By contrast, cosmetic rhinoplasty surgery requires patients to be at least 14 years old or slightly older when dealing with males (as their nasal structure takes longer than girls to become fully matured).  In this way, the results after surgery are less likely to change as the years pass by.

Aside from physical issues, patients younger than 14 are not yet emotionally mature to fully understand the ramifications of cosmetic plastic surgery, which in turn makes them a bad candidate in the first place.

According to a previous study, teenagers have a different view of cosmetic.  While adults see this as a way to stand out from the rest of their peers, younger people seek this to fit into their crowd.

It is safe to say that 16 is already an ideal age to have nose jobs as long as the teenagers are emotionally mature and they have realistic goals and expectations.  As any self-respecting doctor would say, “there is no point of conducting aesthetic surgery if it would not elicit a smile from a patient.”

But as mentioned earlier, reconstructive rhinoplasty does not have an age requirement especially if a patient is experiencing breathing problems and severe deformities. In fact, most doctors will likely address the issues as soon as possible so an individual can live a more normal life.

Either performed for reconstructive or cosmetic reasons, nose surgery is a relatively safe procedure because it does not involve major blood vessels and organs.  However, there are still some risks, although usually minor or at least can be easily treated.

While most teenagers can return to school just a week to 10 days after their nose surgery, some residual swelling and bruising (which can be covered up with make-up) can last for a couple of months.  Also, they can resume most of their daily life’s activities within four to six weeks.

Meanwhile, older patients can also enjoy the benefits of rhinoplasty surgery; but unlike teenagers and young adults, they often seek to regain the youthful appearance of their nose rather than change it dramatically.  This is not surprising since those in their 40s and 50s already have a well-imprinted body image.

The goals of reconstructive plastic surgery are different from cosmetic procedure as it is conducted to make the patients appear as normal as possible and/or improve body functions.

Because reconstructive surgery is deemed as “medically” necessary (to help people live a more normal life), it is often covered health insurance.  By contrast, cosmetic surgery is an elective procedure so a patient has to shoulder all the expenses.

One of the most common procedures in reconstructive plastic surgery is breast reduction that is used to treat macromastia in which the busts become abnormally large (each breast weighs more than 600 grams).  Women with this condition often suffer from chronic back and shoulder pain because of the excess weight, limited physical activities, irritation along the breast crease and cleavage, and poor body posture.

Because patients with macromastia suffer from chronic physical pain and discomfort, some states even require automatic health coverage for those who are “medically” qualified to undergo breast reduction surgery.

But when breast reduction is performed on patients who are asymptomatic (e.g., they do not experience pain and discomfort) but just want to achieve a more symmetrical figure, it is considered a cosmetic and elective procedure, and as a result, it is not covered by health insurance.

Another common example of a procedure that can be used both in reconstructive and cosmetic surgery is rhinoplasty or nose surgery.

Rhinoplasty is the second most popular cosmetic surgery in the US last year, with about 252,000 patients who had the procedure.  However, this is also given to those who are suffering from breathing difficulty, deformities caused by abnormal nasal growth or birth defect, and irregularities due to accidents.

It is possible to perform cosmetic and reconstructive rhinoplasty at the same time.  For example, a person undergoes a procedure to correct his deviated septum (tissue separating the nostrils) so he can breathe more easily and another one to reduce the size of his bulbous nostrils.

In this case, only the reconstructive part of rhinoplasty is covered by health insurance while the procedure that involves reducing a patient’s nostrils is not because its only purpose is to improve the appearance of the nose.

The surgical technique used in rhinoplasty is a case-to-case basis since every patient has unique nasal structure, particular aesthetic problems, and goals and expectations with the surgery.

But regardless of which surgical approach is used, rhinoplasty involves incisions which may be hidden inside the nostrils (called as closed technique) or placed across the columella or the tissue separating the two nostrils (referred as open technique).

For minimal to moderate alterations, plastic surgeons prefer the closed rhinoplasty technique as it involves shorter recovery, almost no risk of visible scarring, and minimal bleeding.  However, this surgical approach may not be ideal in treating patients who need the most correction since doctors may have a limited view.

Nowadays, plastic surgeons prefer using a patient’s own nasal cartilage and bone to change the structure of the nose by filing and reshaping them.  But in case that there is not enough supply of these tissues inside the nose, doctors may graft these from another source such as behind the ear, pelvis, or rib.

