Armando Boccieri - Gobba Nasale
THE RIGHT AGE FOR RHINOPLASTY
THE RIGHT AGE FOR RHINOPLASTY

Rhinoplasty is generally performed after the age of 18, primarily as it is preferable to wait until the growing phase is completed so that the result of nasal reshaping will remain stable and not deteriorate over time. There are also legal reasons, as an operation on a minor requires the signed and fully informed consent not only of the patient but also of the parents.

There can in any case be exceptions to this general rule when a minor suffers from impaired respiration and/or aesthetic nasal deformity of such severity that delay in correction would cause considerable functional and psychological damage. In these cases, if the surgeon is to take decisions with complete tranquility and safety, it is essential for open and sincere dialogue to be established with the patient and his or her family so that the reasons for the operation are fully clear to all those involved.

At the other end of the time scale, rhinoplasty can be performed on mature patients for functional and reconstructive or aesthetic reasons. Functional disorders with aesthetic implications neglected for many years due to various problems and fear are sometimes addressed with the necessary determination only much later in life, whereupon the wholly unexpected improvement in quality of life at the price of slight discomfort often makes the patient regret not having the operation long before. Rhinoplasty performed for purely aesthetic reasons on mature patients can also have valid justification, as the rejuvenating effect often obtained can give patients the necessary stimulus to improve or expand their interpersonal relations in this later phase of their lives.

 

 
RHINOPLASTY WITH PARENTAL APPROVAL

This 18-year-old patient had begun asking her parents some years earlier for an operation to correct an overly protruding nose with a hump in profile.
The rhinoplasty performed fully lived up to the young patient’s expectations by straightening her profile and reducing the projection of the nasal tip.

       
       

 

 

 
WAITING FOR THE RIGHT TIME TO OPERATE

This patient had been wanting an operation to remove a small hump on the nasal dorsum since the age of 17.
By agreement with the family, it was decided to take the logical and prudent course of action and wait for her to turn 18 before performing the operation, which not only eliminated the hump but also gave the nasal tip a slight degree of rotation to make the results still more attractive.

       
       

 

 
RHINOPLASTY, THE STEPPING STONE TO A DREAM

The story of patient operated on when she turned 18.

   
        Shortly before   rhinoplasty
   
              Today: a model  professional

 

Testimonial of the patient:

"Dr Boccieri, thanking you for your professional expertise is the very least I can do. You cannot imagine how your operation changed my life.
I still remember when we first met and your courteous, reassuring presence convinced me that you were the right person to solve my “little” problem of a hump on my nose that made me so shy and vulnerable, not to mention the constant sneezing in the morning due to deviation of the nasal septum, which was perhaps the major problem.
It may seem silly but that little flaw caused me all sorts of psychological problems. I was very self-conscious and whenever anyone looked at me I thought they were just staring at my nose.
I still have a vivid memory of the day of the operation, your green cap, your smiled, your assistants, and my face on reawakening. My parents still laugh about how I thanked everyone as soon as I opened my eyes. I was over the moon, Dr Boccieri had made my dreams come true!
Pain? What pain? I really don’t remember any. I just saw my face completely changed on removal of the tampons. It was harmonious. My nose was perfect and the most important thing was that I could breathe perfectly. In short, my shyness disappeared. I felt happy with myself, strong and self-confident.
It is thanks to this operation that I had the courage to break into the world of fashion and become a professional model."

N.L.

 

 
FINDING THE TIME FOR RHINOPLASTY LATER IN LIFE

This patient had put off correcting the effects of trauma to the nasal pyramid combined with very apparent defects such as a nasal hump and a particularly drooping tip for many years.

     
       

The operation performed corrected the deviation of the nasal pyramid, eliminated the dorsal hump, raised the tip and rotated it upward, and reduced the length of the nose. The results show that the correction of some nasal flaws in maturity also brings a certain degree of overall rejuvenation of the face.

I published this case in 2010 in an article describing a new surgical technique of my own invention: ‘Barrel Roll Technique for the Correction of Long and Concave Lateral Crura,’ Archives of Facial Plastic Surgery, 2010, 12(6), pp. 415–21.

 
RHINOPLASTY THAT ALSO MEANS REJUVENATION

This patient complained of a very evident hump on the nasal dorsum and a drooping tip.

       
       

In addition to the protruding dorsal hump, analysis revealed that the tip not only drooped but was also vertically misaligned in frontal view. The operation was designed to straighten the bridge as well as reshaping and repositioning the tip. As the end result shows, the elimination of these aesthetic flaws was also accompanied by an evident effect of facial rejuvenation.

I published this case in 2008 in my the article: ‘The Lateral Crural Stairstep Technique: a Modification of the Kridel Lateral Crural Overlay Technique,’ Archives of Facial Plastic Surgery, 2008, 10(1), pp. 56–64.

 

 

 
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