Stuff You Should Know - Rhinoplasty, aka Nose Jobs
Episode Date: May 12, 2022Nose jobs have been around a lot longer than you think. And the process is pretty interesting. Tune in for all things rhinoplasty. See omnystudio.com/listener for privacy information....
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Welcome to Stuff You Should Know, a production of iHeart Radio.
Hey and welcome to the podcast. I'm Josh and there's Chuck and there's Jerry.
And this is Stuff You Should Know, the Schnauz edition.
Such a great word. It is man and it's such a great descriptor too. Like I consider
my nose a schnauz. There's a big difference between a schnauz and a nose and I've got a schnauz.
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 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 schnauz, like schnauz without the sh. And it just made it even funnier.
He said, we don't make schnauzes. You're talking about fake noses.
So 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, this has nothing to do with that, but we're teasing out
listener mail today early because we have collected, I knew we'd get some good grilled
cheese tips and we collected a little small compendium so it's going to 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 just stick around.
So we're talking nose jobs today, Chuck, also called rhinoplasty. You would think
rhinoplasty is the clinical term and I guess technically it is, but if you are a plastic
surgeon or cosmetic surgeon, 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 jobs today. That is a little bit here, a little bit there, nothing too ridiculously
radical and that's a far cry from the rhinoplasty of the past from what I understand.
Yeah, I've heard it calls nose reshaping as well and rhinoplasty itself comes from Greek,
of course, rhino, meaning nose. Or schnaz.
And plasticos, 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. So rhinoplasty is just reshaping the schnaz.
Man, you are on fire in 2022, man.
Really?
Yeah.
Yes.
I mean, no.
It took 14 years.
No, you've been on fire, but I'm saying 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 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 setup. You're going to do great, Chuck.
What kind of snot? Thank you for that, by the way. I do mirror and try to move on very quickly
when given a compliment.
Yeah.
So let's do that here.
That's fine. That's fine, but I also want to add something to that. 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 totally not funny anymore. Now I'm fully on board, so I'm just going to play along.
Okay.
And act like it's just normal.
Yeah.
What kind of nose job would someone get? Why would someone want a nose job?
There's all sorts of reasons you could want a nose job. You could be a seventh century BCE
Indian thief or adulterer and have had your nose lopped off as punishment.
Okay. Bring it forward.
You could have been in one of the world wars and been facially injured by a mine.
Bring it forward.
You could have been born with a kind of nose that is a characteristic of your ethnicity
and want to have changed it to fit in with Waspe mid-century America. Getting closer.
And then lastly, 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 led at a time in our history that left you with kind
of a hole in the front of your face. 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 to forget anytime soon.
Yeah. Because apparently syphilis causes necrosis of your soft tissues and,
you know, soft tissues combined and kind of give us a characteristic appearance. And
then when that soft tissue is missing, it can be, you know, disarming at first or alarming
at first until you just stop and think like, well, it's the person, you know.
That's right. 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 get it to look the way I
want it to look. 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 do with a visible hump or bump, which I love.
Oh, yeah.
Yeah. I think it's called a Roman nose.
Yes.
That has sort of the hump.
Yeah.
Yeah.
I find that to be a very attractive feature on a lady.
Gotcha. Okay. Cool.
So I'm a fan. 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, 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. That's definitely true. And one of the things 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, the 50s and 60s, when, you know, nose jobs really started to take off for cosmetic
reasons, especially among people of Jewish ancestry in America. There was like a, 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 looked natural on your face. Right. And it's evolved over time. And one of
the reasons why is because there was like a perfect nose, an American nose, a Caucasian nose that was
like an ideal version of beauty. And over time, especially in the last like 10 or so years,
it seems like there's been a huge sea change in the way people who get nose jobs approach it and
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 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,
I just couldn't remember if it was Bill Pullman. Sure. 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, 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 common for someone to say like, hey, I'm not trying to
look like a completely different version, but this one thing has always bothered me.
Yeah. And then one other thing I want to say too, that seems to be a common
part of the discussion around nose jobs is a lot of people who get them tend to view them as not
so much like a physical 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 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 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 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 21st century
and the people in their late teens and 20s and even early 30s are just so aware, way more aware
than we were when we were their age, that that kind of has to do with nose jobs who has 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 is a lot more sort of shunning of this idealized beauty notion than there has been in a
long time. And 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 kicked to
the curb to say something more modern. Indeed. There are a few things that have been more harmful
that didn't involve like guns or explosions than a single idealized form of beauty, you know?
All right. So, I agree. 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 2.3 million,
I think this is complete cosmetic surgical procedures in the U.S. in 2020. And I think
nose reshaping is and was the most common. About 352,000 nose jobs in 2020 in the U.S.
Far more women, 287,000 compared to 65,000 men. And teens make up about 13% of those.
