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“Switch places with me.”
For years I would parrot this mantra during every group photo, no matter how formal or casual, if my right side was pointing toward the camera. Calm, measured, but insistent that I be photographed from the opposite angle, my “good” side. Otherwise the bump on my nose—known in the aesthetics business as a “dorsal hump”—would be on full display. If it was, I’d see the final picture, zero in on this relatively minute detail, and feel crestfallen, even if no one else noticed this supposed “flaw.” Worse, I’d feel ashamed that it bothered me so much. So to admit that I dreamed of one day getting a nose job to straighten the bump and maybe slim the tip? Out of the question.
Although I’ve always considered myself a fairly confident person—a Leo through and through—and I have loved ones who are more than willing to hype me up, my nose always bothered me. We all have that thing that sticks out as a source of insecurity (trust me, I’ve interviewed several supermodels over the years and not one considers herself perfect). For some, it’s a wonky toe, crooked teeth, or a smattering of cellulite. All are normal and none of them need to be changed, unless one day you decide you want them to be. The irony, however, is that even though we are all self-conscious on occasion, to admit that you dislike something about your physical appearance and actually plan to change it via plastic surgery is still rather taboo.
Blame the body-positivity movement if you must, a well-meaning rallying cry to combat decades of unrealistic beauty standards. But for many people, myself included, this type of messaging felt like yet another form of criticism, a reminder that you must love your body at all costs. To feel otherwise would prove that you were ultimately a part of the problem. That’s why for years it seemed like I couldn’t divulge that while I am grateful for my bodily health and reject the idea that there is a right or wrong way for a body to look, I simply didn’t like the shape of my nose or how it fit with the rest of my facial features. Even more than that, to admit that I was curious about a rhinoplasty signaled that I’d failed to be confident in my own skin, a glaring indicator of runaway vanity.
Luckily a few welcome changes happen when you hit your 30s, namely that you care less about what people think of you and you grow increasingly self-assured in your choices. So once the haze of pandemic restrictions lifted and life more or less went back to normal, I allowed myself to consider whether or not a rhinoplasty was right for me. More importantly, I realized that I didn’t owe anyone an explanation for that decision, and the only judgment I needed to reconcile was my own. Wanting a rhinoplasty didn’t make me guilty of anything other than making an informed decision as a fully grown woman with the (incredibly privileged) resources to do so. What a novel idea!
So, three months ago, after decades of pondering and planning, I finally went under the knife for a rhinoplasty. Keep reading for all the details on my nose job journey, from the initial consultation to the (almost) final results.
What Goes Into Designing a New Nose?
Once I was ready to move forward, I reached out to renowned board-certified plastic surgeon Adam Kolker, MD, FACS, for a consultation. However I only told my boyfriend, my sister, and sister-in-law about my upcoming appointment just in case my aesthetic goals weren’t feasible, or if I decided a nose job wasn’t the right choice for me after all.
Keeping rhinoplasty patient expectations in check is sometimes a challenge, says Dr. Kolker, especially given how many variables can affect the final outcome. As he explains, “There are times where people have an unreasonable image in their minds of what they want and it simply is not achievable based on a sense of harmony and proportions between the nose and the face.” Similar to art and design, the upper and lower halves of the nose need to remain balanced, while also supporting the internal structure so you can, you know, breathe.
Dr. Kolker adds that rhinoplasty is one of the most artistically and scientifically complex procedures that plastic surgeons perform. “There’s so much three-dimensionality to it…and there are so many different elements that need to be addressed,” he says, citing the structural support of the cartilage and bone, the soft tissue inside the nose, and the overlying skin. Basically, if you want to improve the size or shape of your nose it’s not as simple as, say, requesting a certain size of breast implant—the nose still requires peak functionality.
There’s also the additional factor of how a patient responds to the surgery. As Kimberly Lee, MD, a board-certified facial and reconstructive plastic surgeon in Los Angeles, explains, “Balancing both functionality and aesthetics can sometimes be tricky with rhinoplasty [since] it’s difficult to predict the healing process and scar tissue formation…which can alter the initial outcome.” And since it can take 12 months for the swelling to go down and the final results to emerge, it’s essential that rhinoplasty patients clearly communicate their goals with their choice of surgeon prior to entering the operating room.
