When it comes to the shape of the nose, there is no such thing as one size fits all. Influenced by genetics, aging, and external factors, there are a variety of cosmetic nose concerns that patients may wish to correct.
You don’t need to look much further than the Greek and Roman exhibits at a museum to see that there has always been a fascination with facial features — particularly, the human nose. The lack of curvature of the Greek nose (a.k.a. straight nose), which can most notably be seen on Michaelangelo’s David, stands in contrast to the more realistic qualities of the Roman nose. With its exaggerated bridge, sloping curve, and prominent protrusion from the face, the larger nose highlights an evolving appreciation for beauty and natural aging. In reality, there are many more types of noses, and, depending on lineage, genetics, ages, and external factors, there are a number of cosmetic concerns related to nose shape.
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What determines the shape of the nose?
Before we dive into the cosmetic concerns related to the shape of the nose, it is important to understand the anatomy of the nasal structure. The external nose consists of two nasal bones and lower lateral cartilages.
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Starting from the top (i.e. near the forehead), the “root” of the nose falls between the eyebrows, and the “bridge” of the nose connects the root to the rest of the nasal structure. The length between the bridge and the tip (or “apex”) of the nose is known as the dorsum nasi, and the cartilaginous alae (a.k.a. nostrils) fall on either side of the tip. Last but not least, the philtrum is the concave skin that connects the tip of the nose to the upper lip.
What causes variations in nose shape?
Evolutionarily, the shape of your nose is correlated to where your ancestors called home. Have relatives who resided in warm, muggy climates close to the equator? Expect a broader, shorter nose with wide nostrils. Did they come from a cold and dry region? Your sniffer is likely long and narrow.
Because the lungs prefer processing air that is warm and moist, it relies on the nasal passages to deliver it in that form. If you’re living in an area where the humidity is low and the temperature is cold, a longer nose allows the body more time to moisten and warm the air before it is delivered to the lungs. If the air is already warm and moist (like in humid climates), there’s a lot less work to do.
While you can likely trace the general shape of your nose back over generations, additional genetic subtleties exist that determine the type of nose someone is born with. From there, the natural aging process and external factors (like trauma) can cause additional changes.
What are the main concerns related to nose shape?
Whether you were born with a nose shape that you don’t feel suits your face, have noticed changes in your nose as a result of aging, or had an injury or trauma that impacted the appearance of the nose, there are a variety of cosmetic concerns related to nasal aesthetics:
- Crooked Nose: More often than not, lateral variations in nose shape are caused by injury secondary to trauma (read: a broken nose).
- Drooping Nose Tip: As the collagen in the soft lower cartilage part of the nose breaks down during the aging process, the tip of the nose may begin to droop (a.k.a. ptosis) or sag.
- Low Nasal Bridge: Better known as a “saddle nose,” the condition involves a flattening and loss of height at the bridge as a result of bone loss, cartilage loss, or a combination of the two. It may be a side effect of trauma or medical conditions like leprosy, syphilis, and rheumatologic disease.
- Nose Bump: Whether it’s genetic or the result of an injury, nose bumps refer to an overly pronounced appearance of the dorsal hump.
- Upturned Nose: Commonly referred to as a “celestial nose” or “button nose,” the apex (i.e. tip) of the nose is over-rotated, causing the nostrils to be more prominent and creating a disproportionately short or stout appearance. The upturn can be caused by genetics, trauma, or a previous rhinoplasty.
- Wide Nose: Also known as a “nubian nose” or “hawk nose,” a wide nose is most common in African American, East Asian, and Hispanic ethnicities and characterized by an undesired broad nasal bridge, expansive nasal tip, or wide nostrils.
Who may wish to alter their nose shape?
Nose shape is primarily determined by genetics, but the natural aging process causes distinct changes. As we age, the cartilage (which contains collagen) of the lower nose loses its shape and will droop or sag —sometimes resulting in a fleshy nose appearance. Additionally, the oil glands of the nose can enlarge, causing the nose to appear wider (i.e. a bulbous nose).
Teens with nose shape deformities may consider undergoing a corrective rhinoplasty. It is important to note, however, that girls’ noses generally aren’t considered fully formed until one year after menses (around 15 years old). Boys are usually considered fully grown one year after their last noted growth spurt (around 18 years old).
How can someone change their nose shape?
The most common way to change the shape of the nose is with a rhinoplasty (a.k.a. “nose job”). And, just as there are a variety of different nose shapes, there is an array of surgical and non-surgical rhinoplasty techniques to address various concerns related to nose size and shape. Which type of procedure is chosen will depend on the patient’s anatomy, skin type, and concern.
For Crooked Noses
Rhinoplasties are primarily divided into two main categories — open and closed — and either type can be used to correct lateral deviations in the nose. While both open rhinoplasty and closed rhinoplasty (including ultrasonic, rejuvenation, and endoscopic techniques) involve external or internal incisions to access the bone and cartilage, less invasive treatments include filler-based liquid rhinoplasty.
For Drooping or Sagging Nose Tips
Since patients often develop a sagging nose as a result of age, a rejuvenation rhinoplasty can be an ideal option to rotate the droop upwards. If the drooping is due to a previous procedure, a revision rhinoplasty may be able to correct and improve upon the results. A minimally invasive (and non-permanent) liquid rhinoplasty, meanwhile, involves injecting dermal fillers to reshape and re-volumize the region. A muscle paralysis rhinoplasty uses botulinum toxin type A injections (like Botox®) to reduce the appearance of fine lines and wrinkles around the nose.
For Low Nasal Bridges
To correct a saddle nose, an open rhinoplasty can be performed to create a small incision under the nose between the nostrils that allows the surgeon to access the nasal bone and make adjustments. Additionally, cartilage grafting may be considered to help restore volume to the area.
For Nose Bumps
Commonly corrected during youth and teen rhinoplasty, which are best performed after the nasal bones are believed to be finished growing, dorsal humps and nose bumps are often best treated with open rhinoplasty. An ultrasonic rhinoplasty, performed with an open technique, employs ultrasound waves to precisely chisel away unwanted bone.
For Upturned Noses
Since upturned noses can be the result of genetics or a previous rhinoplasty, a revision rhinoplasty can be used to change the rotation of the nasal tip. For a less invasive approach, dermal fillers can be used as part of a liquid rhinoplasty to create a more proportional appearance.
For Wide Noses
Whether a patient prefers a closed or open approach, an ethnic rhinoplasty can be performed to create a slimmer and more pointed nose. To achieve the narrowing effect, cartilage is often harvested from the ribs or ear and implanted into the nasal bridge.
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Nose shape is primarily influenced by genetics and then altered naturally by aging, though injury and certain medical conditions can also change the shape of the nose. Consulting with a board-certified plastic surgeon who understands the important role the shape of the nose plays in the overall proportion of the face will allow prospective patients to determine which nose shape and rhinoplasty procedure best suits their needs.
