Is Rhinoplasty Safe for Adolescents?

TRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.

Background

Rhinoplasty is a common aesthetic procedure performed on adolescents, but surgical intervention in a developing patient raises anatomical, psychological, and ethical challenges. Adolescents are still undergoing nasal and facial growth, and premature surgery is hypothesized to potentially disrupt development, nasal function, or long-term satisfaction. While functional concerns such as airway obstruction may justify early intervention, cosmetic motivations require caution. Emotional maturity also varies widely in this age group, making informed consent and motivation assessment essential. Adolescents may seek surgery due to social pressure, bullying, or media influence. Ethical concerns, including autonomy and beneficence, must guide surgical decisions. This review synthesizes existing research and professional guidance to inform age-appropriate clinical decision-making in adolescent rhinoplasty.

Best Practice

Rhinoplasty in adolescents requires a cautious, evidence-based approach that prioritizes skeletal maturity, psychosocial readiness, and ethical responsibility. Current literature supports delaying elective cosmetic procedures until nasal and midfacial growth is complete—typically around age 15 for females and 16 for males—to minimize the risk of growth disruption, nasal asymmetry, and revision surgery. This is not clear, however, and it cannot be stated definitively that there is a need to wait. Often, rhinoplasty is done for a large nose, and preventing additional growth is not necessarily problematic. When surgery is indicated at earlier ages due to functional concerns such as nasal obstruction or congenital deformities, growth-preserving techniques should be employed to reduce interference with developing structures. Surgeons should assess emotional maturity and motivation to ensure that expectations are realistic and not driven solely by external pressures such as peer influence or media. Pre-operative counseling and shared decision-making with both the patient and guardians are essential to achieving long-term satisfaction. In borderline cases, skeletal maturity should be confirmed using radiographic evaluation or clinical staging methods before proceeding with surgery. Taken together, these best practices aim to preserve functional integrity, safeguard developmental progress, and optimize aesthetic and psychosocial outcomes in adolescent patients seeking rhinoplasty.