Written By: Erin Storm, PA-C
The Skinny
From a human evolution perspective, prevailing research suggests that nose shape is first determined by local climate (humid climates vs. dry climates; colder climates vs. warmer ones). People with ancestors from cool, dry climates can generally expect narrow noses and narrower nostrils than those with family from hot, humid locales. In those cases, wide noses with wider nostrils are more common.
When comparing someone of British descent to someone of West African heritage, the climatic effects are clear. But the differences between the nose shape of an East Asian versus South Asian native is more subtle because geography isn't the only factor. The shape of the nose across the human population evolves with age and can be impacted by factors like injury or illness. Within similar ethnic groups, less obvious differences can exist in nose protrusion, nose ridge length, and more (to learn more, check out our guide to Nose Shape Concerns). Fortunately, there are a number of surgical and non-surgical procedures to enhance and perfect the nose shape.
The Specifics
Who might consider nose shaping procedures?
There are a variety of concerns related to the shape of the nose that may be caused by genetics, age, or injury.- Crooked Nose: Lateral variations in nose shape are often caused by injuries like broken bones. See our more in-depth guide to Nose Angle Concerns.
- Drooping Nose Tip: Also known as ptosis, sagging or drooping can occur when the collagen in the soft lower cartilage part of the nose breaks down during the aging process.
- Low Nasal Bridge: Better known as a 'saddle nose,' the condition, which involves a flattening and loss of height at the bridge as a result of bone loss, can be caused by trauma or the side effect of a medical concern.
- Nose Bump: Whether it's genetic or the result of an injury, nose bumps present as overly pronounced dorsal humps. Check out our deep dive into bumps on the nose.
- Upturned Nose: Commonly referred to as a "celestial nose" or "button nose," an over-rotation of the nose tip (as a result of genetics, trauma, or a previous rhinoplasty) causes the nostrils to be more prominent and creating a disproportionately short or stout appearance.
- Wide Nose: Also known as a 'nubian nose' or 'hawk nose,' a wide nose is most common in African Americans, East Asian, and Hispanic communities and characterized by a broad nasal bridge, expansive nasal tip, or wide nostrils.
Patients dealing with such concerns may wish to alter the shape of their nose with a surgical or non-surgical rhinoplasty (a.k.a nose job) procedure.
What can you expect from a nose shaping procedure?
Whether you’re interested in taking a cue from the latest makeup trends and contouring a more sculpted nasal shape with makeup or wish for a more permanent procedure, there are a number of cosmetic treatment options available. While makeup offers a quick fix, rhinoplasties provide long-term results.The Anatomy of the Nose
Generally speaking, there are two main types of rhinoplasty techniques — open and closed — which come with varying degrees of invasiveness.
- Open Rhinoplasty: The more invasive option "opens" the nose in a broad way to give the surgeon the most access to the nasal area. An incision made between the nostrils and the flaps of nasal skin are lifted up and off the nose to expose the cartilage and nasal bone during surgery. It is often recommended for patients interested in tip reshaping, straightening a deviated nasal bridge or nasal septum, removing a dorsal hump, or other nasal repairs.
- Closed Rhinoplasty: Unlike its open counterpart, a closed rhinoplasty involves making invasions on the inside of the nose as the nasal bone, cartilage, or septum is operated on. While there is often less swelling and downtime associated with the technique, there are also limitations to how much can be done, especially as it relates to the nasal skin and tip.
As with any surgery, side effects typically include pain, swelling, and possible scarring. Non-surgical techniques, like muscle paralysis and liquid rhinoplasty, also exist for those who do not wish to go under the knife. The scope and longevity of the results may be impacted.
When should you consider a nose shaping procedure?
As with most cosmetic procedures, timing of an operation is generally only limited by active health issues or infection. If a rhinoplasty procedure is being considered for a younger person, age becomes an important factor. Surgeons will not operate on teenagers whose nasal bones have not stopped growing. Girls’ noses generally aren’t considered fully formed until one year after menses (around 15 years old), while boys are usually considered fully grown one year after their last noted growth spurt — around 18 years old.Why should you consider a nose shaping procedure?
According to the American Society of Plastic Surgeons 2018 Plastic Surgery Statistics Report, there were nearly 215,000 nose reshaping (read: rhinoplasty) procedures performed in the U.S. in 2018 alone. As one of the most cosmetic procedures, there are an array of techniques that can be employed to yield a result that address a number of cosmetic concerns in a way that complements the existing facial features. Additionally, injury or trauma may necessitate a procedure in order to restore previous appearance.To better understand the healing and downtime associated with the procedure, check out our complete guide to rhinoplasty recovery.
Surgical Nose Shaping Procedures
With a multitude of techniques available, rhinoplasty is the most common and permanent surgical procedure to refine the shape of the nose.- Open Rhinoplasty
- Overview: The most invasive type of rhinoplasty allows for the best visualization of the internal nasal structures. A small incision is made just below the nose tip and the skin is retracted for amendments to bone and cartilage.
