Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson discusses male rhinoplasty.

Thirty years ago, when Sydney plastic surgeon Dr
Darryl Hodgkinson first started performing rhinoplasty
or ‘nose jobs’, male patients were rare. ‘Perhaps one
in 20 nose patients was a man,’ he says. But today, thanks partly to shows like Extreme Makeover and Nips Tucks, which introduce many men to the world of cosmetic and plastic surgery, almost half Dr Hodgkinson’s requests for nose reshaping come from men.

‘We get men coming in who work in fields that are very
image-sensitive – law, marketing, media – professional
people very keen to maintain their appearance,’ says Dr
Hodgkinson. ‘We also see men after a divorce keen to get back on the scene who want to improve their appearance.’

"For Dr Hodgkinson, a successful nose job is a nose that does not stand out "

After three decades, Dr Hodgkinson has seen countless times the effect changing someone’s appearance can have on their self-esteem.

‘A rhinoplasty can change someone’s life because of the amount of confidence it can give – especially a young person who may have been hounded at school for their appearance. If they have always considered themselves an ugly duckling and suddenly they look attractive, the change in their self-esteem can be quite profound.’

For that reason, Dr Hodgkinson will perform nose surgery on teenagers he feels have realistic expectations. ‘You have to be careful with teens and spend a longer consultation time with them. I have turned some down because I can’t see the deformity they’re worried about.

‘But in some cases if there is a real issue with their appearance, it is quite good to do the surgery earlier before a young person’s self-esteem is damaged. Often I find the psychological benefits far outweigh the physical change.’

Dr Hodgkinson’s clients are encouraged to bring in photos of noses they like. Digital imaging is also available to give an idea of what the finished result may resemble. But clients are always reminded that their nose may not be identical to the one requested, as the result depends partly on the individual’s healing and scar formation, which is unpredictable.

If a nose needs building up, Dr Hodgkinson generally uses bone and cartilage from the patient’s own body – usually from the ear, inside the nose or the back of the elbow. ‘I call them ‘building blocks from your own body’. Silicone implants are not so popular now for enhancing the nose. I find you can often see these implants. They usually wobble and sometimes the silicone implants come out.’

For Dr Hodgkinson, a successful nose job is a nose that doesn’t stand out.

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Roughly three-quarters of Dr Hodgkinson’s patients wish to change their nose for cosmetic reasons; the other 25% are operated on for a combination of cosmetic and breathing problems.

‘I did a lot of ENT (ear, nose and throat) surgery in my training. With nose surgery, I have to make sure that function is maintained or is better. If a patient has polyps in their nose, I take care of that at the same time. A lot of the time, patients can’t believe how much better their breathing is after the operation.’

For men seeking rhinoplasty, Body Dysmorphic Disorder (BDD) is sometimes an issue. ‘The symptoms are overfussiness, spending too much time staring in the mirror, touching the nose constantly and avoiding social situations because of embarrassment over one’s nose. Two per cent of the population suffers from BDD, where they become fixated on a particular body part. They are not good candidates for rhinoplasty and if I suspect someone has BDD, I will refer them to a mental health carer.’

But for Dr Hodgkinson, rhinoplasty remains one of the most fascinating areas of cosmetic surgery. ‘I work with tiny bones and tiny instruments in very small spaces. It’s technically very demanding and challenging. I have a very high rate of success so ultimately, it’s very satisfying.’

27-year-old male with ski jump nose from previous rhinoplasty (performed elsewhere)
BEFORE and AFTER rhinoplasty by Dr Hodgkinson

21-year-old with deformed nasal tip and hump
BEFORE and AFTER rhinoplasty by Dr Hodgkinson. Note a strong masculine profile is achieved