The most notable advantage of using a patient’s own nasal bone and cartilage is that there is no risk of allergic reaction which is one of the concerns in introducing synthetic implants such as the silicone plastic.  Another benefit of this approach is the natural result instead of the “operated” nose look.

However, grafting cartilage and bone from another source means additional surgery and scarring.  For this reason, many patients still prefer using synthetic implants such as Medpore, Gore-tex, and silicone plastic which is no longer a popular choice for many doctors due to its high rejection rate and unnatural result.

Nowadays, many plastic surgeons prefer Gore-tex due to its high tissue compatibility and flexibility that can lead to a more natural outcome.  And because this synthetic material has a porous structure, it also permits the tissue to grow inside and become part of the nose.

The characteristics of Gore-tex are almost similar to Medpore, although the latter is relatively firm which makes it harder to mold into the desired shape.

In 2010 alone, 750,000 male cosmetic procedures were conducted in the US, or an increase of 88 percent from 1997.

Dr. Tarick Smaili, a leading cosmetic surgeon in Los Angeles, said the changing attitude of men toward cosmetic surgery is influenced by many factors.

“But in my opinion, looking good is more important than ever especially that appearance, more often than not, has a great impact on people’s self-esteem and confidence—things which can help them succeed in the workplace and climb the corporate ladder,” he said.

Smaili is not the only one who is noticing the change.  According to a recent survey, a third of board-certified plastic surgeons said the number of male patients seeking their expertise is increasing.

“Most male patients I encountered cite that looking young and competitive in the workplace is their primary reason of getting cosmetic plastic surgery.  Perhaps the growing trend can be also attributed to the fact that senior men are more sexually and socially active than the previous decades,” he added.

Over the past couple of years, rhinoplasty or nose surgery has been the most popular male cosmetic surgery that in 2010 alone, about 64,000 procedures were conducted.  While the treatment alone can improve one’s appearance, Smaili said that it is not uncommon for his patients to ask for chin implant surgery to further define their facial features.

“By improving the projection of the chin, the changes can complement the new contour of the nose, thus creating more facial harmony,” Smaili said.

Chin implant surgery is usually performed on men with “weak” chin that makes them look effeminated, just like a recessed jaw does to their face.

Aside from facial plastic surgeries, Smaili has also noticed that liposuction is also particularly appealing on his male patients.

“Liposuction is used to remove the excess fats in the body.  Usually, the target area is the abdomen because the fat bulge or in layman’s term beer-belly makes men conscious with their body,” Smaili said.

But as with any cosmetic surgery, the surgeon warned that liposuction should not be treated as a substitute to weight loss and healthy diet and lifestyle.

The result of this plastic surgery procedure is supposed to last a lifetime, although some patients may need a revision rhinoplasty due to the natural changes in their nasal structure that are beyond the control of doctors, or breathing or aesthetic problems that remain after the initial treatment.

To avoid or at least reduce the chance of revision nose surgery, plastic surgeons make sure that their patients’ nose and facial structure are fully developed before they perform rhinoplasty, unless if there is a severe disfigurement or breathing problem.  With this consideration, patients should be in their middle or late teens before they can have cosmetic rhinoplasty surgery.

Nowadays, there are many plastic surgery techniques to achieve the most natural result possible.  Doctors may use synthetic implants to augment the overall nasal structure, carry out suturing methods to alter the size or shape of nostrils, or perform cartilage grafting in which they reshape or file this tissue inside the nose.

One of the new techniques is called ethnic rhinoplasty which is a broader term for nose surgery performed on non-Caucasian patients.  With this approach, they can improve their appearance without losing their ethnic look which was the main concern during the previous years when the “ideal” nose was pointed and narrow (almost Greek-like).

For patients of Pacific Asian descent (Japanese, Koreans, Chinese, etc.), ethnic rhinoplasty usually involves augmenting the nose particularly the bridge.  This technique is very different from the one commonly performed on Caucasian patients whose usual problem is an excessively prominent bridge or hump in the area.

Plastic surgeons usually augment the nose by using synthetic implants or a patient’s own bone derived from his rib or pelvis.  With this technique, the nostrils are usually narrowed and the tip is also heightened.

In treating African-American patients, plastic surgeons usually rearrange the bones in the bridge to heighten this area, and reshape the cartilage in the tip to correct the downturned appearance.  Doctors ensure that the nose still looks “African” and avoid the very pointed and narrow structure which appears unnatural to these people.

As with any plastic surgery, rhinoplasty involves risk of complications and recovery which means that it is very important to choose a doctor who has board certifications and extensive experience on this particular craft.