- Cost: $3,000 - $15,000
- Recovery and Results: Recovery begins within one week (when the cast is removed) and continues for up to 18 months for permanent healing. Most all activities can be resumed six weeks post-op.
- Closed Rhinoplasty
- Overview: The permanent procedure utilizes incisions inside the nostrils (resulting in no external scarring) to access bone and cartilage. This restricted access does limit the level of adjustments that can be made.
- Cost: $3,000 - $15,000
- Recovery and Results: Initial recovery within one week with limitations on strenuous activity and sun exposure for up to six weeks.
- Endoscopic Rhinoplasty
- Overview: A closed procedure that employs a lighted camera to visualize the internal nasal structure without an open incision, there is a lack of consensus as to whether this technique can adequately mimic the benefits of a fully open procedure.
- Cost: $3,000 - $15,000
- Recovery and Results: Patients can expect to resume activities within two or three days and be back at work within a week with no external scarring.
- Ethnic Rhinoplasty
- Overview: Used to create a straighter and narrower nose, the procedure can be performed open or closed (depending on the scope of the changes) and usually involves harvesting cartilage from other parts of the body.
- Cost: $3,000 - $15,000
- Recovery and Results: When done as an open procedure, the results usually completely heal in about a year. A cast is used for the first week post op and bruising/numbness resolves within two weeks allowing resumption of most normal activity.
- Rejuvenation Rhinoplasty
- Overview: Performed open or closed, a rejuvenation procedure is typically more superficial (and less invasive) to correct aspects relating to aging (like a drooping tip or excess skin).
- Cost: $3,000 - $15,000
- Recovery and Results: Results are permanent, and the recovery is dependent on technique used. Open rhinoplasties have a longer recovery than closed. Full healing does not occur for about one year, but most activities can be resumed within six weeks.
- Revision Rhinoplasty
- Overview: For patients who have previously undergone a rhinoplasty and are unhappy with the outcome, an open, revision procedure can be performed to correct or enhance the results.
- Cost: $8,000 - $20,000
- Recovery and Results: Swelling and pain typically resolve within two weeks, and the permanent results take about a year to heal.
- Ultrasonic Rhinoplasty
- Overview: Ideal for treating nasal bumps or nasal bridge abnormalities, ultrasonic waves are used to precisely chisel away unwanted bone during an open rhinoplasty procedure.
- Cost: $3,000 - $15,000
- Recovery and Results: Swelling and pain resolve in one to two weeks, full activity within six weeks, and complete healing within one year.
- Youth/Teen Rhinoplasty
- Overview: Performed on patients with nasal deformities under the age of 18 (with parental consent and appropriate physical and mental health), an open closed, or endoscopic procedure can be performed depending on the needs of the patient.
- Cost: $3,000 - $15,000
- Recovery and Results: While further revision later in life, full results typically present within a year.
- Cartilage Grafting
- Overview: As part of an ethnic rhinoplasty or to correct for concerns like saddle nose, cartilage can be surgically harvested from the nose, ear, or rib to place and used in the nose to amend shape.
- Cost: $3,000 - $15,000
- Recovery and Results: Results are immediate and patients can expect to recover within one to two weeks.
Non-Surgical Nose Shaping Procedures
For patients who are not ready for a surgical procedure or are looking for a temporary solution to their nose shape concerns, there are less invasive, non-surgical treatment options available.- Liquid Rhinoplasty
- Overview: Minimally invasive dermal fillers (like Restylane®, Juvederm®, etc.) can be injected around the nose to reduce the appearance of bumps, correct a drooping tip, smooth lines and wrinkles, and more.
- Cost: $1,000 - $2,000
- Recovery and Results: Patients can expect immediate results within about five days, but regular maintenance will be required. Fillers typically last six months to two years.
- Muscle Paralysis Rhinoplasty
- Overview: Botulinum toxin type A injections (think: Botox®, Dysport®, Jeuveau®, and Xeomin®) are used to “freeze” the facial musculature and smooth lines and wrinkles around the nose to soften the shape.
- Cost: $500 - $1,000
- Recovery and Results: Redness and bruising is possible for a few days after the procedure. Results kick in within three to five days and last for three to six months.
Makeup
For a more contoured nose without a trip to the plastic surgeon's office, makeup can be used to create the appearance of a more sculpted face and nose.
The Takeaway
While different populations, different climates, human evolution, and natural selection have led to a great variety of nose shape and nose measurements, there is a similarly wide array of surgical and non-surgical procedures available to create the ideal nose shape. A consultation with a board certified plastic surgeon will help to ensure you select that treatment that is best for you.
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Source List
- Andreas Zanki Growth Charts for Nose Length, Nasal Protrusion, and Philtrum Length from Birth to 97 Years onlinelibrary.wiley.com
- Jack R Harkema The Nose Revisited: A Brief Review of the Comparative Structure, Function, and Toxicologic Pathology of the Nasal Epithelium pubmed.gov
- Stewart, MG, et al. “Development and Validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale.” Otolaryngol Head Neck Surg, vol. 130, no. 2.; 2004-02-01
