In my practice it is common for both adolescent young men and women to be unhappy with the size and shape of their noses. Teenagers express many of the same complaints that I hear from
adults. The nasal tip is too big, there is a prominent dorsal hump, and they have been unhappy for quite some time.
A complaint shared by adolescents that I do not hear from adults is in relation to bullying at school. A recent article posted by ABC News addresses the peer pressure, name calling, bullying and everything else in between can dramatically impact the way a teenager grows into an adult. Historically I think we used to overlook how difficult it can be to successfully progress through high school. In the last two years a number of high profile adolescent suicides have shed light onto burdens suffered from being bullied.
As a physician my primary responsibility is to do no harm. Nasal reshaping procedures are not recommended until a person has reached adult size. Generally speaking, most surgeons recommend waiting until the patient is 15 before they perform an elective nasal procedure. The fear of performing surgery at an earlier age is that a disruption of growth centers will cause the nose to stop growing. This could lead to a disastrous scenario of a 10 year-old’s nose on an adult sized face. A secondary concern is that adolescents may not have the maturity to make life-lasting decisions.
The patients age can help determine if they have reached adult size. But a better estimation can be inferred from their shoe size. If the patient’s feet have stopped growing, their pants are still fitting, even if the they are only 13 years-old, they have reached adult size. If their concerns are reasonable and if their parents consent, in my opinion rhinoplasty can safely and ethically be performed at this age.
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