Pre-Rhinoplasty Surgery Prep
As for my wish list of changes, I sat with Dr. Kolker in his Manhattan office for about 20 minutes and chatted about the overall shape of my nose from the bridge to the tip and nostrils. He asked me which angles I liked and those that I didn’t, asked for photo examples of other people’s noses I admired, and then took pictures of my face straight on, to the side, at three-quarters turned, and a “worm’s eye view,” a.k.a. with my head tilted back to see my nostrils. Then he utilized a photo-morphing program to design a prospective final outcome, positioning it side-by-side with my original photo, and talked about the changes to my nose, some of which were so minute I couldn’t even tell what had been done—only that I liked the outcome.
“Millimeters matter,” says Carl Truesdale, MD, a board-certified plastic surgeon in Beverly Hills. “If you’re doing a rhinoplasty and you’ve got a little bump, it’s not forgiving at all…so it’s a lot of artistry.” Dr. Truesdale also uses photo morphing for his rhinoplasty patients, describing it as a tool to communicate and ensure that his plans match his patient’s goals. “I can’t see inside their mind. That’s where the software can help,” he says.
Having such a realistic example of how Dr. Kolker could alter my nose was extremely helpful, not only to pinpoint areas that I wanted to tweak but also to assuage my fears that I would look too “done.” Because while I was eager to smooth the bridge and alter some characteristics, I still wanted to look natural—my nose, but better.
Regarding this initial consultation, Dr. Kolker explains that, “when we had discussed things…I was doing everything I could from an educational perspective to manage your expectations with the outcome of the procedure,” adding that I was already a great candidate for surgery (meaning mentally and physically prepared for the recovery). “But when we talk about the unique challenges of a rhinoplasty, it’s a matter of refining certain areas while preserving a sense of character at the same time, so that, ultimately, the result becomes more subtle and natural.”
Once Dr. Kolker and I both felt aligned on the proposed result, we scheduled the surgery and I began a supplement regimen —including taking arnica and bromelain—to minimize potential swelling and bruising. I also stopped drinking red wine and taking any nonsteroidal anti-inflammatory drugs (like ibuprofen) to mitigate the risk of bleeding. I also, after 12 years, removed my septum ring for the last time. Finally, six weeks after my first appointment, I arrived at the office for my rhinoplasty.
What to Expect From Rhinoplasty Surgery
Since I was going under general anesthesia for the four-hour surgery, I stopped eating or drinking anything at midnight prior to the procedure. After a few fitful hours of sleep, I woke up and took a shower with presurgical antibacterial soap, wishing I could slam a cup of espresso before the 45-minute drive from my apartment to the Manhattan office. Once I arrived, Dr. Kolker’s team brought me back to an exam room so we could clarify my goals one more time and he could mark my nose with a few guideline dots. Then I changed into my scrub gown, took a few final selfies with my original nose, and walked into the surgical suite.
The last thing I remember was talking with the anesthesiologist about my tattoos and then suddenly—or at least it felt that way—I was blinking awake in the recovery room. I felt groggy but fairly pain-free other than the inconvenience of not breathing through my nose, which was taped up with a splint and a layer of gauze beneath my nostrils to catch any blood. I heard my boyfriend speaking with the nurse in the next room and he came in to learn all about the aftercare instructions and review my various medications for the next week of recovery before driving me home.
At this point the anesthetic was starting to wear off and my face felt very heavy and sore. My stitches were tender and I hated that I had to breathe through my mouth (your throat gets raw very quickly). But after eating a small bowl of butter noodles and sipping as much water as I could handle, I settled into my giant pregnancy pillow (a tip from a friend who had also had plastic surgery) to keep my head elevated while I slept on my back.
“Head elevation is by far the most important aspect of recovery because that’s going to minimize swelling and discomfort after the procedure,” says Dr. Kolker. And for someone who would sleep flat and face down if I could, this was definitely the most annoying part of the healing process. But luckily, in terms of pain, I only needed a narcotic painkiller for the first night. After that I could get by on Tylenol, plus all of my supplements to minimize swelling and bruising and an antibiotic. By day two my eyes and cheeks had started to swell, and by day three I looked very chipmunk-esque. The purple bruises were first contained to my eyes and then gradually moved down my cheeks as the week went on, turning a very unpleasant shade of yellow.
