Cosmetic surgery may seem like choosing from an a la carte menu: a little work on the nose here, eyelid lifts there, and maybe a facelift for dessert. Yet some procedures seem to naturally complement each other, just like wine can complement a main course.

Rhinoplasty, popularly known as a ‘nose job,’ typically is a stand-alone surgery, but some individuals undergo additional surgical enhancements at the same time. “The most common add-on in those under 40 is a chin implant, chin liposuction or ear-pinning procedure. I also do a fair number of rhinoplasties in middle-aged and older patients when eyelids or even full face/neck/brow lifts are done with the rhinoplasty,” says Dr. Mike Nayak of Nayak Plastic Surgery. However, he notes that about 70 percent of the rhinoplasties he performs are solo surgeries.

Dr. Herluf Lund, a plastic surgeon with St. Louis Cosmetic Surgery, agrees that the ‘main course’ of rhinoplasty often needs no accompaniment. “Because improvement of their nasal appearance is the primary focus of most patients having a rhinoplasty, often other more subtle cosmetic concerns are not noticed or focused upon until after the nasal correction. Then other procedures may be requested to achieve the desired appearance,” he says.

In fact, Lund reminds patients that rhinoplasty should result in a seamless blend of the nose with existing facial features and symmetry. “Occasionally, when a patient requests alterations to their nose that will not blend with the rest of their facial features, it is important to remind the patient that the most successful rhinoplasty is one that meshes so well with the rest of the face that no one really notices the changes that were made,” he says.

Most people requesting rhinoplasty want their nose made smaller, Nayak says. He agrees with Lund that the ultimate goal is balance of facial features. Thus, if the chin is especially small, enhancing it can help the entire face appear more balanced and symmetrical. In fact, some people who seek to reduce the size of their nose may actually benefit more from chin augmentation, bringing the chin into proper proportion with the nose and other features.

Not all accompaniments to rhinoplasty require additional surgery. Nonsurgical enhancements are popular ‘side dishes.’ “Fillers are great to add on to any surgery, and especially noses,” Nayak says. “In my younger female patients, a conservative lip augmentation with fillers is the perfect complement to rhinoplasty. In older patients, we commonly fill lip lines, smile lines or cheeks while the patient is already in surgery.”

Botox and physician-directed skin care are other popular additions that can enhance rhinoplasty. Lund emphasizes that a good maintenance regimen for the skin, possibly including Botox and fillers, helps protect and maximize post-surgical results.

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