Why I Got a Nose Job in My Mid-30s

A monthly column about the latest, wildest ways people are modifying their bodies — and what it’s really like to live through it.

Photo-Illustration: Courtesy of the author.

For a long time, my nose wasn’t something that bothered me. It was nondescript: cute, average size with a slightly bulbous tip and a slender bridge with the slightest, almost unnoticeable bump, not something that I ever yearned to change. Then COVID happened.

Once I had started to live through Zoom, I was suddenly constantly staring at my face. I would focus on my imperfections like crazy to the point where it would become distracting. I was working as a beauty and aesthetics writer and editor, which meant frequent conversations and consultations with dermatologists and plastic surgeons, taking product photos and before and after treatments of my face. Being in this industry requires a nice amount of upkeep and self-criticism can get to you, but this was another level.

About three years ago, my focus shifted toward my nose. I visited a well-known facial plastic surgeon in New York City for a Botox-treatment-cocktail party — attending events like this is par for the course as a beauty editor — and over the course of the evening, I ended up in his exam chair. Though I was there for a Botox touch-up, he looked at my face closely, focusing on my nose. He felt the bridge of my nose and asked me to tilt my head up.

“How old are you?” he asked.

“I’m 35.”

“You look much younger than your age, and if you had a smaller, more symmetrical nose it would balance out your face and make you look even younger,” he said. I agreed to take some pictures so he could render a 3-D image of what my nose could potentially look like after surgery. I was thrown at how different my face looked and how small my nose could be. After the ambush consultation, I thought about how I couldn’t deny the fact that my nose had changed over the years — it had gotten a little bigger and the tip had dropped ever so slightly. I found myself editing my nose slightly in pictures with an airbrush app on my phone: I would decrease the size of it and try to turn it up slightly, being very careful not to distort it. Eventually, I vowed I would get a nose job — as soon as I worked up the courage to.

Photo: Courtesy of the author.

A year later, I started my hunt for a surgeon who aligned with what I wanted out of my rhinoplasty and whom I felt I could trust. After about seven consultations over the course of about a year and a half, I found Dr. Anil Shah.

The first time we spoke was over FaceTime; he was warm and easy to talk to. He examined my nose as best as he could through the screen to assess. I told him what was bothering me: an almost unnoticeable bump in the bridge of my nose and my tip. It was bulbous. Not overly so but enough to irk me because only certain angles of my nose looked good in photos, and I wanted it to look good at every possible angle. I also felt that my nose just didn’t fit my face well; it was larger than it should have been for my small face. When I was done, he explained, using some anatomical jargon I don’t quite remember fully, how he would essentially redesign my nose. He told me that he would have to reshape my tip, addressing the columella (a term I specifically do remember because of the number of times he referred to it), which is the tissue that separates the nostrils at the base of the nose that plays a key role in the structural support and aesthetics of the nose. He also noticed some asymmetries to my nose and the tip, when I smiled, dipped down. We also discussed a surgical timeline and set a tentative date for August.

I appreciated that he didn’t guarantee me a perfect result. I had done enough research and had been to more than my fair share of consults to know that “perfect” in plastic surgery does not exist, and if promised by a plastic surgeon, consider it a huge red flag. No one, including an experienced doctor, can predict how you will heal and what the true final result will look like. The second time Dr. Shah and I spoke was in person at his New York City office last June. (His practice is mainly in Chicago but he flies in to perform surgery on his New York patients.)

During our consult, Dr. Shah examined my nose and I told him I was terrified of ending up with a Barbie nose — a nose too small for my face and with too much of an upturned tip. All I wanted was my nose but better and more symmetrical. My journalistic side took over while questioning him about the surgery.

“Will this be a closed or open rhinoplasty?” I asked. (An open rhinoplasty is more invasive and employs an external incision for more significant reshaping of the nose, whereas a closed rhinoplasty uses internal incisions for more minor adjustments to the nose with less significant recovery time.)

“Open. It has to be open because I am adding structure to your tip. Lifting it and giving it projection.”

“What is the healing process like? How long will I have to wear the cast for?”

“You’ll wear it for about a week, and then when it comes off you’ll have to wear tape anywhere from three months to a year. We want to make sure that the soft tissue conforms to the new shape of the nose,” he said.

Dr. Shah rendered several 3-D images of my potential nose. He would reshape the nose in five dimensions, he explained, addressing symmetry, contour (addresses the nasal structure), nasal projection (how far the tip extends out horizontally from the tip or base of the nose), and proportion to harmonize the overall look of the face. The images were from straight on, my left profile, and my right. Dr. Shah rendered two different nose options, both with differing degrees of tip projection. I selected the one with slightly more projection because it was closer to my original nose. While it would still look “done,” meaning the bridge and slope of my nose would be straight and the tip would be noticeably smaller, it looked the most natural and complemented my face.

Dr. Shah also discussed repairing my deviated septum, which blocked a lot of my right nostril. My primary-care doctor was the first to point out that I had a deviated septum about ten years earlier while using a nasal speculum to examine my congestion. “Your nose is very deviated in your right nostril,” I remember him saying. I was surprised because it was something I never thought about. Over time, the deviation must have gotten worse because it was now legitimately blocking my airflow.

He asked if I have anxiety at all and, well, who doesn’t? Many patients who have had their deviated septum fixed, he told me, tend to experience less anxiety. Beyond his own anecdotal evidence, he cited studies. Apparently, in the absence of any obstruction in the nose, the ability to take in more air into your nostrils decreases the amount of cortisol production — the hormone associated with stress — which supports the ability to calm yourself.

Pain and discomfort also came up in discussion. I was deeply concerned about postsurgical pain — I’m prone to headaches and the thought of having to take Percocet, which once gave me the worst migraine of my life, to control pain frightened me. Dr. Shah told me that my recovery would essentially be pain-free; he explained that he uses his own concoction of a multimodal nerve block that he called “The Shah Shot.” During surgery, he injects this nerve block around the surgical site. It lasts for about three days and allows him to operate without the use of any narcotics. Basically, I should expect to not feel my nose at all for several days after surgery.

The date for my rhinoplasty was set for August; the surgery would cost $26,000. I told a few close friends and family members; as expected, they said that I didn’t need it, but mostly everyone was supportive. My brother was the most outspoken: “Did you read reviews on the surgeon? Were other people happy with their results?” he asked me more than once.

A few days before surgery, my brother texted me, asking, “Are you sure you thought this through?” On the day before surgery he made it a point to take pictures of me with my old nose to memorialize who I was. Dramatic, sure, but he’s seen the same nose on my face for 30-plus years. Having this surgery when you’re older feels different than traditionally having it when you’re younger. There’s even more emotion tied to it because your nose has truly become a part of you and how the outside world sees you. And it becomes more about balancing out your changing face — an unavoidable consequence of aging.

On the day of surgery I woke up early, took one last really good look at my nose in my bathroom mirror, and said farewell. I got ready, called an Uber, and headed into Manhattan to the surgical center. There, I quickly changed into the surgical gown and downed a few medications to prevent nausea, infection, and pain (just in case). I spoke to Dr. Shah one last time before going in for surgery. He took some photos and videos to compare my results before and after surgery. Upon waking and the days following surgery, I was pain-free (truly, he wasn’t kidding), though there was quite a bit of blood flowing out of my nose the first few days that I had to plug up by taping gauze pads across my nostrils. I was able to leave about an hour after waking up from surgery; I was able to walk just fine with the little assistance from my mom to the car to drive home.

After surgerytwo days post-opCourtesy of the author.