The Skinny
The size of the nose plays a big role in the overall proportion of the face, and noses that appear too large or too small and nostrils that are wide, narrow, or asymmetrical may lead to aesthetic concerns (learn more in our complete guide to Nose Size Concerns). Fortunately, there are a number of surgical and non-surgical procedures that can augment or reduce the size of the nose and/or nostrils.
Rhinoplasty (a.k.a. nose job) is the most common solution to adjust the size of the nose, and, according to the American Society of Plastic Surgeons (ASPS) 2018 Plastic Surgery Statistics Report, it was one of the most common cosmetic surgery procedures performed in the United States. Additionally, an alarplasty can be done alone or in conjunction with a rhinoplasty procedure to correct the size of the nostrils. Both procedures are performed on an out-patient basis by a board certified plastic surgeon and, depending on the technique, come with different levels of permanence, invasiveness, and recovery.
The Specifics
Who needs to augment or reduce the size of their nose
Invasive and non-invasive nose augmentation or nose reduction procedures are ideal options for patients who wish to change the structure of the nose as a way to enhance or balance out their other facial features for cosmetic reasons. It has also been shown that rhinoplasty surgeries lead to increased confidence and decreases in anxiety, depression, and obsessive compulsive disorder.The Anatomy of the Nose
Common concerns related to nose size include large and small nasal areas and nostrils (read our full guide to nose size concerns). While noses generally average 2 to 2.2 inches long in women and men respectively, there is not a standardized medical measurement for the length or overall area of the nose. Additionally, the angle between the lips and nose should be between 95 and 105 degrees in women and 90 to 95 degrees in men. The angle between the tip of the nose and the base of the forehead, meanwhile, should be between 115 and 125 degrees.
- Small Nose: Individuals who feel their nose is too petite for the overall proportion of their face may seek out augmentation procedures to provide balance.
- Large Nose: "Big" or wide noses can be hereditary, the result of aging, or caused by trauma. In addition to becoming crooked or developing bumps (as outlined on our guide to Nose Shape Concerns), broken noses often end up larger than before.
The size of the nose may also be impacted by the size of the nostrils. Nostrils that are too large, too small, or asymmetrical can impact both the appearance and, in some cases, function of the nose.
What can you expect from nose augmentation and reduction procedures?
Expectations of results and recovery should be geared toward the specific procedure being considered. While minimally invasive, non-surgical rhinoplasties have hardly any downtime and temporary results, a surgical rhinoplasty might take up to a year to fully heal but the results are permanent. To better understand the healing and downtime associated with the procedure, check out our complete guide to rhinoplasty recovery.There are two main categories of surgical rhinoplasties — open and closed — that differ in their techniques and scope.
- Open Rhinoplasty: The more invasive option involves opening the nose in a broad way to give the surgeon the most access to the nasal area by making an incision between the nostrils. The flaps of nasal skin are then lifted up and off the nose to expose the cartilage and nasal bone during surgery.
- Closed Rhinoplasty: A closed rhinoplasty, meanwhile, involves making invasions on the inside of the nose as the nasal bone, cartilage, or septum is operated on. While there is often less swelling and downtime associated with the technique, there are also limitations to how much can be done — especially as it relates to the nasal skin and tip.
Regardless of which technique a patient chooses, recovery is also impacted by general anesthesia versus local anesthesia. In more invasive procedures an external splint is used for the first week and then removed. Patients can also expect bruising and numbness with a few weeks of downtime and limitations on strenuous activities. In non-surgical rhinoplasty, patients will likely be able to resume activity on the same day.
When should you consider a nose augmentation or reduction procedure?
A candidate should seek consultation with a certified plastic surgeon once they have determined they are ready to proceed with creating their ideal appearance. Good candidates should consider overall health, side effects, and downtime and recovery time as possible mitigating factors.For patients under the age of 18 who are interested in a rhinoplasty procedure, surgery should not be performed until the face has finished developing. Girls’ noses generally aren’t considered fully formed until one year after menses (around 15 years old), while boys are usually considered fully grown one year after their last noted growth spurt (around 18 years old).
Why should you consider nose augmentation or reduction?
As with any cosmetic procedure, the choice to pursue available options is a personal one. If the size of the nose, as a result of genetics or trauma (think: a broken nose), is interfering with a patient's self confidence, it may be time to consider meeting with a board certified plastic surgeon to discuss possible treatment options to refine the appearance of the nose.Surgical Nose Augmentation & Reduction Procedures
We all know about the so-called ‘nose job.’ Turns out, there are a number of different rhinoplasty techniques depending on the state of the nose and aesthetic goals of the patient.- Open Rhinoplasty
- Overview: External incisions ensure surgeons have the best access to the nasal structure — including nasal bones and cartilage — to correct concerns relating to tip reshaping, straightening a deviated nasal bridge or nasal septum, removing a dorsal hump, or other nasal size repairs.