There are two ways to perform rhinoplasty: the open technique in which surgeons place an incision across the columella or the strip of tissue separating the two nostrils, or the closed technique in which doctors make small surgical cuts inside the nostrils.

Between these two techniques, most doctors in plastic surgery prefer the closed rhinoplasty because it involves shorter recovery, almost no risk of visible scarring, and lower risk of complications compared to the open incision.  However, this approach may not be ideal for patients who need extensive corrections as it may limit their surgeons.

Regardless of which rhinoplasty technique is used, most plastic surgeons require their female patients to wait until they reach the age of 14 and slightly older for men to make sure that their nasal structure has stopped developing.  However, this age limit may not apply if the surgery is performed as a reconstructive procedure to treat breathing problems, congenital defects, and traumatic injuries.

In most instances, doctors in Los Angeles plastic surgery just reshape, file, or remove some of the nasal cartilage and bone to alter the appearance of the nose without introducing synthetic materials.  But in case that there is not enough supply of such tissues, they may graft these behind the ear or in the pelvis or rib of a patient.

By using a patient’s own cartilage and bone, there is almost no risk of rejection which may happen if plastic surgeons introduce synthetic implants.  However, grafting these tissues from another source entails a separate surgery which means additional risks and scarring.

In case the patients lack nasal cartilage but do not want to have a separate surgery, they may opt for Gore-tex which is said to be the safest synthetic implant used for rhinoplasty.  According to plastic surgery specialists, this material has a porous structure that allows tissue to grow inside and become part of the nose, thus giving a natural look.

The Gore-tex also has a high rate of tissue compatibility which makes it safe to a significant number of patients.

If performed for cosmetic reasons, rhinoplasty plastic surgery aims to remove the humps and other asymmetrical features, reduce or increase the size of the overall structure, narrow the flared nostrils, correct the downturned tip, and treat aesthetic problems in order to create harmony in the face.

Before the procedure is conducted, plastic surgeons examine the physical health, overall nasal structure, and expectations of their patients to ensure if these are realistic and attainable.

As with any major plastic surgery, rhinoplasty carries certain risks such as infection, adverse reaction to the anesthesia, excessive bleeding, delayed healing, and asymmetrical appearance.  For these reasons, the procedure should only be conducted by board-certified plastic surgeons to the right candidate.

The right candidate is defined as: patients who are physically fit with no major health issues that may delay healing; well-rounded individuals with realistic goals and expectations; people with a noticeable aesthetic problem in their nose.

Nowadays, most doctors perform rhinoplasty by simply rearranging, reshaping, or filing the bones and cartilage inside the nose to improve its appearance.  This process may be done through incisions made inside the nostrils which means no visible scarring, or a vertical cut across the tissue that separates the two nostrils.

In case that there is not enough nasal cartilage and bone, many plastic surgery specialists would prefer to graft these from a patient’s own ear (without affecting its function and appearance), rib, or pelvis instead of introducing a synthetic implant which has a risk of rejection and adverse reaction.

However, cartilage and bone grafting requires a separate surgery which means more risk of scarring.  With this consideration, some patients would rather have synthetic implants for their rhinoplasty.

Today, many plastic surgeons stay away from silicone plastic especially if they will reshape the nasal tip.  This is because the synthetic material is criticized for giving an “operated nose look” and has a higher rejection rate.

Fortunately, there are some implants which have a high tissue compatibility rate which makes them relatively safe.  For example, Gore-tex is probably the most commonly used material in rhinoplasty since the rejection rate is only 1.9 percent and it usually provides a very natural look.

Gore-tex is a porous material that allows tissue to grow inside and become part of the nose’s structure.

But as with any cosmetic surgery, rhinoplasty is associated with certain risks and complications.  For this reason, doctors in LA plastic surgery conduct screening tests, interviews, and other pre-operative procedures in order to determine a person’s candidacy with nose-reshaping surgery.

• Medical history.  Plastic surgeons ask the medical conditions, previous surgeries, and current medications of their patients to determine if they are the right candidates and give them certain pre- and post-operative instructions that will help them avoid the risks and complications associated with any surgery.

• Physical examination.  In this procedure, doctors will examine the overall nasal structure that will allow them to decide on the most appropriate techniques they have to perform to achieve a desirable result.  Meanwhile, it is important to note that the physical features of the nose such as thickness of the skin and amount of cartilage and bone may affect the result.

