First published in A2: Aesthetic Surgery and Anti-Aging magazine (2013)
‘Botched’ cosmetic surgery is never more devastating than when the disfigurement narrates its sad story on the most visible part of the face, the nose.
A patient can sometimes conceal a disappointing result with a scarf, or under layers of makeup; but not the nose. A botched ‘nose job’ locates itself at the very centre of a triangle defined on the face by the eyebrows along the top, and the tip of the chin at the bottom – the epicentre of human attention.
The nose, in this sense, is the first item on the human appraisal agenda, when in those crucial initial seconds that occur moments after a social encounter, or an introduction, our eyes swiftly gravitate to the nose, eyes, and mouth clustered around the centre of the face. Note this phenomenon the next time you appraise someone during a chance social encounter. Your gaze tends to settle on the nose; especially if it’s oddly shaped, or disfigured.
What happens next is almost instinctive. Human nature being what it is, we quickly notice, evaluate, and then form an opinion about this new person; about character, social status, and ‘likeability.’
This is the story cosmetic surgeons hear repeatedly from patients investigating surgical solutions for hump, ‘saddle depressed’ or bulbous noses; or again when unhappy candidates for ‘revision’ surgery explore remedies for an earlier botched operation.
The result of a nose operation is one of the few plastic surgery procedures a patient cannot hide. Good or bad, the result advertises the disappointment, or the happiness brought on by the competence, or not, of the surgeon responsible for the operation.
The Michael Jackson case study proves that repeated revisions of the nose – in a vain quest for perfection – merely invites more deeply entrenched disappointment. Revision surgery eventually weakened and collapsed the internal architecture of pop star Michael Jackson’s nose. Neither fame nor money salved the disappointment.
Why does nose surgery so often end with disappointment? The answer, says Pieter Swanepoel, one of South Africa’s most experienced Rhinoplasty specialists, is lack of advanced training linked to limited experience.
Swanepoel uses golf to illustrate the point. “If I practice my swing for three hours a day every day of the working week,” he says, “my swing should improve. If I engage a golf professional to guide me through the mechanics of putting, I may eventually find myself placing the ball in the hole or near the hole nine times out of ten. That’s comparable to the surgical skills needed for nose surgery. Likewise, if you submit to advanced mentoring and training from a Rhinoplasty ‘master,’ the results of surgery inevitably improve. Further, if you perform nasal surgery once a day, every day of the week, you hone skills that ultimately ensure consistent results.”
No surgeon, Swanepoel explains, sets out to achieve a sub-standard result. A poor result is the consequence of four limitations– limited experience, limited understanding of the inter-relating dynamics of nasal anatomy, limited exposure to advanced training in Rhinoplasty, and limited regular exposure actual surgery.
“A general plastic surgeon might do one or two nose jobs a month; a dedicated Rhinoplasty specialist might operate on four noses a week. That’s the difference.
“The results of ‘nose’ surgery,” says Swanepoel, “emerge from a surgical process that shapes the nose in three dimensions. It’s a combination of scientific training and artistic feel. The science lies in knowing what and how much tissue to shape and trim. The art in knowing how to shape the nose into a pleasing 3-dimensional shape that complements the facial proportions of the patient.”
The shape and function of the nose ultimately hinge on the harmonious inter-relationship of 240 anatomical components. “It does not look like that from the outside,” says Swanepoel, “but because of that, Rhinoplasty remains one of the most difficult and challenging procedures in cosmetic surgery.”
Statistics compiled by the Nose Clinic in Pretoria over 30 years reveal that many patients, having undergone nasal surgery elsewhere, walk away from surgery disappointed. How then, do patients avoid disappointment? “Do extensive research. Find a good surgeon,” If a surgeon cannot show you a gallery of good ‘before and after’ results, take that as a warning sign. The other red flag is lack of advanced training. Ask for credentials. If a surgeon can’t provide credible proof of advanced training, take that as another warning sign. We have a number of good and talented surgeons in South Africa, you just have to find the right one.”
