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Nose Job Trends

While the American Society of Plastic Surgeons reports a drop in rhinoplasty procedures—37 percent fewer Americans got nose jobs last year than in 2000—there has been an increase in the procedure for specific ethnicities and a decrease for others. 

Asian and Hispanic Americans are embracing the procedure, while it is becoming less popular among the modern Jewish population, says Tablet Magazine, an online Jewish journal. What was once considered a "rite of passage" for affluent young Jewish teens coming into adulthood, a nose job to create more anglo features no longer seems to be the status symbol it once was. 

"Across the board, most individuals are having procedures not to change ethnicity or assimilate, but rather to reduce outstanding features and still preserve their ethnic heritage," says Beverly Hills, CA, facial plastic surgeon Babak Azizzadeh, MD, who says, "most people want to preserve their personal and ethnic 'essence.' Jewish women are no different."

With celebrities like Lea Michele embracing their ethnic features, perhaps the shift in nose jobs is due to the fact that there are beautiful role models opting out of the cookie-cutter small and upturned nose that was so popular for celebrities in the 80s and 90s. We all remember how much Jennifer Grey, from Dirty Dancing, completely altered the look of her face when she changed her nose—becoming almost unrecognizable—a mistake she has openly discussed with the media. 
Credit: Thinkstock
In a recent study published in JAMA Facial Plastic Surgery. Study author and Greatneck, NY, facial plastic surgeonAndrew Jacono, MD, found that many patients lack the ideal bone structure in order to make common cheek rejuvenation procedures successful, and are consequently unhappy with their results. Dr. Jacono has identified a simple method to determine if a patient’s facial structure will allow for optimal results from certain cheek procedure as well as a simple algorithm for choosing the optimal technique.
"Tuck a pencil over the top of your ear, keeping it perfectly horizontal. Then, place your index finger vertically against your forehead to form an intersection," explains Dr. Jacono. "Where these two intersect is where your cheekbone should fall, if you're a prime candidate for basic cheek rejuvenation procedures. The issue is that most of the population does not fall into this realm.”
For those with bone structures that aren’t typically ideal for cheek procedures, the algorithm is based on a variety of anatomic and genetic factors. This tool will help both patients and their surgeons in choosing the procedure with the best possible results.
"Aging of the cheeks is complex and multifactorial, and so cosmetic consultation for rejuvenation is thus the most difficult," says Dr. Jacono. "This algorithm, organized into a simple flowchart that aesthetic surgeons may consult, will assist in selecting a plan that has the highest likelihood of success because it affords a customized and integrated approach specific to each patient's facial structure. Often, a combination of procedures is required to help build cheek volume. For example, an endoscopic mid-face or mini-S type facelift can be combined with fat transfers or cheek augmentation for optimal results."
Dr. Jacono believes that this method will increase the satisfaction rate of cheek procedures. "As a surgeon, patient satisfaction is my most important goal," says Dr. Jacono. “We hope that this valuable tool will assist aesthetic surgeons and patients in having critical conversations that result in selection of the best plan possible."
Are you considering cheek augmentation?

Of course the state of the economy could also be contributing to the decline, as plastic surgery has become a sort of economic indicator—when the economy is healthier, more people schedule appointments for procedures.

Another theory is that the decline in nose jobs is due to the fact that fillers can now reshape the nose in a very natural way. Injecting hyaluronic acid into the nose (an off-label use) can fill small depressions and even out bumps and humps. Indianapolis plastic surgeon Janet Turkle, MD, says that injectables are great for correcting some nasal deformities and for adding height to make a bump less noticeable. While the results of an injectable nose job are not permanent, the effects can be seen immediately. 

While some ethnicities are still embracing the classic nose job, one thing is for sure, more and more plastic surgeons are specializing in "ethnic" nose jobs—keeping the integrity of the shape of the nose while slightly fine-tuning the features—for those that want a slight change, but not a complete overhaul. "I have a simple statistical rule for ethnic rhinoplasty—we never want to change one's nasal features more than one standard deviation from the norm for their ethnicity. That means we want to make sure that their nose fits their facial skeletal features, gender, eyes and overall ethnicity in a balanced manner," says Dr. Azizzadeh.
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  1. Many patients not happy with the cost of rhinoplasty in the UK have decided to look to international destinations for rhinoplasty surgery.
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