Every evening I would change the gauze pad and tape, and then cleanse my face with a Sofie Pavitt Micellar Cleansing Pad. You can’t get the splint wet, so I could only shower from the neck down (I highly recommend getting a blowout before surgery since you won’t be able to wash your hair for a week). Then I gingerly applied a layer of fragrance-free moisturizer since my face was extremely dry, but no other serums so as to not risk irritating the skin.
During our day-three Zoom call, Dr. Kolker confirmed that my healing was on schedule and that my bruising was normal, even a bit less than average. He also suggested I use a cotton bud and micellar water to clean up some of the dried blood around my nostrils and stitches at the base of my nose before applying my antibiotic ointment in the morning and evening. I could also ditch the tape and gauze at this point.
I’ll admit that by day five of resting at home, I started going a little stir crazy, so I decided to get dressed, throw on a baseball cap, and walk to my local coffee shop. The beautiful thing about New York City is that everyone minds their business and no one cares what you look like, so my barista only commented on how nice my perfume smelled—nothing about the splint still covering my nose. And by the one-week mark, when my bruises and cheek swelling finally disappeared, I headed back to Dr. Kolker’s office to remove the bandage and finally see my new nose.
The Final Nose Reveal (Almost)
Although I was extremely eager to remove the splint, I knew that the nose I would see wasn’t my true final outcome. “Unlike other parts of the body, swelling in the nose often takes 12 to 18 months to fully subside,” says Dr. Lee. “This can distort or delay visualization of the final results.” She adds that the nasal tip often takes the longest to heal because it has the thickest amount of overlying skin and tissue. Dr. Kolker reminded me of this fact before finally lifting off the splint and examining my nose from the inside and out. Then he handed me a mirror so I could finally see his handiwork.
I was relieved to discover that I still looked like myself. Yes, my nose was smoother, a little thinner at the bridge, and the tip less bulbous, but the essence remained the same. I could tell there was still plenty of swelling but Dr. Kolker walked me through the changes I could expect to see over the next three, six, and 12 months, especially in the size of the tip. Regardless, I couldn’t stop checking my reflection in the mirror, turning from side to side to examine every angle. And by the time I left the office (with another appointment in three days to remove some of the stitches) I was grinning from ear to ear.
As I walked down the block to the train, I wondered to myself: Do they see how cute my nose is? My “bad” side is almost identical to my “good” side. Actually, both sides are perfect! Can these people tell I just had surgery?
As these thoughts crept into my brain, I just as quickly realized that I didn’t care. I was so content with my nose and so grateful to Dr. Kolker and his team that the surgery went well (and that the healing process was on schedule) that any regard for other people’s opinions flew right out the window. I was happy, and that’s all that mattered.
“The stigma around plastic surgery overall is definitely decreasing,” says Dr. Truesdale. “It’s more normalized, so patients are feeling more comfortable with making that decision.” I can attest that so much of the fear I felt presurgery has been replaced by confidence, not only in how I look but in my choice to finally undergo the rhinoplasty I had wanted for so long.
I still have eight months to go before I reach the final phase of my rhinoplasty journey (and a few more check-ins with Dr. Kolker to ensure I’m continuing to heal well), but I’ve told several friends and colleagues about my nose job, and I’m continually surprised by how many people respond with their own rhinoplasty reveal. It warms my heart to think that maybe we can all be a little more transparent about our beauty choices, whether that means plastic surgery, Botox, or even just a new hair color, because 99% of the time, the response will be overwhelmingly supportive. And if it’s not, well, ignore that feedback and keep it moving. You and I don’t owe anyone an explanation for a decision that helps us feel like the best version of ourselves.
Hannah Baxter is a New York-based creative consultant and contributing writer for Allure, The Cut, Harper’s Bazaar, Elle, Air Mail, and more. She is the author of the mental health newsletter Anxiety Beer and was most recently the deputy beauty editor at The Zoe Report.
