I would like to address the issues surrounding one such procedure, adolescent rhinoplasty. It is an area I have studied and written about for many years, as well as performing thousands of these procedures.
First, some comments about human growth and development. We all know young girls are becoming young women earlier than in the past – the age of menarche, or the first period, has fallen about one year over the past century, and is now averaging about age 12.5 for Caucasian girls and age 12 in African-American females, and usually two or three years later in males. Associated with this growth is an increasing interest by both girls and boys in the opposite sex, and a much-heightened awareness of their body and perceived attractiveness to others. Every normal human being wants to have an outer appearance that reflects her inner spirit and sense of self. We all wish to have others want to know us and like us. Our feelings about ourselves are unique and special to each of us in our own way and will persist regardless of what others might think or say.
If a young girl or boy dislikes their nose as a teen, they will dislike it all their life. Certainly rhinoplasty is never mandatory, but when performed it will decrease the teen’s anxiety about their appearance, increase their sense of self-esteem and confidence, and improve their quality of life. We have good studies which prove this.
Besides the teen being healthy, there are two major considerations as to whether and when to proceed with adolescent rhinoplasty. The first is that physical growth, and by extension, nasal growth, is complete. This usually occurs within one year after menarche and is reflected in little or no growth in height in the previous year.
The second major consideration is the teen’s psychological and emotional maturity. For the teen who has always been concerned about their nose, who has realistic expectations of the aesthetic result and how it will positively affect their life, the procedure is highly likely to be successful. Obviously, parental support and involvement in the decision-making is required in any patient who is under the age of majority. This could be as young as 13 or 14 for a girl, although rhinoplasty is more commonly done after age 15 or 16, and age 16 or 17 for boys. Particularly for boys, but also true for some girls, if they are still engaged in competitive sports or activities where they have a high risk of injuring their nose, it is best to delay rhinoplasty until these activities have been put aside. Also, boys may grow for a longer period of time and rhinoplasty should be deferred until their growth is complete.
In our experience, adolescents are often the very best patients for rhinoplasty, with an easy and early acceptance of their new, improved nose, and long-term satisfaction with their decision.