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Like many others, one thing about my body that always brought about feelings of insecurity was my nose. I could wax poetic about the kid in elementary school who nicknamed me “pelican” (kids can be mean—but hey, if you’re reading this, all is forgiven!). Or the way my grandma so lovingly yet annoyingly referred to the shape of my nose as “Roman” (it’s true, I am Italian, but that didn’t help quell any self-doubt). However, the bottom line is—everyone else’s snarky or well-intentioned comments aside—that I've always simply wanted my nose to look different. What’s more, for as long as I can remember, I’ve also had a weird psychological and physical disconnect; I inherently thought that my nose looked different than it really did, only to see a profile photo of myself and be legitimately surprised (not in a good way).
All of this is to say that rhinoplasty—specifically, to get rid of the hump on the bridge of my natural nose—has been in the back of my mind since my early teen years. Though while my nose always irked me, another part of me (and my bank account) could never fully justify an actual surgical procedure. I explored other less-invasive options, including using fillers to even things out (a.k.a the non-surgical nose job), but nothing seemed to make sense for the outcome I wanted. Eventually though, after becoming engaged to my long-time partner, the timing finally felt right to pursue a more permanent solution. I also finally had a reason to justify it (if only to myself): Wedding photos that would, as I so dramatically quoted to my partner on numerous occasions, last for generations.
Trust me, the decision to go under the knife was not one that I took lightly. On the contrary, after ruminating about it for years and years (and years), I did my homework. I talked to friends who had the procedure, a handful of plastic surgery and rhinoplasty experts and many fellow beauty writers and editors. Eventually, after thoroughly plotting out and exploring all options, I settled on an open rhinoplasty with a surgeon who I trusted completely.
And the eventual outcome was even better than I ever anticipated—so incredibly satisfying that I wanted to write about it (and even share photos of my old nose!) to share my experience with others; something that I never in my life thought I would be doing. But alas, here are all the details about my own pre-wedding surgery (before and after pictures included), and the many reasons why I am so genuinely happy that I had it done.
Two quick asides before we jump in... First off, no—I’m not going to argue that in order to feel your very best on your wedding day, you should get plastic surgery. Or even Botox. Or even wear makeup. Everyone is different, and this just happens to be my story.
Second, when my editor and I envisioned this article more than a year ago, we obviously had no idea that the year 2020 would completely upend every facet of life on an unprecedented level—my wedding plans, and plastic surgery in general, included. Needless to say, the unfortunate ways in which 2020 continues to unfold make my elective rhinoplasty and the postponement of my wedding ceremony feel incredibly frivolous compared to what’s going on around the world.
That said, with plastic surgeons in most states currently getting the green light to move forward with elective procedures—and my own recent last-minute decision to elope—writing this now finally feels more appropriate. So, here goes...
What Is a Rhinoplasty?
Rhinoplasty is the medical term for a nose job, which involves surgically (re: invasively) changing the shape, size and/or appearance of the nose. Nose jobs can be performed for purely cosmetic reasons, as in my case, or to correct a deviated septum (or other structural issues) and improve breathing.
The cost of the surgery, as with all plastic surgery, will depend on a few different factors, including where you live, your preferred surgeon, and the extent of surgery you need. In general, rhinoplasties can range anywhere from approximately $5,000 to over $15,000. This is obviously a huge price range, which is why it's important to really do your research beforehand (and you already are by reading this).
The Benefits of a Rhinoplasty
Again here, the benefits can be cosmetic or medical (or both!). On the cosmetic side, a nose job can correct certain elements of a natural nose that the patient is unhappy with, some of the most common being a bump along the bridge and the size of the tip of the nose.
On the medical side, nose jobs can be performed to correct airways that are naturally or have otherwise become obstructed (this is called a deviated septum), and improve the patients breathing ability.