• Discuss the expectations and goals of a patient.  According to doctors in plastic surgery, it is very important for patients to have realistic goals and expectations which may affect their satisfaction after the procedure.  For this reason, surgeons believe that rhinoplasty is only ideal for well-rounded individuals who can fully understand the limitations of this treatment.

• Avoid certain medications and herbal supplements.  Two weeks before the surgery, patients should avoid drugs containing aspirin, ibuprofen, and those which are categorized as “blood thinners.”  Plastic surgeons said that these medications have been found to increase bleeding which may lead to delayed healing, infection, and other serious complications.

• Quit smoking.  The nicotine has been found to prevent the wound from properly absorbing the oxygen, which is an important element in the healing process.  For this reason, smokers take longer time to heal compared to non-smokers, and as a result, they are very prone to skin necrosis (death of skin tissue) which may lead to unnecessary scarring, infection, and other serious complications.

• Assign a companion during the most crucial time of recovery.  According to doctors in cosmetic plastic surgery, patients should have a companion who will help them while they are still recovering, especially during the first few days after the rhinoplasty procedure.

While many patients can enjoy the result of this plastic surgery procedure for a lifetime, about 5 to 12 percent of them may undergo a revision or secondary rhinoplasty due to several reasons such as unsatisfying result, natural changes in the nasal structure that are beyond the control of plastic surgeons, and certain complications such as breathing problems and asymmetrical appearance.

Patients should remember that revision rhinoplasty is usually more expensive and complex compared to the initial procedure since the cartilage and bones have already been reshaped while the tissue and skin already have some scarring which made them thicker and harder to work with.

Another consideration is that secondary plastic surgery in the nose involves more risks; for this reason, a person should really take time to choose a board-certified doctor who has an extensive experience in conducting this particular procedure and has a good record of satisfied patients.

For anyone considering this procedure, most plastic surgeons require to wait at least a year after the initial nose surgery so the swelling and bruising have completely subsided.  In this way, a person can also be sure that the aesthetic problem is not caused by such symptoms.

Because every patient needs a different correction, there are several rhinoplasty techniques nowadays such as bone and cartilage grafting, suturing procedures, dermal fat removal, and introduction of biocompatible implants.  However, most plastic surgeons prefer reshaping or filing the nasal cartilage and bones in order to change the structure; in this way, there is no risk of rejection because no synthetic implant is introduced.

But in case that there is not enough supply of nasal bones and cartilage, these can be grafted from the rib, pelvis, or behind the ear which is the most popular choice for majority of plastic surgery specialists.

However, this approach always requires a separate surgery aside from the rhinoplasty itself in order to collect bones or cartilage.  For this reason, some patients would rather choose to use implants to change the structure of their nose.

To date, most doctors recommend Gore-tex which is said to be one of the safest nasal implants due to its ability to allow tissues to grow inside its structure and become part of the nose.

As with any plastic surgery, rhinoplasty involves certain risks and recovery.  For such reasons, patients are required to meet several requirements before they are considered as a good candidate for this procedure.

If the surgery is performed for cosmetic reasons, most plastic surgeons require their patients to be at least 14 years old or slightly older for males.  In this way, the nasal development has already stopped and may not affect the result of the procedure, thus reducing the chance of having a revision plastic surgery in the future.  However, this age limit may not apply if rhinoplasty is used to treat injuries, birth defects, and breathing difficulty.

Another important requirement for patients seeking cosmetic rhinoplasty is to be emotionally and psychologically stable.  In this way, they can set realistic expectations and goals that usually result to higher satisfaction rate.

Meanwhile, patients with mental disorder (manic depression, schizophrenia, etc.) and individuals who are experiencing emotional crisis are generally considered as a bad candidate for cosmetic rhinoplasty which are only ideal for well-rounded individuals.

Because nasal cocaine users usually have perforations in their nasal tissue and septum (the wall separating the two nostrils), most doctors consider them as a high-risk patient.  For this reason, they may not be allowed to have rhinoplasty especially if this is performed for aesthetic reason.

But in some instances, they may be allowed to have the procedure, although this should be always combined with septal perforation repair to fix the “holes.”  Plastic surgeons usually perform this additional surgery through the use of silicone button or flap of mucosal tissue.

According to plastic surgeons, patients with too many previous rhinoplasty are also not a good candidate for this procedure because they have significant scarring and thicker skin and tissue which are harder to work with.  In fact, revision nose-surgery is more complex, involves higher risk of complications, and more expensive compared to the initial procedure.

In a recent study, about 15 percent of rhinoplasty patients will need a revision surgery at some point in their lives.