It is a cherished aim of plastic surgery, far trickier than a boob job, fiddlier than liposuction and more technical than a facelift. But at an international plastic surgery expo in London yesterday, one surgeon announced he had cracked it: how to lengthen a short nose.
Given that one typically thinks of rhinoplasty patients as being more Depardieu than button-nosed, it may seem mystifying why anyone with a short nose would want it longer. But according to surgeon Martin Kelly, who revealed at the annual meeting of the British Association of Aesthetic Plastic Surgeons yesterday how to expand the nasal tip, it is quite common.
"There are 'cocaine noses', where the septum has disintegration because of abuse, and there are trauma patients whose nose has collapsed after an accident or illness," said Mr Kelly, who, it seems fair to mention, sports a neat, natural-looking, medium-sized nose.
"You also get people who are born with a facial defect, such as Binder's syndrome, where people develop an abnormally short nose and flat nasal bridge."
Plus, of course, the victims of nose jobs where an over-enthusiastic surgeon has chipped away too much and the patient ends up with an upturned snout. Among the 120 noses he works on annually, Mr Kelly sees a lot of those. Known in celebrity circles as "the king of rhinoplasty", he has patients including the former cocaine addict and socialite Tara Palmer-Tomkinson.
Successfully lengthening a nose is the most difficult feat in rhinoplasty, he said.
Mr Kelly's procedure involves placing a "self expander", which looks like a thick contact lens, under the skin of the tip of the nose for two weeks. This then swells up, allowing the patient to gain extra skin. Combined with another operation, it enables the nose to be lengthened by "two or three times" what used to be possible.
The other headline act at the BAAPS conference yesterday came from Texan surgeon John B Tebbetts, who told of his "out to dinner boob job".
Backed by some solid peer-reviewed research, Mr Tebbetts explained how 85% of patients at his Dallas clinic are well enough hours after their operation to go to a restaurant or "to see a movie or to go to the mall". Twenty-four hours later 96% are able to return to "full, normal activities - including sex".
They do not need any bandages and, apart from the initial general anaesthetic, require no drugs stronger than Ibuprofen.
The gathering heard concerns about a lack of adequate regulation in the UK industry, particularly of non-surgical treatments such as Botox and "fillers" injected into the skin to smooth out wrinkles.
BAAPS president Douglas McGeorge said the government's failure to introduce legislation - instead leaving the industry to regulate itself - encouraged a "wild west" culture.