Either way, the overall goal of a quality rhinoplasty should be to correct the specific issues of each patient in a way that is balanced and proportional to the rest of the face. "This is important for any rhinoplasty," explains Adam Kolker, a plastic surgeon based in New York City. "The nose needs to be internally balanced, meaning that the upper third needs to match the middle third, which needs to match the lower third, which needs to be balanced with the entire face."
Rhinoplasty vs. Non-Surgical Nose Job
I first considered the non-surgical nose job, which involves using injectables to correct cosmetic issues such as evening out a dorsal hump, making the nose look more proportional to the face, and even lifting up the tip. The non-surgical version is temporary, as all fillers are, and typically lasts somewhere in between six and twelve months, depending largely on the patients own metabolism.
Because I was ultimately looking to decrease volume, rather than add it, and also wanted a permanent solution, I opted for the surgical route.
Finding the Right Surgeon
As a beauty writer, I’ll admit that I had a leg up here. After talking with everyone I knew who knew anything about nose jobs, plus diving down many an internet rabbit hole, I ended up consulting with a few rhinoplasty experts in New York City (where I live), until I found the right fit in Dr. Kolker.
Not only is he literally the kindest, most genuine and professional doctor I have ever met with (and I am not just saying that; the man is a genius), but he also said things like: “It’s always best when refinements are subtle and natural looking,” and “It’s important to bear in mind that natural and proportional are always better than over-done.” And perhaps most importantly in my own mind, especially since I knew that my dad (who I have to thank for my natural nose in the first place) would never be fully on board with this until seeing the final results: “People will say you look amazing, but it will be so subtle that they won’t even know what changed.”
Meet the Expert
Adam Kolker, MD, is a board-certified plastic surgeon in New York City specializing in cosmetic surgery of the face, body and breasts.
Dr. Kolker was speaking the exact words I had thought repeatedly in my mind: Subtle and natural-looking. He also took the time to answer all of my many questions, explain in detail how he would personally perform the procedure (this is important, since every plastic surgeon operates slightly differently and has their own preferences), and also show me a mock-up image of what the intended outcome would look like. Basically, he hit everything on the nose—pun intended—and I knew in my gut that he was the right doctor for me.
After a few pre-op meetings to finalize exactly what I was hoping for and some routine bloodwork, my surgery was scheduled for mid-September. In the land of rhinoplasty, there are two types of procedures (though again, each surgeon has their own nuanced approach): Closed and open. Per Dr. Kolker’s advice, I opted for the latter.
“An open rhinoplasty approach offers a tremendous amount of exposure to the architecture of the nose, including all of the cartilage and bone elements,” Kolker explains. As opposed to a closed rhinoplasty, an open surgery would give him “almost limitless control over the fine-tuning and sculptural modification of those elements.”
This seemed crucial to me because I couldn’t (and still can’t) wrap my mind around how someone could shave down the bridge of my nose without having full access to seeing it. But again, every surgeon is different, which is why it’s so important to discuss the intended logistics of any plastic surgery procedure beforehand.
"It's not as if there is one absolutely uniform, ideal way to do a rhinoplasty for every individual," Kolker emphasizes. "There are some surgeons who only perform closed rhinoplasties, and there are some who only do open ones."
The downside of an open rhinoplasty, I was told, is a small incision underneath the nose along the tiny bridge of tissue that runs in between either nostril (technically called the columella). But the many upsides of an open procedure, plus my complete faith in Dr. Kolker’s expertise, made it definitely worth it to me. Besides, the tiny scar from said incision would fade over time (and, as I found out, was also easily covered by concealer).
This part was probably more difficult for my fiancée than it was for me—in part because I repeatedly sent him to the store to get more ice cream. Also, partly because I think it was uncomfortable to see my face so swollen and bruised.
In the recovery room right after surgery, dark bruising had already begun to form underneath my eyes. But overall, I was feeling pretty good. Very out of it, definitely, but not in any pain. The car ride back to Brooklyn was slightly uncomfortable, but as soon as I got home and propped up in bed, in terms of pain level, I was feeling fine. Said fiancée helped set me up with a bowl of mashed potatoes and some Bravo reality shows to binge, and I was comfortable until I passed out a few hours later. One slightly difficult lifestyle adjustment: I had to sleep on my back with my head propped up on a few pillows—for at least two weeks, per the paperwork I initialed—which I at first found to be uncomfortable but quickly got used to. Turning to sleep on either side, as I normally do, would put pressure on my splint and also increase swelling.
