The shape of the nose is determined by a complex framework of bone, cartilage, and soft tissue, including the overlying skin. The upper third is supported by the nasal bones, forming a rigid vault, while the lower two-thirds are supported by flexible cartilage. Despite its seemingly fixed nature, the nose is a dynamic structure that can and does change shape throughout a person’s lifetime. These alterations occur through natural growth, the slow process of aging, and sudden, acute events like trauma.
How the Nose Develops During Childhood and Adolescence
The formation of the nose begins long before birth, but its most visible changes occur during the rapid growth phases of childhood and adolescence. At birth, the structure of the nose is disproportionately small compared to the rest of the face, and it is largely composed of flexible cartilage. The nasal bones and surrounding facial structures begin a period of rapid enlargement in the first few years of life, which then slows down until puberty.
A second, significant growth spurt accelerates the changes in the nose during the teenage years, mirroring the overall skeletal growth velocity. This period is characterized by the continued growth and eventual ossification of the nasal bones and the septal cartilage. The nose typically reaches its final, genetically predetermined adult size and shape when skeletal maturity is achieved, generally around 15 to 16 years old for girls and 17 to 18 years old for boys.
Changes to the Nose as We Age
After the nose reaches its adult dimensions, the mechanisms of alteration shift from growth to slow degradation. After a person’s 40s or 50s, the shape begins to change due to the effects of gravity and biological weakening of supporting tissues. A primary cause is the gradual weakening of the cartilage structure, which loses its inherent elasticity and ability to resist downward pull.
This loss of support results in a phenomenon known as nasal tip ptosis, or the drooping of the nasal tip, which can make the nose appear longer than it was in youth. The skin and soft tissue overlying the framework also contribute to this change by losing collagen and elastin, which diminishes their firmness and elasticity over time. Furthermore, the sebaceous glands in the nasal skin, particularly at the tip, can enlarge, which contributes to a wider and heavier appearance.
The nasal bridge may seem wider, and the overall projection and length of the nose can increase. These changes are the cumulative effect of slow biological processes occurring over decades.
Acute Alterations Caused by Injury and Trauma
Unlike the gradual changes from growth and aging, external physical force can cause immediate and dramatic alterations to the nasal shape. Nasal fractures are the most common type of facial fracture due to the nose’s prominent position. A significant impact can fracture the nasal bones, displace the septal cartilage, or cause a combination of injuries.
Initially, severe swelling and bruising will distort the nose’s appearance, which is a temporary change that resolves within a few days to a week. However, if the underlying bone or cartilage is fractured or displaced, the resulting structural damage can be permanent, leading to a visible deviation or a crooked profile. A severe injury can also cause a septal hematoma, a collection of blood that, if untreated, can compromise the blood supply to the septal cartilage.
The destruction of the septal cartilage from such a complication can lead to a condition called saddle nose deformity, characterized by a collapse and flattening of the nasal bridge. This type of acute structural damage requires medical intervention to restore both the cosmetic shape and the functional airflow of the nasal passages.
Debunking Myths: Non-Surgical Changes and External Factors
A common misconception is that the underlying structure of the nose can be physically manipulated without surgery or trauma. Devices like nasal clips, shapers, or specialized exercises are often promoted with the claim that they can slim or reshape the nose. This is inaccurate because the nose’s shape is dictated by the rigid framework of bone and cartilage, which cannot be molded by external pressure or muscle exercises.
The small muscles around the nose primarily control facial expressions and do not have the power to alter the permanent shape of the cartilage or bone. Similarly, significant weight fluctuations do not directly change the shape of the nose itself, as the bone and cartilage components contain virtually no fat cells. The nose may merely appear more prominent or defined against a face that has lost volume.