Rhinoplasty (nose job) is one of the most commonly performed plastic surgery operations in young individuals under the age of 18. But just like your mom says , everyone else getting it doesn't make it the right choice for you. So what are the factors determining whether a young person under 18 is an eligible candidate for rhinoplasty?

Growth Factors

The key reason why plastic surgeries are rarely performed in pre-adult age groups is that the body is still developing physically during these years. Planning of premature plastic surgery may predict poor long-term results. For instance, we never place breast implants on a young girl whose breast development has not been completed yet.

However, the situation is slightly different in rhinoplasty because the nose reaches full maturity years before the rest of the body. Typically around the age of 15 or 16, the nose reaches a significant percentage of its size in adulthood. The exact age will vary depending on multiple factors, but an experienced rhinoplasty specialist should be able to give you a definitive answer during consultation.

When rhinoplasty is performed during the growth phase, it can stop the growth of the nose. Growth arrest is a major problem particularly in male patients. Accordingly, the development of facial bones in men continues actively until the age of 24-25 under the effect of testosterones. While the nose of a male patient at age 15 is normal in size for his face as of that age, it may be smaller in proportion to the face in the picture that comes up when the other bones of the face have grown but the nose has not grown at age 25. Small noses create a feminine expression and are not much preferred by men. Therefore, in male patients under the age of 18, surgery may be an option only if the nose is too large in terms of volume, even for an average adult male face. The common feature for all young male patients aged 15-16, whom we operated under the consent of their parents, was that they already had very large noses.

The situation is a little different for girls under the age of 18, because even if the nose development stops due to surgery and they have a small nose in the future, a “small nose” is a feature that many women dream of and desire. We want the development of the nose to hit the mark in girls as well, but the limits are a little more flexible than those in boys.

Permanence of Surgical Results

Although it is accepted that nose development generally stops after rhinoplasty, such an arrest does not occur in every individual and in every surgical technique in a similar and symmetrical way. For instance, nasal bones may continue to grow after surgeries that only interfere with nasal cartilage. A 15-year-old patient whose nasal tip cartilage was thinned by tip rhinoplasty (nasal tip surgery) may come back at the age of 20 and say, “After the operation, an arch developed on my nose, but I did not have such a problem before the operation”. What happens here is simply that the parts of the nose that are not tampered with during surgery continue to grow naturally. Sometimes after the surgery, one of the nasal bones may grow a little more than the other, and this may lead to irregularities on the nasal ridge as well as deviation in the nose. Briefly, after surgical operations performed at an early age, the nose may not “remain as it was done”. In order to prevent this, when operating adolescent patients, I prefer total roof dissections in which all growth centers are treated equally, rather than limited dissections. By the way, “dissection” means the surgical separation of tissues from each other.

 

 

Impact on Sports / Academic Success

Respiratory problems due to a nasal trauma may affect individuals engaged in sports/activities that require high performance at a young age. In cases where functional problems in the nose affect sleep quality, school success, daily concentration, sports performance, or where they trigger septum-induced headaches or recurrent sinusitis episodes, rhinoplasty may become a medical necessity rather than an arbitrary aesthetic procedure. In such cases, surgery is possible at earlier ages.

Traumatic Deformities

Deformities caused by a serious accident and trauma may need to be treated at an early age. Some deviations in the nose will not improve as age progresses, and on the contrary, they will make the patient's life increasingly difficult. In such cases, as there is no use in waiting, the required medical intervention can be performed at an earlier age.

Emotional Maturity

Besides physical maturity, there is also the question of emotional maturity to consider. Rhinoplasty is a permanent change in the physical appearance of a young individual. After the operation, it is not possible to say, “I'm bored with this model. I'll switch to another.” An emotionally-mature adolescent who knows what they are doing can accept permanent changes in their body in an adult-like manner.

My advice for parents is that they make sure their child has realistic expectations about rhinoplasty and is also physically and emotionally stable. Although rhinoplasty can have a positive effect on the adolescent's body image, the new nose will not improve, for example, a bad emotional relationship.

Particularly in a high school environment, young individuals may be exposed to cruel criticism and cynical attitudes by their friends. It is imperative that young individuals to undergo rhinoplasty are able to receive negative or positive feedback from their social environment maturely and have reached a level of maturity to construct their self-concept independently from the opinions of other individuals.