Facial Rejuvenation and Rhinoplasty
6 October 2021 onur
Is it possible to perform rhinoplasty on an aging face?
What are the differences compared to the younger age group?
Are there additional risks?
The majority of our rhinoplasty candidate patients are individuals under the age of 25. However, we also perform these procedures in middle-aged patients and aging patients. Let me give the answer from the beginning: Age alone is not an obstacle to rhinoplasty.
However, rhinoplasty is an operation that has its own nuances not only in different age groups, but also in different facial structures, different nose structures and different races.
Interestingly, studies on individuals over the age of 50 who have undergone rhinoplasty have shown that although rhinoplasty is not actually a rejuvenation procedure, these patients are perceived to be 5 to 6 years younger. The reason for this is that large and particularly thick-skinned noses are a feature that older people share more often.
The usual scenario goes as follows:
The patient has already been dissatisfied with their nose since they were in their 20s and has always wanted to have it done. But that’s life – Years pass with daily concerns such as school, work and children. In some cases, rhinoplasty candidates may have to postpone surgery for many years due to financial difficulties. I have often met young lawyers and young physicians who took their mothers to me for surgery.
Whether the rhinoplasty candidate is 20 years old or 50 years old, the excitement of surgery is the same.
However, we cannot say the same for the reaction of kith and kin.
As you know, we are a society having difficulty in adjusting and maintaining personal distance.
While young girls often come with familial support, there are definitely some people among the relatives of middle-aged patients who say, “You have lived with this nose until this age. Why do you need to change it now?” A kind of peer pressure…
However, I emphasize once again that age alone is not an obstacle to rhinoplasty.
Now let’s review the special cases in the advanced age group.
In middle-aged patients, the skin becomes a little thinner and looser. If the nasal bone skeleton shrinks in patients over the age of 40, it may not be possible for this skin to shrink enough to adapt to the underlying skeleton. That’s why you shouldn’t aim for very small noses.
Another issue is about the aging of the nose. As people age, the nasal wings rise and the nasal tip drops. The natural suspension system of nasal connective tissue relaxes. Therefore, it would be risky to base nasal support on these connective tissues in middle-aged and older patients. Therefore, I always prefer structural rhinoplasty in the middle-aged and older patient group. The nose becomes rigid, but the nasal tip does not droop again during the aging process. Furthermore, in older patients, we almost always use alar rim grafts that support the wings.
In the middle-aged group, particularly in patients with a very high nasal bridge, it is necessary to avoid lowering the bridge excessively. The bridge keeps the skin taut like the pole of a tent. If you lower this arch aggressively, the nasal skin may extend to the cheeks and upper eyelids.
Thus, it is very important to design the nose in the middle-aged and older patient group by considering the special conditions I have mentioned above.
Another point that occupies the minds of candidate patients is whether there would be an age-related prolongation of the recovery process after rhinoplasty. As a general rule, it does not get longer. However, since the skin is loose, microhemorrhages in the tissue can travel slightly longer distances. We see postoperative bruises a little more frequently in middle-aged patients.
Finally, I would like to emphasize the importance of evaluating rhinoplasty in the advanced age group together with other aesthetic problems. For example, if there is a very obvious age-related eyelid deformity, a very pronounced undereye deformity or advanced facial aging, it may be more reasonable to prioritize rejuvenation surgery. After all, people undergo all plastic surgery procedures to look good and be happy. It is our duty to inform you if there is a result that you can be happier with when you spend the same amount of money and time for another procedure.
Albeit rarely, I ask my patients who come to me for rhinoplasty this question: “Wouldn’t you consider starting your aesthetic treatment with facial rejuvenation surgery?”
Please feel free to contact us for more detailed information on rhinoplasty in the facial aging process.
Take good care…
… of yourself and your beauty.