- Cost: $3,000 - $15,000
- Recovery & Results: The permanent results continue to heal for up to 18 months after surgery, but most activities can be resumed within six weeks.
- Closed Rhinoplasty
- Overview: Internal incisions made through the nostrils are used to access nasal structure and correct concerns that require less cartilage grafting and work on the nasal tip. Instead it services the upper portions of the nose — including the nasal dorsum or septum.
- Cost: $3,000 - $15,000
- Recovery & Results: Like an open rhinoplasty, the results are permanent but may take less time to heal.
- Endoscopic Rhinoplasty
- Overview: The closed procedure employs a lighted camera to visualize the internal nasal structure without an open incision.
- Cost: $3,000 - $15,000
- Recovery & Results: Permanent results are attained with significantly reduced recovery time given the less invasive approach, but there is some question as to whether this technique can adequately mimic the benefits of other procedures.
- Ethnic Rhinoplasty
- Overview: Performed as an open or closed procedure, cartilage harvesting from the ribs or ear is usually involved to help with refining the width, height, or projection of the nose.
- Cost: $3,000 - $15,000
- Recovery & Results: Like any open or closed rhinoplasty, the results are permanent and heal in about a year.
- Rejuvenation Rhinoplasty
- Overview: Ideal for patients who are dealing with visible signs of aging like widening or sagging noses, the less invasive procedure can rejuvenate the nasal area.
- Cost: $3,000 - $15,000
- Recovery & Results: While the invasiveness and subsequent recovery is dependent on the technique used by the surgeon, the results are permanent.
- Revision Rhinoplasty
- Overview: Typically performed as an open rhinoplasty, the procedure is used to correct the results of previous operations.
- Cost: $8,000 - $20,000
- Recovery & Results: The permanent results allow patients to return to normal activities within six weeks, but healing can take up to 18 months.
- Ultrasonic Rhinoplasty
- Overview: Ideal for treating nasal bumps or nasal bridge abnormalities, ultrasonic waves are used to precisely chisel away unwanted bone during an open rhinoplasty procedure.
- Cost: $3,000 - $15,000
- Recovery & Results: Swelling and pain resolve in one to two weeks, with full activity resumed within six weeks, and complete healing in about one year.
- Youth/Teen Rhinoplasty
- Overview: Performed in patients under the age of 18 with parental consent, the procedure can be an open, closed, or endoscopic rhinoplasty.
- Cost: $3,000 - $15,000
- Recovery & Results: Recovery time varies depending on the approach and may require further revision as patients mature.
- Alarplasty
- Overview: To correct concerns related to nostril size, the surgery removes a small, wedge-shaped piece of skin to create more symmetrical nostrils. The procedure can be performed alone or in conjunction with a rhinoplasty.
- Cost: $6,000 - $7,000
- Recovery & Results: After the initial swelling, full recovery is generally seen within four weeks.
Non-Surgical Nose Augmentation & Reduction Procedures
Less invasive but also less permanent, dermal fillers, neurotoxins, and even makeup can be used to refine an angular or crooked nose.- Liquid Rhinoplasty
- Overview: Dermal fillers (like Restylane® and Juvederm®) are strategically injected around the nose to alter the size, shape, and volume.
- Cost: $500 to $2,000
- Recovery & Results: Results last six months to a year and are immediate. Activity can generally be resumed the same day (6).
- Muscle Paralysis Rhinoplasty
- Overview: Botulinum toxin type A injections (think: Botox®, Dysport®, Jeuveau®, and Xeomin®) are used to temporarily freeze the facial musculature and smooth lines and wrinkles around the nose to soften the shape.
- Cost: $500 to $1,000
- Recovery & Results: Redness and bruising is possible for a few days after the procedure. Results kick in within three to five days and last for three to six months.
- Makeup**
- For a more contoured nose shape and size without a trip to the plastic surgeon's office, makeup can be used to create the appearance of a more sculpted face and nose.
The Takeaway
You can’t control your genetics or turn back the hands of time. But, with continuing advances in modern cosmetic dermatology and plastic surgery, there are corrective procedures that, when performed by a board certified plastic surgeon, can create your ideal nose.
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Source List
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- Goin, MK, and TD Rees. “A Prospective Study of Patients’ Psychological Reactions to Rhinoplasty.” Annals of Plastic Surgery, vol. 27, no. 3.; 1991-09-02
- Rohrich, R, Afrooz, P. “Primary Open Rhinoplasty”. Plastic and Reconstructive Surgery; 2019-07-01
- Tebbets, JB. “Open and Closed Rhinoplasty (Minus the “Versus”): Analyzing the Process”. Aesthet Surg J; 2006-07-03
- Dennis, SCR, den Herder, C, Shandilya, M, Noist Trenite, GJ. “Open Rhinoplasty in Children”. Facial Plast Surg.; 2007-11-01
- Johnson, ON, Kontis, TC. “Nonsurgical Rhinoplasty”. Facial Plast Surg. ; 2016-10-03
