Last week I had been to the Bhau Daji Lad Museum in Mumbai (Erstwhile Victoria and Albert Museum), where a statue of a noseless, decapitated (and probably rejoined) statue caught my eye, sitting on a beautiful throne with her flowing gown with all her regalia! Oh! what a shame -I thought. How could an otherwise impeccable statue lose its entire charm because of an absent nose. The same night I saw the trailer of the Michael Jackson movie with my father. He detests MJ’s face. Rather MJ has become the poster-child for rhinoplasties gone bad and in general- at least in my family- to discourage anyone for nasal surgeries.
Oh, the irony in my own family! This is my humble attempt to educate, dispel some myths and possibly guide one’s journey to rhinoplasty!
Rhinoplasty, commonly known as a nose job, is one of the most discussed and misunderstood cosmetic procedures today. Social media, celebrity images, and quick online videos have created both curiosity and confusion. Some people believe rhinoplasty can completely change their face or life, while others fear it is unsafe or purely cosmetic. The truth lies somewhere in between. Rhinoplasty is a powerful surgical tool when used correctly, for the right reasons, and with realistic expectations. It can improve appearance, breathing, or both, but it has clear limitations. Understanding what rhinoplasty can and cannot do is essential before considering any form of treatment, whether surgical or non-surgical.
Rhinoplasty can improve the shape, balance, and proportion of the nose in relation to the rest of the face. This is called cosmetic rhinoplasty. It can reduce a hump on the bridge, refine a broad or bulbous tip, straighten a crooked nose, or adjust nostril size. Modern techniques allow these changes to be subtle and natural rather than dramatic. Closed rhinoplasty, where all incisions are inside the nose, is often used when moderate reshaping is required and avoids visible scars. Preservation rhinoplasty focuses on maintaining existing nasal structures rather than removing them aggressively, helping retain natural dorsal lines. In recent years, ultrasonic rhinoplasty has improved precision. Using a piezo ultrasonic device, surgeons can reshape nasal bones accurately while protecting surrounding soft tissues, leading to less swelling and bruising. When done well, cosmetic rhinoplasty does not draw attention to the nose but instead improves overall facial harmony.
Rhinoplasty can also improve nasal function, which is often overlooked by patients. Functional rhinoplasty focuses on breathing rather than appearance, though both are often addressed together. Many people suffer from nasal blockage due to a deviated septum, weak nasal valves, or previous trauma. Septoplasty, which straightens the nasal septum, is commonly combined with functional rhinoplasty to improve airflow. This type of surgery can reduce mouth breathing, improve sleep quality, and relieve long-standing nasal obstruction. Functional correction is especially important in revision rhinoplasty, where previous surgery may have weakened the internal support of the nose. Ethnic rhinoplasty deserves special mention here. It is not about changing ethnic features but about respecting them while improving structure and function. Each nose has unique skin thickness, cartilage strength, and shape, and modern rhinoplasty aims to work with these differences rather than erase them.
Non-surgical rhinoplasty, also known as liquid rhinoplasty, has become popular because it does not involve surgery. It uses injectable fillers to temporarily change the shape of the nose. It can smooth a small hump, lift a drooping tip, or improve symmetry. Results are immediate, and there is little to no downtime. However, non-surgical rhinoplasty has clear limits. It cannot make a large nose smaller, correct breathing problems, narrow the nostrils, or fix a deviated septum. It only adds volume and cannot remove bone or cartilage. The results are temporary and usually last one to one and a half years. While liquid rhinoplasty can be useful for selected patients, it is not a replacement for surgical rhinoplasty and must be performed carefully due to the risks associated with nasal fillers.
Just as important as knowing what rhinoplasty can do is understanding what it cannot do. Rhinoplasty cannot give perfect symmetry because no human face is perfectly symmetrical. It cannot make you look like someone else or guarantee happiness or confidence. It cannot override the limits of your skin thickness, cartilage strength, or healing response. Even the best surgery is influenced by how your body heals. Revision rhinoplasty, while effective, is more complex and cannot always restore the nose to an ideal state. Rhinoplasty also does not stop aging; the nose continues to change slowly over time. Unrealistic expectations are the most common cause of dissatisfaction after a nose job, not poor surgical technique. A good outcome depends on honest discussion, proper planning, and choosing the right option—cosmetic rhinoplasty, functional rhinoplasty, non-surgical rhinoplasty, or sometimes no procedure at all.
In summary, rhinoplasty is neither magic nor minor. It is a precise medical procedure that can improve appearance, breathing, or both when chosen wisely. Today’s options include closed rhinoplasty, preservation rhinoplasty, ultrasonic rhinoplasty using a piezo ultrasonic device, ethnic rhinoplasty, functional rhinoplasty with septoplasty, revision rhinoplasty, and non-surgical liquid rhinoplasty. Each has clear benefits and clear limitations. The goal of modern rhinoplasty is not perfection but balance, safety, and long-term stability. For anyone considering a nose job, the most important step is education. Understanding what rhinoplasty can and cannot do helps replace fear and fantasy with informed, realistic expectations—and that is where truly satisfying results begin.
I hope this helps me educate my family and yours!
Dr Girish N. Mirajkar
Assistant Professor,
Topiwala National Medical College and BYL Nair Charitable Hospital,
Mumbai
Disclaimer : The opinions here are personal views of the authors. IAAPS is not responsible. All members may not have the same scientific view point
