(Excerpted from Dr. Peter Adamson’s book Fabulous Faces (available on Amazon.com) and edited for our blog.)

Rhinoplasty is like painting or sculpting in a patient’s tissues. The last day I do one—and I will have done thousands of them— I know that it will still be a challenge, and I’ll still be trying to do things better.

If you’ve decided to have rhinoplasty, you’ll want to know what will happen and how you’ll feel before and after. You’ll also want tips on what to do and what to avoid as you prepare for and recover from your big journey. Allow me to introduce you to Brad, one of my Toronto rhinoplasty patients who provided detailed accounts of their experiences—before, during, and after surgery.

Brad, a young computer programmer, says that he’d had a good nose until puberty and then it became crooked. That’s typical. Often people say that a bump grew in their teens and they feel it was due to an accident. They must have broken it. It’s usually just congenital. It’s the nature of the nose.

People in Toronto who consult me about their noses are usually specific about the problem. They don’t like the bump or the droopy tip or the length. They usually say that they want it smaller. Not Brad. Brad was even more specific: He wanted his nose reduced by 10 percent. Here is Brad’s story. In his own words, it’s “an almost perfectly normal boy’s journal.”

Chapter 1
Big and Crooked
“Hey! What the heck. My nose doesn’t look straight. Let’s see. No. No. It definitely has a curve in it. Hmm. It can’t be that noticeable, though. I mean, I just saw it now.”
I’m sixteen years old, looking in the mirror and seeing that my teenage growth spurt isn’t exactly treating me very fairly. Isn’t it bad enough that I’m skinny as a rail and have just started on tetracycline for my acne? Now I have to contend with a nose that’s clearly getting too big—and crooked. Great! Just fantastic! But still, I’m resilient. I have a good group of friends. I’m smart and funny, and I know very well that, physically speaking, nobody’s perfect. Besides, I’m still a growing teenager. Eventually I’ll become a good-looking adult. Right? Wrong!

At school, a classmate turns to me and says, “What happened to your nose? It’s all…” [he grabs his own nose and pretends to twist it out of shape while making a groaning noise]. I quickly came up with a lie. I tell him I broke it when I was younger and can’t get it fixed until I stop growing. He buys the lie and never mentions my nose again. But the thing is, I buy it too. I realize that the flaws in my face (which I’d barely noticed in the past) are more obvious than I thought— and are perhaps even becoming worse. I tell myself that someday I’ll be getting these flaws corrected. There’s no way I’m going to have to deal with this for the rest of my life.