrils in the Caucasian nose vs. the Asian or African nose. The Asian and African nasal bridges are flatter and broader than the Caucasian. In some cases the bridge may be so flat that it appears scooped out or ski sloped. The nasal tip skin is usually thicker with a more rounded tip in the Asian and African noses. The thinner nasal tip skin in the Caucasian nose makes the tip cartilages and their shapes more visible on external viewing.


As you can see in the above diagram these differences are due to differences in the skin but mostly due to differences in the underlying bone and cartilage. In Asian and African noses: