Rhinoplasty, aka Nose Jobs

Nose jobs have been around a lot longer than you think. And the process is pretty interesting. Tune in for all things rhinoplasty. 

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Episode Transcript

Speaker 1 (00:01):
Welcome to Stuff You Should Know, a production of I
Heart Radio. Hey, and welcome to the podcast. I'm Josh,
and there's Chuck and there's Jerry, and uh, this is
Stuff you should Know. The Schnaz edition. It's such a

(00:21):
great word. It is man and it's such a great
descriptor to like, I consider my nose a schnaz. There's
a big difference between schnas and a nose and I've
got a schnaz. Yeah. And what I think is even funnier.
And this goes back to the Saturday Night Live, which
one was it? It was a Martin Short season and

(00:44):
it was one of the Martin Short sketches where he's
doing I think Nathan Thurm was the attorney that he
did occasionally, and he said the word schnas like snaz
without this and it just made it even funnier. He said,
we don't make snazzas he's talking about fake noses. So

(01:05):
did he did he get it wrong or did he
mess up a line or what was the deal? Oh?
I think it was just the comedic genius of Martin Short. Yeah,
he's pretty good. And speaking of which, uh, this has
nothing to do with that. But we're teasing out listener
mail today early because we have collected I knew we'd

(01:27):
get some good grilled cheese tips, and we collected a
little small compendium. So it's gonna be a bit of
an extended listener mail where we go over the listener
mail tips for grilled cheese sandwiches. We're really going to
wear out that background music. Let's a stick around. So
we're talking nose jobs today, Chuck also called rhinoplastic. You

(01:49):
would think rhino plastics the clinical term, and I guess
technically it is, but if you are a plastic surgeon
or cosmetic surgeon, um, you would probably not call it
that any longer. You'd call it nose sculpting instead, which
to me really kind of underscores the vibe about nose

(02:11):
jobs today. That is a little bit here, a little
bit there, nothing too ridiculously radical, and that's a far
cry from, you know, the rhino plastic of the past,
from what I understand. Yeah, I've heard it calls no
nose reshaping as well. And rhino plastic itself comes from Greek,
of course, rhino meaning nose or SNAs uh and plasticoast

(02:39):
p l A s I k O s which looks
so so. Greek means to shape into mold, and that's
what plastic surgery comes from. Of course, a rhinoplasty is
just reach re shaping the snaz man. You are on
fire in man, really, yes, I mean no, it's not no,

(03:04):
you've been on fire. But I'm saying like, like you've
really just stepped it up in the last like this
past year. I don't know what the deal is, but
I love it. I'm I'm loving it. I'm here for it,
and I want more and more. All right, nowhere to
go but down. That's right, that's what they call a
set up. You're gonna do great, chuck, what kind of snot?

(03:27):
Thank you for that, by the way, demur, but and
try to move on very quickly when given a compliment. Yeah,
well so let's do that here. That's fine, that's fine,
But I also want to add something to that. I
I that is now the last time I'm going to
like drag one of your great jokes out and like,
you know, beat it with a rug beater until it's

(03:49):
totally not funny anymore. Now I'm fully on board, So
I'm just gonna play a lot like it's just normal yeah, Uh,
what kind of nose job would someone get? Why would
someone want a nose up? Oh, there's all sorts of
reasons you could want a nose job. You could be
a um U seventh century b c. Indian thief or

(04:09):
adulterer and have had your nose lopped off as punishment. Okay,
bring it forward. You could have been in uh one
of the world Wars and been facially um injured by
a mine. Bring it forward. You could have been born
with a kind of nose that is characteristic of your

(04:31):
ethnicity and want to have changed it to fit in
with waspy mid century America getting closer. And then lastly,
um you can also want to reshape your nose for
medical reasons as well. Right, the only thing you left out,
which and we're going to get to all this stuff
in greater detail, is you may have had syphilis, which

(04:54):
let at a time in our history that left you
with kind of a hole in the front of your face. Us.
And just big tip for people, do not google syphilis
nose and look for images because while you will see
that and that is alarming in and of itself, you
will see lots of nastiness that you won't be able

(05:16):
to forget anytime soon. Yeah, because apparently syphilis causes necrosis
of your soft tissues, and you know, soft tissues combined
to kind of give us a characteristic appearance, and when
that soft tissue is missing, it can be you know, um,
disarming at first or alarming at first until you just
stop and think, like, what's the person? You know? That's right?

(05:37):
Uh So as far as cosmetic stuff goes, and if
this is purely like, hey, I just don't really like
the way my nose looks and I would like to
to to get it to look the way I wanted
to look. Uh. Some of the reasons are just facial balance,
like how big your face is in relation to the
size of your nose. You might have trouble with the
width of your nose. Or it might have something to

(06:00):
do with a visible hump or bump, which I love.
Uh yeah, I think is it called a Roman nose? Yes,
that has sort of the hump. Yeah. You find it
to be a very attractive feature on a lady. Gotcha? Okay? Cool,

(06:20):
So I'm I'm a fan. Um, so you know that
would be something you would see more in profile, or
you know, it might be the tip of your nose
might droop or be turned up in a more I
guess they call it technically they call it a pug
fashion um or it might be hooked, or you might
not like your nostrils they may not be symmetrical like
they can kind of do whatever you want done these days. Yeah,

(06:43):
that's definitely true. And one of the things that um
that has evolved as far as nose jobs goes, that
I kind of touched on earlier is it's no it
used to be, especially in the heyday of the mid century,
of the fifties and sixties, when you know, nose jobs
really sorry to take off for cosmetic reasons, especially among
um people of Jewish ancestry in America. There was like

(07:06):
I want this nose. You go in with a magazine picture,
or you go in with your friend and be like,
give me her nose. You did her nose, I want
the same nose, And like there was a just this
kind of general idea that you you just got exactly
the nose you wanted without any regard to whether that
nose actually look natural on your face. And it's evolved

(07:27):
over time. And one of the reasons why it was
because there was like a perfect nose in American nose,
a Caucasian knows that was like an ideal version of beauty.
And over time, especially in the last like Tanner so years,
it seems like there's been a huge sea change in
the way people who get those jobs approach it, and

(07:47):
that they're like, can you just take the more extreme
features of my nose, like you just went over on
that list and just kind of tone them down a
little bit. Don't give me a different nose. I want
a slightly more idealized version of my nose. I want
to look like myself. I don't want somebody else's nose.
I just want it tamed a little bit. And that's
kind of where it stands today from everything I saw

(08:09):
as far as nose jobs go. Yeah, and it sort
of reminds me of that great scene from the movie
Singles when Bridget Fonda goes in for breast augmentation surgery
and Bill Pullman is the surgeon. Yeah, Bill Pullman, and
I wasn't thinking Bill Paxton, and I just couldn't remember

(08:29):
if it was Bill Pullman. Uh, and she You know,
they have the little weird science program where they make
the breast larger or smaller by just hitting up or
down on the computer, and she goes way big, and
he's like, why don't we like fit your frame a
little more. He's sort of trying to talk her into
just a more reasonable form of that surgery. And I think,

(08:50):
and that was a long time ago, and I think
you're right. I think these days, and of course people
get all kinds of extreme, you know, body surgery done,
but I think these days it is a little bit
more or common for someone to say like, hey, I'm
not trying to look like a completely different version, but
this one thing is always bothered me. Yeah, and then
one other thing I want to say too, that seems
to be a common um part of the discussion around

(09:14):
nose jobs is um. A lot of people who get
them tend to view them as not so much like
a physical um operation, or it is a physical operation,
but it's to correct a psychological issue that the person
doesn't actually like. There's nothing wrong with their nose, they
just don't like their nose, and they've come to dislike

(09:36):
their nose so much that they have trouble like living
their life because they're so self conscious about it. And
to them, people who get nose jobs say this is
this is this, this is just smart, Like, there's no
reason for me not to do this. It's going to help,
and apparently it does help sometimes. So I don't encourage
it one way or the other. I certainly don't um

(09:57):
judge or criticize or anybody who does get a nose
job if they feel like it's the right thing for them.
But it just seems chuck very much in step with
the century and the like people in there, you know,
late teens and twenties and you know, even early thirties
are just so aware, way more aware than we were
when we were their age. Um that that kind of

(10:18):
has to do with nose jobs. Who has trans translated
and transferred over to nose jobs that people are just
thinking more about it rather than I hate my nose,
I want this nose, you know. Yeah, I think it
falls into the general umbrella of like, now there's a
lot more um sort of shunning of this idealized beauty
notion then there has been in a long time. And

(10:40):
I'm not weighing in one or the other either because
it's a very personal choice. But I will say that
I do love the idea of this idealized form of
beauty being kind of kick to the curb to say
something more modern. Deed, there are a few things that
have been more harmful that didn't involve like guns or
explosions than and a single idealized form of beauty, you know, alright,

(11:01):
so I agree. Um, let's go over some statistics right
out of the gate. Most of these are from the
United States. We do have a few international statistics, but
it seems like those are a little harder to trust
just based on how they're gathered. But about two point
three million, um, I think this is complete cosmetic surgical

(11:23):
procedures in the US, and I think it knows reshaping
is and was the most common. About three D fifty
two tho nose jobs in the US far more women
two eight seven thousand compared to sixty five thousand men
and teens make up about of those. Nine year olds

(11:46):
make up thirty one. If you live out West, you're
more likely about a third of the nose jobs are
performed dot West. I don't know if that means, you know,
Los Angeles County and probably uh and then called Aasian
White people get way more nose jobs than anyone else
by a long shot. Seventy one of the nose jobs
in twenty were on Caucasians African Americans with just five percent, Hispanic,

(12:11):
ten percent, in Asian Pacific Islander eleven percent. So if
you're a white American twenty five year old woman living
in Los Angeles, there's basically a hundred percent chance that
you're going to get a nose job. I think you
have to from what I'm seeing here. Um, what about internationally, Well,
like you said, the stats are a little wobbly compared

(12:33):
to the U. S A stats, But apparently Brazil is
number one, they're the leader, um, followed by Turkey and America. Um,
and then Argentina and Russia. This list, I've seen reference
elsewhere that Iran is actually number four behind Brazil, Mexico,
and America. So it's just it's just up for grabs.

(12:56):
Apparently the rhino plastic reporting standards around the world or
have have something to be desired. Sure, but let's just
say in the top five, six seven, you could definitely
have Brazil, the United States, Mexico, Iran, Turkey, that kind
of thing, right. I think that's because the way they

(13:17):
count rhino plasty around the world is they just have
a little like a suggestion box type thing on the
way out, and they say, well, you like to keep
track it? Who does this? To just write your real
name on a piece of paper and just stick it
in there, or we'll just trust you to do that.
There is a big mistranslation and they accidentally translated translated
not Schnas but SNAs confused everybody else. That's good. Uh,

(13:42):
should we take a break here and then dive into
the history. All right, let's do it. So, Chuck, I

(14:11):
made reference before about living in six hundred or the
seventh century BC. Um, and maybe you were undergoing a
rhino plastic operation because you had your nose removed as
a punishment. Um. That's actually where rhino plastic began. Like,

(14:32):
it's not like there was some ridiculously primitive procedure that
somebody tried once and then the idea was lost for
a couple of thousand years, and then it got developed
in the nineteenth century by some British guy. That's not
at all how it happened. There was an Indian surgeon
named sush Rida, which is not his name is actually
an adjective that means renowned. But Sushrita is considered the

(14:53):
father of cosmetic surgery, and that this guy was not
only performing cosmetic surgery like rebuilding noses from nothing, um,
he was documenting it too, in in medical texts that
he wrote that survived, and he created a technique called
the Indian flap that was still in use into the
twentieth century. Is that how it's pronounced his name, Sushrida.

(15:17):
Mm hmm, that's what I'm going sus Shrewda. I mean
that's you. I guess I'm in the mood for a margarita.
I'm in the mood to do a little dance called
the Indian flap because that sounds like a lot of
fun at a party. Um, the surgical procedure not so fun.
I mean, should we read part of this? Yes? Or

(15:37):
should we read all of it? I think it's it's worthwhile. Yeah, alright.
So this was a description of the Indian flap technique
from Sa Shrewda aka Sashrida himself. The portion of the
nose to be covered should be first measured with a
leaf as you do. Uh. Then a piece of skin
of the required size should be dissected from the living

(15:57):
skin of the cheek, which is super advanced. Still what
I mean scrafting right right, and it's leaving bud supply
coming from the cheek. Still yeah, very smart, very good.
Uh So we're we're approving of these surgical methods, year
old surgical methods. You know, we're we're in a position
to do that. We live in the twenty one century, baby, yeah, exactly. Uh.

(16:18):
Let me see, uh dissected from the looming skin in
the cheek and turned back to cover the nose, keeping
a small uh pedical attached to the cheek, which is
what you referenced. The physician should then place the skin
on the nose and stitch the two parts swiftly, keeping
the skin properly elevated by inserting two tubes of ronda,

(16:40):
which is a castor oil plant, and the position of
the nostrils so that the new nose gets proper shape
when the skin has united and granulated. If the nose
is too short or too long, the middle of the
flap should be divided and an endeavor made to enlarge
or shorten it so it sounds like they're just taking
part of the cheek, folding it back over into itself
to meet the other part with a tube in the

(17:02):
middle and then having it grow together, right, yeah, two
tubes tubes. Yeah, and they still do that today. They
use um stents to hold to to have the the
procedure hold its place or shape afterward, um, and they
leave it in there to until it heals. So like
this guy was basically it's like that saying, I can't
remember where it came up, but um, somebody was describing

(17:25):
how advanced this development was or whatever development it was
right out of the gate where they said that they
basically invented the airplane fully functioning with like trade tables
for in flight meals and everything. Like totally, this guy
like just figured it out from the outs. And it's
not like we're taking you know, the skin from your

(17:48):
cheek today and using that um to to um to
build a brand new nose that would probably actually be
more likely to take it from other parts of your body.
But the concept are still very much the same. And
it's weird to think that rhino plastic has been around
kind of unchanged for almost three thousand years. Yeah, And

(18:09):
just to reiterate, so it's clear, this is the procedure
when there was no more nose because it had been
completely cut off so they're really starting from zero and
forming a new nose. Uh. And yeah, it's pretty amazing.
And I'm sure compared to what I mean, no matter
the result, it probably looked better than what they had
going on before, would be my guess. Yeah. Um, so

(18:31):
this uh, this, this technique made its way um through
uh Egypt or out from India and to Egypt over
to Europe. Finally, um, where they were dealing with syphilis
outbreaks in the fifteen and sixteenth century, like you were mentioning, Um,
there's an Italian surgeon that made his contribution guests, bar actually,

(18:52):
I think you should take this Gaspari Techlia Colzy very
nice and back. He said, I'm really going to advance this.
Instead of that skin from your cheek, I'm going to
take it from your upper arm. So he just kind
of did a modified Indian flap, and I guess you'd
call that the Italian flap. But then finally in the

(19:12):
nineteenth century, Um, there were a couple of surgeons in
the late nineteenth century who really kind of duke it
out for the title of father of plastic surgery, or
at least aesthetic plastic surgery, because we got really good
at doing things like rebuilding noses using rhino plastic, and
we got so good at that people started saying like, hey,

(19:35):
your nose is perfectly fine and it functions, but would
you like to take a little off the top, And
cosmetic surgery was born. That's right. I believe the first
gentleman you're referring to is a michigan Er. Is that
what they call themselves? I think it's actually Gander. I'm
not kidding, yes, because I saw an interview with UM.

(19:57):
I can't remember their governor's name, but she had a
sign that said like proud Michigander. Yeah, yeah, I know
the governor, Okay, Michigander. I like that. Seven. His name
was John Orlando or Rowe. And this was I think
technically the first paper about cosmetic nose jobs, called Correction

(20:17):
of the Pug Deformity. And then the next guy, he
had some fun nicknames. He was a Jewish German surgeon
named Dr Jacques Joseph uh and his nickname was nos Joseph.
Pretty good. Yeah. He actually UM kind of ties into

(20:37):
our episode on World War One soldier masks. Do you
remember that? Yeah? Yeah, I knew this wrong A bell
I get the impression that he was probably working in
the same maybe the same campus that the guy who
led that mask department to to build masks for UM
soldiers who came back with UM facial differences from from

(20:58):
like bombs and bullets and stuff. Uh, this guy was
actually doing cosmetic surgery UM to help prepare those injuries. UM.
And he got interested eventually in making UM changes to
help uh Jewish Europeans fit in better. And we'll talk

(21:19):
a little more about that later when we talk about
ethnic cosmetic surgery. But UM, that was kind of like
his evolution. He went from helping soldiers to kind of
helping you know, wealthy citizen re in Europe. Uh. And
because of that, because this guy showed that there was
a huge demand that no one realized was actually there
before a huge explosion of I don't know, Charlatan's ne'er

(21:43):
do wells, shiftless slackers, snake oil salesman. I'm sure um
who who figured out like, hey, I'll just give this
a shot. How hard can it be? Um? And the
rise of the beauty doctor came along. Yeah, the beauty doctor. Uh,
it's sort of a contradictory name, I would imagine because

(22:04):
these were the unlicensed practitioners out patient knows jobs like hey,
I've got some paraffin wax, let me inject that in there,
because that's a great idea. Just don't go out in
the sun. And it's also carcinogenic. So this was you know,
a very sort of um cut rate job that you
didn't have to pay a lot of money for and

(22:27):
it's probably the you know, the expectation was not great,
but it was at a time where I guess, you know,
legitimate plastic surgery was just entering the fray, so people
didn't know any better, and so there were a lot
of bad, bad outcomes. I think from these beauty doctors.
What what's nuts to me, Chuck? Is this still going
on today with button augmentation. There's a lot of underground

(22:51):
like unlicensed people who use non medical stuff like silicone
and pump it into people's bots to like make your
butt bigger. Um, And it's cheaper. Like you said, it's
much cheaper because their unlicensed and they kind of know
what they're doing from experience. But they also have no
way of getting you to the hospital. They're not doing

(23:13):
this in the hospital, and some people have died. I
wrote about a mother daughter team who killed a woman
because they injected silicon and they accidentally got it into
her muscle, which introduced to the bloodstream and killed her
within an hour or so. Um, it is really sad.
Um And apparently there's been other people who died like this,
so it's still going on. But as far as rhinoplasty
is concerned, I'm pretty sure it's widespread enough and just

(23:37):
affordable enough that people aren't going to underground surgeons like
they were in the nineteenth century for it. Yeah. I
mean it's sad that that still exists and that people
can get away with doing this stuff like out of
their houses, you know. Um, So things boomed in the
nineteen fifties in the US, like you were talking, and
I guess now comes the time where we talk a
little bit about the procedure itself and the nose itself. Um,

(24:01):
it's a little you know. What really helps is if
you're not driving a car or something, if you can
just look up sort of a a profile of the
nose that's labeled for the different parts, which Dave Ruse
put this together for us, right, Yeah, he did did
a great job too. Yeah, Dave was kind enough to
actually include a picture like this, which really helps kind
of break it all down. Um, you've got your upper

(24:23):
third of the nose, which is the nasal bone, and
his and his just you know, that's where the bone is.
That's where if you get your if you get popped
in the square in the nose with somebody's fist and
you break your nose, you're breaking that nasal bone because
almost all of the rest is what's known as cartilage,
which is just you know, that's what that's the shape

(24:43):
that you're seeing, and that's why you can squish on
the front of your nose and your nostrils and it's
you know, it just feels like, uh, what does it
feel like? Help me out. It feels more rubbery than
the top part of it. Rubbery. There you go. And also,
even if you don't have a phone or you can't
look at pick sures right now, you can feel the difference.
Like if you pinch the bridge of your nose and

(25:04):
just kind of slide it down past about a third
of the way down towards the tip and just kind
of move it, wiggle it back and forth, you can
feel that's bone that's not moving, that's cartilage. That's that's
gonna move. It's gonna do the Indian flap. If you
move on a sneeze, don't make me sneeze. Just put
your corn applicat roof them off. Is that supposed to work? Actually? Yeah,

(25:26):
it also works for ice cream headaches too. Okay, man,
we're just slaying the knowledge today. Uh So, then you've
got your rate x R A D I X. This
is the built up cartilage um over the ridge of
your nose. And this is where you might get like,
if you have a hump on your nose, it's probably
gonna be on that rate x. And this might be

(25:48):
something that people choose to get flattened out. Yep. You
also have um. One of the more interesting pieces of
your body that I didn't realize the name of it,
but I love it now that I know it, the columella,
which is the little skin between your two nostrils, the
little kind of vertical strip of skin that separates your nostrils.

(26:09):
And I thought that was a septim. I learned all
kinds of stuff when I did that, the septims inside
your nose. The columella is the part you can actually touch. Yeah,
so just touch the little piece of skin between your
your nose and my friend, you're touching your columella. That's right.
The septums up inside your nose above that, and it
actually continues the separation of your nostrils in your nose. Yeah,

(26:36):
and see, I always thought because I just I never
knew much about this stuff or looked into it because
I have a great nose. But I always thought a
deviated septim meant that that that the septum was actually
like had a hole in it. Can that's perforated? Really though,
that can happen to the habitual cocaine use. Well, yeah,
you always heard that story about make Jagger, which is

(26:57):
probably not even true. His septom all out or something. Yeah,
like he had it like it was completely dissolved at
some point. That, No, that can't happen. I saw a
study where out of like a hundred and four cocaine
users who used like ten or more times a month,
just a pretty heavy cocaine user, um like ten of them,
ten percent had had a perforated septum. And that eventually

(27:20):
gets so perforated that your septum can just kind of
fall in and your your actual nose can collapse Yeah,
I think I wasn't saying that that's not possible. I
just doubted that it was Mick Jagger does. It just
seemed like one of those far out celebrity rumor things.
But who knows. He certainly, you know, was familiar with
that drug at one point. It's it's like the time

(27:43):
Reggie Jackson slash Eddie Murphy slash Lionel Richie told that
lady of the elevator to sit down, but it was
actually do she was talking. He was talking to you
refer to our episode on Urban Legends from a gazillion years. Uh,
and then what wait, we're missing one more piece? Oh,
just the tip, just the l R A L A
R cartilage is the tip there? And uh, that's where

(28:07):
you know, if your tip turns up a little bit,
they call that the pug deformity, or they did back then.
I'm I'm not sure what they would call it now,
a cute button nos, acute button nos, or if it
has a little tiny hook at the end. Uh, I
might want to get that done, who knows, who knows?
I mean, that's there's few more personal decisions to whether

(28:27):
you get a nose job or not. Yeah, Like I
almost can't think of one, and by almost, I mean
I can't. Right. So you've got all these different parts
of the nose and we went over and because they
all kind of come into play, um, depending on what
you're going to do. But um, you know, one of
the one of the leading reasons people go in for

(28:48):
rhino plasty is to get their nose reduced in size
in some way, shape or form. You can also increase
the size of your nose. Um. One very common um
uh type of I know plastic is where you actually
elongate the nose to have it come further off of
your face, so that in relation to your face, your

(29:08):
nose appears narrower. Even though they haven't sized down your nose,
they just made it longer, which makes it seem narrower.
A lot of this is kind of optical illusion. Yeah,
that's called projection rhinoplasty, and that obviously is going to
require you graph something from another body part or from
a cadaver. That happens as well. Yeah, I'm not sure

(29:31):
why they would do that instead of one of your
own unless you didn't want any of the rest of
your body being removed. I don't I don't know who knows,
but they, Yeah, they definitely do. They'll use that from cadavers.
They they can use it from rib cartilage, septum, cartilage,
your cartilage. There's a lot of places they can harvest
cartilage from, and you don't need a lot. I think

(29:52):
I get the very distinct impression that a little bit
of rhinoplasty goes a very long way, and I think
that's true. I don't know if if really kind of
harped on this or not, Chuck, but remember when you
said plastic coast means plastic or to shape or to
mold in that sense. That's something I think we should
point out because for a very long time, I always
thought plastic surgery meant that they were inserting like plastic

(30:16):
stuff in there. Yeah. I think a lot of people
thought that. Yeah, interest all right, Now they mean plastic
in the term of something being able to be molded
or bend or changed or shaped. That's what they're using.
The term plastic force. There's no plastic use. They're using cartilage,
they're using bone. They're removing cartilage, they're removing bone, and

(30:36):
depending on where you remove cartilage or where you remove
bone has a huge effect on the overall appearance in
shape and size of your nose. That's right. Uh. The
it's a bit of a misnomer that you have to
have your nose broken to have rhinoplastic That is usually
not true, although it can be. Uh. They've really come
a long way over the years and how and kind

(30:57):
of like with every surgery with it's as non invasive
as it can get these days. And there are a
couple of different types. There are open and closed rhinoplasts,
and they each have their advantages. Both open type. You're
gonna make that incision and the columbula, I think columella, man,

(31:19):
I really mess that up. Uh. And that is that
thin strip of skin that you talked about between your nostrils.
It's a little incision there and then you can access
the cartilage from that point and the bone through that
single incision. Uh. They like this when it takes a
little longer for the swelling to go down, I think,

(31:40):
and you might have a little have a little bit
of a scar, but I think this is the one
that they prefer to use when you need a little
more work done than usual, a little more cartilage, right,
because cutting that columella allows them to lift the skin
off of your nose and access it more readily. So
if they're doing extensive work, this is just gonna make
it easier for them, which just the thought of that

(32:03):
makes me want to faint, But that's what they do.
The closed version makes me want to faint only slightly less.
But they actually go into your nostrils and up to
a certain point depending on where they're going to be
doing work, and they make an incision at each nostril,
which then that allows them access to the cartilage and

(32:23):
the bone along the nose um, and that has a
much quicker recovery time compared to the open rhino plastic.
Like you were saying, right, and you're not gonna have
a visible scar because it's up in your little mastres. Right.
That is something like even though you're not getting your
nose broken, if you get an open rhino plastic and
probably just about any type of cosmetic rhinoplasty um, you

(32:46):
are going to have a recovery time where you basically
want to set aside two weeks to where you can
just take care of yourself at home, um, because you're
going to look very much beaten up with black eyes.
Your nose is going to be extremely sensitive. One of
the things I saw that you're supposed to do during

(33:06):
recovery is to avoid blowing your nose. The thought of
that makes me want to faint too. Blowing your nose
after rhinoplastic um. You want to eat soft foods, brush
your teeth, chasy. Yeah, you don't want to sneeze because
again you're gonna have stents in your nose that are
holding the shape, that are keeping the sutures from coming out.
And um, you're basically after mouth breathe. Uh. And that's

(33:32):
I mean, that's from the rhin like cosmetic rhino plastic.
But there's actually other reasons to get rhino plast two
that are medical reasons. And here's where your insurance kicks in.
That's right, we mentioned I mentioned the deviated septum. I
thought it meant that it was completely like worn away
or there was a hole, which can be the case,
but usually deviated septum more commonly, that is is when

(33:53):
the internal wall is uh. Instead of kind of straight
vertically down the center, which you to like sort of
clear airways for the nasal passages, it's moved over to
one side a little more so you've got one nasal
passage that has very little room, and I would assume
the other has more room, right, not to an advert way,

(34:16):
but I guess, I guess it can depends on what's
going on with the septum. But yeah, I guess like
a three car garage, you know, with you So I'm
actually getting this done, right, Yeah, that's what that was
the idea that sparked this episode. Actually, Okay, So I
went in for a consolt, Chuck, and I saw my
septum and one of them, the the p A was like,

(34:40):
I I can't even get the camera back there. Your
septum is so pressed up against the the inside of
your nose. Um. She didn't say the other one was
wide open, although you know, I can tell I can
actually breathe through it. But so I went in and
got a CT scan and now I'm waiting for them
to go over the results with me. But I'm pretty
sure I'm going to beginning yet. And I'm scared to

(35:01):
death because it turns out a friend of mine didn't
know this. Uh West, his name is West. He just
got it done, and he said that recovery was like
some of the worst days of his entire life. He
said it was so rotten. He said his his throat
was like gravel from mouth breathing. His nose is in pain.
He had these stents in his nose, and apparently his

(35:23):
doctor didn't tell him that he'd put stints in, so
West had no idea what was wrong. He just knew
his nose fell all screwed up. And then he finally
went in for the the like the week later follow up,
and the doctor pulled the stints out and he said
it was just the whish of air through his nose
like he's never experienced before. He said he almost fainted
from hyperventilating breathing. So I'm like, that's what I want.

(35:45):
I'm willing to go through this for that. So um
West scared me. And then another one of our listeners
wrote in when I was talking about getting it done,
who was like, you should get it done, but you
should also go into it knowing how rough the recovery
is because everybody downplays it. And so I'm I guess
hopefully it's going to help me a little bit knowing
to expect it. I think maybe it was so bad

(36:07):
for them because they were caught off guard. And now
if I'm expecting the worst. It might not be as bad,
but I'm I'm gonna go get it done. Good Yeah,
and good luck. Thanks. I'm sure it'll be fine. Let
me ask you a couple of follow ups. Uh so,
if you like, hold the good side, if you pinch
the good side down, can you breathe it all through

(36:27):
the other side A little? A little? Not much? Man,
That must be frustrating to live with. It is. Um, yes,
it is, but I didn't. I just thought it was
normal until I got diagnosed with the deviated septum, and
then I was like, oh okay, And I actually asked
the doctor who diagnosed me, like, dude, how did I

(36:48):
get that? He's like, I don't know. Maybe your mom
dropped you on the head. You got in a fight
when you were little. And I was like, I know
the fight he's talking about. Really, my friends saw me
in sixth grade and I got into a fight and
the only time I've ever been punched in the nose,
he punched me in the nose, and I guarantee that's
when I got a deviated septum. Psommy, we gotta track
that guy. Yeah, make him pay for this. Yeah, yeah,

(37:10):
he should mean financially, you know, not not ref him
up right now. Of course we got to make him pay.
This is like I'm like Kanye and Ssommy's Pete Davidson.
All right, so let me ask you this, and this
may be too personal, but you know they talk about
two birds one stone. If you go in, insurance will
cover the uh, the medical portion, the actual DVD ad sceptum.

(37:35):
But while people are in there, sometimes they will choose
to get a little work done that you have to
put the bill for. But I think the thinking is
while you're in there, I never liked X about my nose. Like,
I know you talked about not liking your nose. You're
gonna do anything or do you even want to talk
about that? Well, you know, I was looking at my
nose as recently as today just to ask myself that question, honestly,

(37:58):
because like, it's not like I don't like I knows that.
It just kind of took me many years to finally
be like, I'm like, I'm fine with my nose. It's fine,
it's my nose. I'm I'm cool with it is what
I look like. Your nose, um, thank you if you
look at it a certain way in profile. I look
like a cartoon gangster, like from a Dick Tracy um strips.
It kind of looks a little bit like that. But um, yeah,

(38:20):
I so I. I actually was like, no, I'm not
going to It's fine. I like my nose. I'm probably
less opposed to it than I I was before I
researched this episode. Um, but yeah, I don't think I'm
going I'm definitely not this time around, but I don't
think I probably ever will. Well, here's what you do.

(38:40):
As you're going under. You just slip a little sticky
note into the surgeon's hand. Right, they'll unfolded, and it
just says, if you happen to get rid of a
little extra while you're in there by accident, I won't.
I won't be mad at you. Are you Are you
telling me that I should get a nose job? Is
that what I'm hearing from me? No? No, I was
just joking around, like like your No. I never thought

(39:00):
your nose was quote unquote big until you started talking
about it. And then I mean, people look how they look,
and you don't like have any prominent nose features, like
like a hump or anything, So I don't I never
thought you had a big nose. I guess I don't
know where I got that idea. I think people look
at themselves obviously more critically, like I look how I look.

(39:24):
I see myself in a picture, and I'm you know,
sometimes horrified at like to kind of shape them in
right now. But you know, your friends and family walk
around there, it's like, that's what you look like right now.
Well that's funny because I I think I trace my
awareness of my nose back to Valentine's Day when I
was eight. My family always made a big deal out
of Valentine's Day. We would say, we we put cards

(39:46):
on one another's chairs at dinner, and then have dinner
and we get to open our Valentine's Day cards, and
I remember one from my mom and dad that said,
your nose is really big, but we love you anyway.
Happy Valentine's Day, Mom and Dad. What I'm just kidding. Okay,
that was good. You got me. I don't know where
I got the idea that my nose is big, but
I'm pretty it's pretty well seated in my my idea

(40:09):
of myself. All right. Well, that's very wonderful of you
to be open like this, because this is the kind
of stuff that people don't talk about a lot. I
think it's true. That's true, I guess not, although I
think people are starting to talk about it more and more. Yeah, alright,
So before we take a break and finish up about
this whole idea of what's called racial passing, we will

(40:32):
just quickly mention how much these things cost all in. Generally,
about five to nine to ten thousand dollars is what
I've seen for rhino plastic. It depends on where you are. Yeah,
in Atlanta, it's in l A. The same thing is
going to cost you ten grand to fifteen grand, And

(40:55):
that's an average cost. There's definitely much higher um. But
from what I'm being like, if you it's one of
those things where you do your research and you find
the doctor that you feel comfortable with and you go
to them. Like, if you're spending ten grand on your nose,
you you probably can swing a couple of hundred bucks
maybe twice to go fly out to somewhere else in

(41:17):
the United States or somewhere else in Europe to go
to the doctor that you feel is going to do
the best job. That's right, all right, So let's take
that break and we'll talk a little bit about ethnic
rhino plastic right after this. All right, Uh, this is

(41:56):
something we have to talk about. It's sort of one
of the uglier parts of this podcast episode, but we
have to cover things in full. And there are surgeons
who specialize in what's known as ethnic rhinoplasty, with the
idea that, uh, and there's really no other way to
say it, then they will augment your nose to look
more uh, European or Caucasian, if that's something that you're

(42:19):
looking for. Yeah, and I mean today it's this kind
of it's some I think in some ways it still
ties into this idea of you know, I could look
more beautiful than I do if I have this. It's
definitely a far cry from I need to pass or
fit in so I can get a job or marry

(42:39):
a husband, like it was in America in the fifties
and sixties as a big driver for nose jobs. Um.
But then I think if we trace it back to
like the nineteenth century was Jacques Joseph Um, there was
this idea that you could you could judge a person's
moral character based on their nose. Right, Oh, absolutely, I
mean if you had just a very sort of um,

(43:03):
smallish straight nose. It was sort of a sign of
a higher class. If you had any sort of like
bumps or hooks to your nose, you were maybe someone
to not be trusted. And these all come from the
oldest like dirty ethnic stereotypes that have been around since
time in Memoriam and you know knows Joseph was one,

(43:25):
like you said, he was one of those doctors that
and these are their words that they're using, but you know,
they called it the defect of Jewish uh nostrility, which
is an actual word, and it would help people, you know,
pass at a time when being Jewish was either looked
down upon or could threaten your life or like you said,

(43:46):
maybe uh lead you to not getting a job as
easily as you should based on your qualifications. Yep, dropped
the burg or the steam from your last stame and
all of a sudden, you're just a playing Jane, average
American mid century Joe or Jane. That's right. So um,
that was actually like Jacques Joseph. And then the advent
of like readily available plastic surgery was it was like

(44:09):
hugely helped along, um by this idea that Jewish people
just kind of needed to do to do this and
apparently became such a rite of passage Chuck that by
like the fifties, sixties, seventies, eighties, like it was a
pretty routine sweet sixteen gift for Jewish girls in America
to get their parents would buy them a nose job.

(44:29):
That was just kind of how it went. Um, which
is extraordinarily sad. Um. But if you, if you kind
of can take that and hold it for a second,
it kind of highlights just how far the younger generations
of today have come in relation to that. Because moms
whose parents bought their nose job when they were sixteen

(44:52):
or like going to to offer it to their kids,
their daughters in particular now, and their daughters are like,
what are you crazy now them, I'm final with my nose.
I love my nose. Why do you not like my nose?
Leave me alone? Um? And that seems to be like
getting more increasingly prevalent. Yeah. I mean I think Generation
Z is uh leading the charge on accepting who you

(45:13):
are and what you look like and what you're shaped like. Uh.
And it's it's great. I mean, we're Generation X, so
we've we see that underneath us, and we came from
seeing boomers above us that had the moms and the
dads were like, hey, why don't you get a nose job, honey,
that kind of thing. So we're just sort of caught
in the middle in this, uh, in a no man's

(45:34):
land almost of the of this generational shift. It seems like, Yeah,
but I think there are plenty of gen xers that
followed in that tradition of of getting the nose job
around age sixteen or something like that. Well, yeah, I
think because the influence of the boomers. I'm not blaming
boomers for everything but us. In that article about the
actress Jennifer Gray and very famously had a larger nose

(45:58):
that I thought looked great and then had a surgery
where she had a very different notes completely changed the
way she looked. And she said in that article she's
talking about it a lot more now that her mom,
who was an actor, said, you know, she was the
one that encouraged her and said, honey, why don't you
go get this done. You'll be more easily cast in rolls.
And she did. And I think she feels like and

(46:18):
I think she's probably right suffered from her new nose
about not being cast. Yeah, the opposite happened of the
intended effect, where her her roles dried up. Like she
went from I'm a successful movie star with my nose
to changing her nose to not you know, to kind
of falling out of limelight and not getting work like before.

(46:39):
She says she regretted her um nose job, actually two
of them. She got two of them because she wasn't
happy with the first one, and she Um, I don't
know if she's ever toyed with the idea. I'm sure
she has, but I don't I didn't read it. But
there's a there's a trend among people who are dissatisfied
with having gotten a nose job, who are going back

(47:00):
to basically get what's called a reverse nose job, which
is as one I think cosmetic surgeon put it, putting
the bump back in. Yeah. And I don't think if
that's something that like a Jennifer Gray is considering anymore,
because she's kind of you know, uh close the loop
on that. But I think it's a pretty cool thing
that people are saying, go back and give me like

(47:22):
embracing themselves now. Um. As far as Jennifer Grey goes.
I mean, there's she was the crush of a lot
of dudes our age thanks to Dirty Dancing and Genie
Bueller Uh. And I remember when that happened, like she
just the new cycle wasn't as invasive back then in
a lot of ways, so I didn't I think I

(47:43):
didn't even know Jennifer Gray just kind of went away. Uh.
And then when I saw pictures of yours, you know,
when it I finally saw a photo of her with
the new nose, It's like, oh my god, is that
even Jennifer Gray, because it was just such a signature
look for her, And anyway, I loved Genie Bueler. That
is what I'm say. It is startling, the difference that
a nose job can make. Like if you look at

(48:04):
and there is a lot of before and after pictures
on the Internet of um Rhino Plassy, the it's incredible
the difference that it makes, the the effect that just
slight changes to the nose have on the entire look,
the entire face of the person that it very frequently
makes them look like an entirely different person. Jennifer Grace

(48:26):
definitely one of those people. She looks just like she
looks like a different person, and not like she looks
like a different person because she had a bunch of
work done. She looks like a different person because she
has a different nose now. And yeah, I think it
was just so characteristic of her. Um, she's not the
only one who regretted getting a nose job famous person. Um.
I believe Bella Hadid did as well. Um. I read

(48:48):
that she was quoted as saying that she wishes she
kept the nose of her ancestors because she thinks she
probably would have grown into it or grown to like it. Um.
And so I mean, at least there's options of going
back and getting it, you know, redone the way it
was before. But um, it's definitely it definitely gives you
pause to say, like, okay, if you if you're gonna
do this, like ask yourself, is somebody pressuring you to

(49:08):
do this? Um? Are you old enough to really kind
of make a decision like this, has your nose grown?
Are you old enough so that your nose has taken
what's probably going to be its final shape or your face?
There's a lot of questions for you to to to
really consider and if you go to a decent plastic surgeon.
They should be helping you consider these questions. Um, and

(49:30):
then lastly you got anything else, Well, I do think
we should mention Iranian women because you kind of tease
that out at the beginning. Uh, they have some of
the highest rates of rhinoplastic in the world, at a
hundred and eighty cases for every one hundred thousand. Uh people.
I don't know if that's says people and not women,
but either way, a very high rate. And uh, you know,

(49:53):
there was there was an article in the l A
Times and a woman from Tehran said women do nose
jobs in Iran because it's the only part of their
body they can show in society. We have to wear
a scarf over our hair, so we get a nose
job to make ourselves beautiful. And it starts in high school.
And but apparently even there, there were much more severe
rhino plastics perform in Iran in previous generations, much more

(50:16):
dramatic reshapings. And now there are more subtle changes that
still embrace the ethnic look of Iranian and Persian women.
So and that seems to be sort of happening everywhere. Yeah. Um,
so what I was hoping to bring up at least
to finish on is that UM because of all those

(50:36):
questions that you need to ask yourself, Like there's a
lot of concern about how how young should you be
before you start thinking about getting a nose job or
any kind of plastic surgery. And there's apparently a big,
big problem on TikTok where there's plastic surgery UM targeting,
like ads for plastic surgeons targeting UM users as young
as fourteen. I think business insiders set up like a

(50:59):
fake profile and set their age to fourteen, and they
scrolled for eight minutes before they started getting plastic surgery
videos served to them. And I guess TikTok band outright
plastic surgeon adds. But the plastic surgeons have figured out like, Okay,
well I'll just make a video talking about how great
plastic surgery is. And it's all basically the same UM.

(51:19):
So it's a it's a huge problem, and you can
understand like, if you're fourteen years old, that's probably not
a good time for you to be thinking solo about
whether you want a nose job or something like that.
You know, Yeah, I mean it's certainly a lot to
weigh for sure. Uh, without the help of a social
media giant pushing you one way or another, you know

(51:41):
that's right. Uh, well, Chuck said that's right, and he
already said he doesn't have anything else. So, uh, if
you want to know more about rhino plastic, go read
up on it, especially if you're considering getting it yourself.
Inform yourself. And since I said that it's time for
a listener mail, that's right to the listener. Man, we

(52:02):
tease and I think we should do you have it
pulled up. We should both kind of go through these, Okay,
since it's a long wind. We got a lot of
great grilled cheese tips from listeners, and the first one
we got was from Pablo Quintana, who said, when I
do grilled cheeses, I make them using manchego cheese or
whackin cheese, grilled olive oil tomato with butter on rye

(52:27):
or sour dough paired with either tomato, soup, clam chowder,
god lintil, super even chili, depending on the occasion. You're
doing it right. Yeah, Pablo knows what he's doing. Um So,
after Pablo, we have Robin Russo, who labels themselves a
Wisconsin cheese lover, they say, try spreading pure maple syrup
on the bread and use Colby cheese. Colby melt very evenly,

(52:50):
so it's perfect. The syrup gives the nice sweetness balanced
by the salt in the cheese, and then as an aside,
just to show off. Also, if you ever eat fresh
squeaky cheese curds, get them a cocktails shrimp sauce first.
It's so good you'll thank me later. So there's two
tips from Robin Russo. That sounds really good. That syrup
that sounds like something you could cut into quarters and

(53:11):
serve at a cocktail park. Yeah, it sounds so delicious. Uh.
Erica Erica Tyler says, use brioche bread if you're living
your best life, but normal bread will also work. Cover
the outside with butter, then dip that buttered side in parmesan.
The cheese inside is GOODA or munster both are delicious.

(53:34):
I learned this method from that Dude can Cook on YouTube.
Hats off to both. Ruth Ann l says, make your
grilled cheese, but add dijon mustard to the inside. Takes
it to an awesome level of omptuousness. Yeah, I'm not
under the mustard. But I bet mustard lovers would love
that for sure. Baard Swedman says, press a couple of

(53:55):
garlic clothes into a small bowl of cream cheese and
mix that. Uh, there you go, use that as your
cheese filler in a grilled cheese and you, my friends,
have entered flavor country. You can think Allison, who is
Baird's wife who introduced Baird to the podcast, and the
recipe that sounds really really awesome. I love cream cheese,

(54:17):
it doesn't it ties into A couple of other people
have sent in, including Virginia Bestwick of Alberta, Canada. So
she says, I like my grilled cheese with old cheddar
and garlic borson, And I think garlic boorson is like
it's like a cream cheese spread with garlic in it.
So that's kind of like Alison is doing the deconstructed version.
This makes me so hungry. Mike Frank says, this mayo

(54:39):
on one side, butter on the other, white cheese, cream cheese,
bread or better yet, borson. Uh is a Borsen or
borson all right? Creamy and tangy without throwing off the bread.
The bread cheese ratio boom. There you have it, good
old grilled cheese. Also love truugh truff hot sauce on

(54:59):
the grilled cheese. It's unique hot sauce made with truffles
and truffle oil, although we know that synthetic. Mike get
us into our episode on truffles. He said, it's pretty niche,
but really great on grilled cheese. Thanks for that, Mike.
And here's one from Jesse Lee of Taos, New Mexico, who,
over the deafening hum said, one of my favorite things
to dip a grilled cheese in is salsa. Try it

(55:22):
out with your next one and thank me later. Nice, simple, simple,
but awesome. But that's really good. Uh. This is a
professional chef and I'm gonna go to this restaurant. Want
to go to Savannah The bell Weather House in Savannah, Georgia,
And chef Ryan white Buck explains why mayo is better.
There's a little bit of a j Kenji Lopez alt

(55:42):
food science explanation which I always loved. Butter contains dissolved
milk solids that when melted, separate and can sog up
a slice of bread. Mayo, however, is oil and multified
with a very small amount of egg, yolk, mustard, and vinegar.
Using mayo for grilled cheese will crisp the bread without
sogging it up, and the mustard and vinegar will season
the sandwich with spicy and charred elements. These flavors, peared

(56:04):
with the hints of sweet from the bread and the
unctuous savory equality of cheese, paints a complete taste profile
for the baalate in a fashion similar to how complimentary
colors work. Very nice the more the Bell weather House
and Savannah Yeah for s out the food. Uh. And
then the last one is from Kayla ruhr Um and
she does not have a tip, but she has a

(56:25):
recollection from playing the Sims. She said. Starting in early
two thousand and eight, the Sims added a secret grilled
cheese aspiration to their little virtual lives. If you played
the Sims, you could create a secondary aspiration in life
which made your sim obsess over grilled cheese. If they cooked,
they cooked that. If they painted, they painted grilled cheese.

(56:45):
And in their backlog of precious memories, you'd see where
they finally remembered a time where they ate grilled cheese,
and the common underneath would read grilled cheese my favorite.
Too funny, agreed Kayla, that is too funny and pretty interesting.
I never knew that. And he actually said she's not
sure if it's related to that two thousand seven craft money.
Remember perhaps been like a billion plus on grilled cheeses. Yeah.

(57:09):
The astute listener, by the way, unless Jerry cuts it out,
will literally hear my stomach girl right then during that
plus when Jerry, I hope you don't cut that out.
Uh oh, that's it. If you want to be like Kayla, Ryan, Jesse, Mike,
Virginia baired, Ruth, Anne, Erica, Robin, and Pablo and write

(57:29):
to us with whatever you have to say, you can
send it via email to Stuff Podcasts at iHeart radio
dot com. Stuff you Should Know is a production of
iHeart Radio. For more podcasts my heart Radio, visit the
i heart Radio app, Apple Podcasts, or wherever you listen
to your favorite shows.