What's happening to my nose?

Key Points

Dh, the nose, often the butt of jokes, doesn't seem to fare well with age, especially for some people.

The images of the aging and aged nose can be depressing.

"Imagine," says noted dermatologist and clinical psychologist, Richard Fried, M.D., Ph.D., "glancing in the mirror and seeing a large, prominent, swollen, blood vessel and pigmentladen schnoz."

"Absolutely not," he says, "with the marvels of modern cosmetic dermatology and surgery."

Is there any validity to the myth about noses getting bigger with age? The reality is that some people do experience some enlargement of the nose as they age. However, it is not caused by actual growth of the nose, but rather loosening of the ligaments that attach the skin to the underlying cartilage.If you are one of these people and it truly disturbs you, a visit to a cosmetic surgeon can help define the surgical options available to you. But, there are other steps you can take first.

CORRECTABLE CHANGES

Your dermatologist or cosmetic surgeon can evaluate your nose to see if its changing shape has something to do with rosacea.

In this skin disorder, which often is characterized by facial redness and sometimes pimples and red bumps, the skin on or around the nose can become thicker, giving the nose a bulbous shape - think of the comedian W.C. Fields. This nose condition, called rhinophyma, can often be very successfully treated with lasers in the doctor's office. The thickened skin can be lasered away to restore the shape of the nose. Treating the underlying cause, rosacea, may help as well.

You may also have noticed that your nose is now hosting a series of broken blood vessels, brown spots or enlarged pores. All or any of these may give you the sense that your nose is changing, but it's not. However, the skin is showing changes, probably brought on by exposure to the sun. A discussion with your doctor will help you decide among a variety of in-office procedures, ranging from chemical peels to lasers, that can help remove hyperpigmentation, broken blood vessels and enlarged, very visible pores.

SHAPE SHIFTERS

Now, for the shape of your nose, if you opt not to have any kind of rhinoplasty (a "nose job"), there are still a number of options that can make your nose look better.

Some cosmetic dermatologists offer "lunchtime fixes," which can be extremely beneficial. Called "lunchtime" because the procedure is done in the office, sometimes in under one hour. These procedures involve the use of filler injections that help minimize an annoying bump or curvature in the nose. They can help to fill in a sunken bridge or make the nose look straighter. Some doctors can even use fat taken from your body to fill in and straighten certain anomalies. "Bunny lines" can be minimized or eliminated with a tiny amount of Botox.

These procedures, alone or in combination, can dramatically improve the appearance of your nose and allow it, as Dr. Fried says, to return as a harmonious member of your collection of facial features. Do not hesitate to discuss your options with a board-certified dermatologist or cosmetic dermatologist. The interventions are usually quick and simple; a private matter that only the nose knows!