The other post-op rules were pretty standard: No alcohol, aspirin (which thins the blood), or spicy foods and plenty of liquids. No showering for the first 48 hours after surgery, and no strenuous activity for at least two weeks (obviously, I happily obliged to this one). Dr. Kolker sent me home with an antibiotic in order stave off potential infection (which I took twice daily until the bottle ran out), and some prescription Percocet, though I personally only needed to take the heavy-duty stuff once or twice. After that, I switched to over the counter Tylenol a few times a day and genuinely was not in any pain.
More apparent than any pain was the swelling, which hit peak-bulge about three or four days post-surgery. Over the first two weeks after surgery, my bruising changed color and shape so frequently that I actually found it fascinating to watch how quickly and efficiently my body could heal itself. What at first was black then became dark blue, then purple-ish red, then so swollen that my eyes could barely poke through my puffed-up cheeks, then a sallow yellow shade, and eventually subsided altogether.
“Everybody bruises differently, and everybody swells differently,” Kolker explains, noting that I was fortunate to experience very mild bruising. I think this mildness was likely due, at least in part, to the pre-op supplement routine Dr. Kolker had me follow the week beforehand, which included hefty daily doses of vitamins C and B, zinc, and arnica montana. After the surgery, my supplement routine stayed the same for two weeks, plus the addition of bromelain.
Over those first few weeks post-surgery, I was able to work from home—I was actually answering emails, albeit my tone a little loopier than normal, the morning after surgery (though I wouldn’t advise doing this!). I showered gently, taking care to keep my face out of the water, and used a washcloth or a makeup wipe to keep the rest of my complexion clean. My splint stayed on for almost a full week, after which I was told I could take it off myself, though it had become so loose at that point that it pretty much fell off on its own. I went into Dr. Kolker’s office eight days post-op to have the stitches in between my nostrils removed, which was slightly uncomfortable but not unbearable. The other stitches, all of them inside of my nose, would dissolve or fall out naturally (cute!).
I was told that the ultimate shape of my nose would not reveal itself fully until, realistically, one-year post surgery. That seemed like a long time, but it’s definitely true: Features of my nose continue to change even now, about ten months out (though these slight changes haven’t really been noticeable by anyone other than myself).
“The nose continues to mature over time, but most of the changes from a rhinoplasty are evident and settled by about twelve months afterward,” Kolker explains. “When you imagine that the nerves are re-connecting in that area, that also means that the veins and the lymphatics in the area, which drain the skin and the soft tissue, are also readjusting as well.”
The swelling on the tip of my nose took the longest to subside—and still today hasn’t fully regained all feeling. “There are certain areas of the nose that heal more quickly,” Kolker explains. “The tip area is the one that takes the longest, and the bridge area usually settles down a bit more rapidly.”
All in all, even while I wait for the final shape of my nose to fall into place, I couldn’t be happier with the results. The irony, of course, is that the very event that prompted me to finally pursue rhinoplasty—our wedding celebration—had to be postponed for another year. Still, the timing of the surgery felt right, just like it did for our last-minute, socially-distanced nuptials, which we recently held outdoors with only immediate family in attendance (we’ve been together for nearly a decade, so we simply couldn’t wait another year to make it legal!).
Before the procedure, I never would’ve felt comfortable posing for—let alone publishing—a profile shot of my face. But now, the image I always had in my mind matches the one I see in the mirror.
My innate sense of self-confidence will forever be boosted—and I mean that genuinely, one hundred percent, as superficial as that may come across in writing. One recent comment from a childhood friend was just the cherry on top: You look amazing, and so happy! But I can’t tell what’s changed...