As more men turn to cosmetic surgery around the world, in Australia too we see the demand for rhinoplasty among them increasing. In fact, at the moment, although overall more females than males elect to have the procedure, about half of my rhinoplasty patients are men.
How different is male rhinoplasty from female rhinoplasty?
I am often asked this question. Although the surgical techniques used in performing nose surgery in males and females are the same, it is important to recognise that masculine noses and feminine noses are different. They look different and are structured differently. Those differences are a matter of aesthetics rather than surgery, but they need to be taken into consideration in the surgical planning if patient expectations are to be met.
Male and female noses are different
Despite wide individual variances, there are a number of ways in which noses of males differ from those of females. The following are considered more masculinising features in the nose:
- The angle between the forehead and the nose when seen in profile—what we refer to as the nasofrontal angle—is more acute in men than in women.
- A straighter profile is considered more masculine.
- A higher and stronger bridge is a masculine feature. Some men even have a slight bump on the bridge of the nose. Females have a softer bridge.
- Males also typically tend to have longer noses than females.
- Noses look more masculine when they have sharply defined angular tips.
- The more the nose tip projects out from the face, the more masculine it usually looks. We refer to this as the tip projection.
- In males the angle between the nose tip and the upper lip—the nasolabial angle—generally forms a right angle or is between 90 and 100 degrees. A higher angle than this could make a nose look feminine, as female noses are typically slightly more upturned.
Differences need to be recognised when planning surgery
If a rhinoplasty is performed without taking into account individual variations as well as gender differences, the outcome can end up a complete disaster for the patient.
Imagine a feminine looking nose on a manly man who only asked for a better profile! Unless a male patient specifically wants a more feminine nose, it is important to preserve and improve on masculine features of the nose during the procedure.
Reasons Aussie men seek nose surgery
Men seek nasal surgery for a variety of reasons. Wanting to correct cosmetic deformities and functional problems following sporting injuries is very common. Men from varied ethnic backgrounds express their desire to reduce the nasal bumps. Most men are, however, merely seeking the surgery to fulfil their desire for a more natural looking and masculine nose. Some want an improved profile. Some have a deviated septum or other issues that compromise their breathing. Others have significant problems with snoring. These issues need to be corrected structurally, and cosmetic issues can be dealt with at the same time. Noses that have become crooked, misshapen or deformed as a result of injuries can also be corrected.
A masculine nose, as I explained earlier, requires a strong nasal bridge and a nose tip that is not overly turned up. That does not mean there is no scope for improvement. The nose can still be narrowed and refined, but the extent of change is far less limited in men than in women. Nostril flare can be reduced and the projection increased to strengthen the profile. Male noses can also be lengthened to make them look more masculine.
Concerns of male rhinoplasty patients
Most men who come to see me regarding rhinoplasty do not want their noses to look “operated on”. That and the fear that their noses will collapse are the greatest concerns men have regarding rhinoplasty. I explain to them that with the meticulous pre-operational planning and assessments I carry out, and the expertise and experience I bring to the operating theatre, they do not have to worry on either account.
The goal of rhinoplasty is to improve the nose both aesthetically and functionally. Even those who are there to correct a deformity or breathing issue can have their noses improved aesthetically at the same time. Most people are more than willing to embrace this double benefit.
Your rhinoplasty consultation
During the initial consultation I carry out a thorough assessment of the nose, both internally and externally. In addition to the physical examination, I use a fibre-optic telescope to look inside the nose and spot any deviation in the septum or other blockages. This is particularly important for those seeking reconstructive nose surgery following an injury or for those with breathing and any of the other functional issues that are common in men. Because people are not always aware of breathing problems, I assess breathing function in all my rhinoplasty patients.
I take digital photos during the initial consultation for computer imaging and assessments. This helps me work with each patient to ‘design’ a new nose that is harmonious not just in the context of the patient’s face, but also their personality. This is a novel experience for most people. Seeing a ‘preview’ of what to expect after surgery helps some people make up their minds about surgery. It can also change their perspective of beauty, balance and proportion.
For the patient, as well as for me, these images are a valuable communication tool. They enable my patients to pinpoint the changes they desire and their expectations of the final result. It is very helpful to show them what each specific change will look like in the overall face, once the desired change is made.
Having realistic expectations is vital
I tell all my patients not to expect exactly the same results they see on the computer screen. These images are just a prediction of the final outcome. And for me they are a great planning tool in the pre-operational phase, as well as during the operation itself.
It is necessary to keep expectations realistic. Even the best surgeons are not always able to achieve exactly what is needed in the first nose surgery. Surgical skill has something to do with it, but other factors—how each individual nose is structured, the skin thickness and how soft tissue settle after surgery—also contribute to the final result.
Rhinoplasty is a technically demanding procedure with a high revision rate. Even the slightest change can make a difference to the final outcome.
Speaking from personal experience, in many cases the final results are very close to the projected outcome. But it should not be taken for granted in all cases of rhinoplasty.
I encourage my patients to ask questions. The decision to have rhinoplasty can have a huge impact on your face and life. It is only fair that you get to express your concerns about the proposed procedure and have your fears allayed.
You can find out more details and what to expect during your first visit in my previous blog post, Your First Rhinoplasty Consultation.
Open rhinoplasty is my preferred technique
I prefer open structure rhinoplasty, which exposes the nose to be worked on. Open-structure rhinoplasty techniques can be employed in primary rhinoplasty—your first nose operation—as well as in revision rhinoplasty, for both minor and major revisions. I find the technique especially valuable in performing revision rhinoplasties and reconstructive rhinoplasty procedures.
This technique helps maintain the skeletal structure of the nose, particularly in cases of male rhinoplasty, where collapse and loss of support can result in a weak and more feminine looking nose. With open rhinoplasty you can see what you are doing, and that goes a long way towards producing great outcomes. It is a more demanding procedure and takes longer to complete, but it ensures that the basic foundation of the nose structure remains strong and can even be reconstructed to become stronger. In my experience the technique results in a predictable shape to the nose after surgery. It also ensures that the nose will resist collapse, improve the patient’s breathing and maintain a natural-looking shape afterwards. This is what makes the extra time and effort worthwhile.
For more information
You may also want to check out the Nose Gallery on this website to get an idea of the wide range of nose surgery performed by Dr Marcells.
Ask a question
Meet Dr Marcells
MBBS (Syd), FRACS (ORL-HNS)
Past President – Australasian Academy of Facial Plastic Surgeons
Dr George Marcells is known for excellence in facial plastic surgery and is considered a true master of rhinoplasty. He performs advanced surgical techniques to restore balance and harmony to the face and can also resolve functional issues such as breathing difficulties.