When ls Rhinoplasty a Good or Bad Idea?

Most patients seeking a nose job are good candidates for rhinoplasty surgery; however, there are some situations in which the risks of surgery outweigh the benefits. In this blog, I will review some of the things that can make a patient a good versus poor candidate for rhinoplasty.

Generally, it is fairly straightforward to determine who is a good candidate for a nose job.  A patient who is in good health, has legitimate concerns about the appearance of the nose, and has aligned expectations with their surgeon is most likely to benefit from rhinoplasty surgery.

One of the biggest reasons not to proceed with rhinoplasty is if your surgeon does not feel he or she will be able to fulfill your goals.  With any cosmetic procedure, there is the risk for dissatisfaction; patients who seek perfection run the risk for disappointment. While nose reshaping may improve your quality of life, it will not completely transform your life; it’s essential to understand the risks and potential realistic benefits of surgery. If a patient suffers from depression, body dysmorphic disorder, or another psychological disorder, I may recommend seeking a consultation with a mental health care professional before undergoing surgery. If a patient recently experienced a traumatic life event, like the loss of a loved one or end of a relationship, I may recommend postponing surgery until the patient is fully prepared to proceed.

There are several medical conditions that may cause patients to be poor candidates for surgery, including high blood pressure, heart disease, or bleeding disorders. Since patients undergo general anesthesia for rhinoplasty, it’s essential that patients with pre-existing conditions are medically cleared by their primary care providers and pre-anesthesia testing to prevent any complications in surgery. Conditions like lung disease, diabetes, obesity, arthritis, high cholesterol, or severe allergies are also factors to consider when preparing for surgery. If a patient’s nasal skin or cartilage is lacking in structural integrity, possibly from previous history of surgery or intranasal drug use, I may recommend against undergoing rhinoplasty. For pediatric patients, I recommend waiting until their facial features have finished growing – about 14 for girls and 15 for boys on average (have you read my blog about the best age to get a nose job? LINK).

As a double-board certified ENT and Facial Plastic Surgeon, I have expert understanding of both the internal and external anatomy and function of the nose. As a facial plastic surgeon at an academic medical center, a significant portion of my practice is reconstructive surgery, which means that my cosmetic patients get a comprehensive triage when they come to the office, with full vital signs and medical history.  A resident physician (medical doctor pursuing specialty training in head and neck surgery) and/or a physician’s assistant are often involved in my patients’ care.  These are skilled and knowledgeable physician extenders who do the initial history taking and analysis, which lets me focus more immediately on your concerns and makes our face-to-face time more productive.  This exposure to multiple sets of expert eyes is a huge benefit to my patients and gives the opportunity to discuss any pertinent medical history or risks for surgery.   The operating rooms where I perform cases are associated with MedStar Georgetown University Hospital, a world class institution with top-notch staff; patients often feel an additional layer of comfort when undergoing surgery in this type of team-based environment.

With any surgery, it’s essential to consider the risks along with any potential benefits. With thorough pre-operative analysis, realistic expectations, good communication between the surgeon and patient, and the skills of a qualified facial plastic surgeon, rhinoplasty leads to a successful outcome in the overwhelming majority of patients.


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