20 to 29-year-olds make up 31%. If you live out West, you're more likely about a third of the
nose jobs are performed out West. I don't know if that means, you know, Los Angeles County.
And then Caucasian white people get way more nose jobs than anyone else by a long shot.
71% of those jobs in 2020 were on Caucasians, African Americans with just 5%,
Hispanic 10% in Asian Pacific Islander 11%. So if you're a white American 25-year-old
woman living in Los Angeles, there's basically 100% chance that you're going to get a nose job.
I think you have to. From what I'm seeing here.
What about internationally? Well, like you said, the stats are a little wobbly compared to the
USA stats, but apparently Brazil is number one. They're the leader, followed by Turkey and America.
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 up for grabs. Apparently the
rhinoplasty reporting standards around the world 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 count
rhinoplasty 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 of who does this. So just write your real name
on a piece of paper and just stick it in there. Sure. Or we'll just trust you to do that. There
is a big mistranslation and they accidentally translated not schnaz, but snaz and confused
everybody else. That's good. Should we take a break here and then dive into the history? Sure.
All right, let's do it.
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So Chuck, I made reference before about living in 600 or the 7th century BCE.
And maybe you were undergoing a rhinoplasty operation because you had your nose removed
as a punishment. That's actually where rhinoplasty began. It's not like there was some
ridiculously primitive procedure that somebody tried once, and then the idea was lost for
a couple thousand years. And then it got developed in the 19th century by some British guy.
That's not at all how it happened. There was an Indian surgeon named Sushrita, which is not
his name. It's actually an adjective that means renowned. But Sushrita is considered the father
of cosmetic surgery, and that this guy was not only performing cosmetic surgery like
rebuilding noses from nothing. He was documenting it too in medical texts that he wrote that
survived. And he created a technique called the Indian Flap that was still in use into the 20th
century. Is that how it's pronounced? His name? Sushrita? That's what I'm going, or Sushrita?
I mean, it's a U. 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. The surgical procedure, not so fun. No. I mean, should we read part of this, I guess,
or should we read all of it? I think it's worthwhile, yeah. All right, so this was a description
of the Indian Flap technique from Sushrita, aka Sushrita himself. The portion of the nose to
be covered should be first measured with a leaf, as you do. Then a piece of skin of the required size
should be dissected from the living skin of the cheek, which is super advanced. They still,
I mean, scrafting, right? Right. And it's leaving a blood supply coming from the cheek still.
Yeah. Very smart. Very good. So we're approving of these surgical methods.
But 2600-year-old surgical methods, you know? We're in a position to do that. We live in the
21st century, baby. Yeah, exactly. Let me see. Desected from the living skin of the cheek and
turned back to cover the nose, keeping a small pedestal 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 Iranda, which is a castor
oil plant, in the position of the nostril 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 middle
and then having it grow together, right? Yeah, two tubes actually. Yeah, and they still do that
today. They use stents to have the procedure hold its place or shape afterward, and they
leave it in there until it heals. So like this guy was basically, it's like that saying, I can't
remember where it came up, but somebody was describing 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 tray tables for in-flight meals and everything. Like totally,
this guy just figured it out from the outset. Yeah. And it's not like we're taking the skin
from your cheek today and using that to build a brand new nose that would probably actually
be more likely to take it from other parts of your body. But the concepts are still very much
the same. And it's weird to think that rhinoplasty has been around kind of unchanged for almost
3,000 years. Yeah. And 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. 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. Yeah. It would be my guess.
Oh yeah. So this technique made its way through Egypt or out from India into Egypt over to Europe
finally where they were dealing with syphilis outbreaks in the 15th and 16th century like you
were mentioning. There's an Italian surgeon that made his contribution, Gaspar. Actually,
I think you should take this. Gaspar I taglia cosi. Very nice. And back in 1597, 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 19th century, there were a couple of surgeons in the late 19th
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
rhinoplasty. And we got so good at it that people started saying like, hey, 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 Michigander. Is that
what they call themselves? I think it's actually Gander. I'm not kidding. A Michigander? Yes,
because I saw an interview with, I can't remember their governor's name, but she had a sign that
said like proud Michigander. Yeah, yeah, another governor. Okay, Michigander. I like that. 1887,
his name was John Orlando Rowe. And this was, I think technically the first paper
about cosmetic nose jobs called correction of the pug deformity. And then the next guy,
he had some fun nicknames. He was a Jewish German surgeon named Dr. Jacques Joseph.
And his nickname was Nose Joseph. Pretty good. Yeah, he actually kind of ties into our
episode on World War I soldier masks. Do you remember that? That's right. Yeah, I knew this
Rungabelle. 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 build masks for soldiers who came back with
facial differences from like bombs and bullets and stuff. This guy was actually doing cosmetic
surgery to help prepare those injuries. And he got interested eventually in making changes to help
Jewish Europeans fit in better. And we'll talk a little more about that later when we talk about
ethnic cosmetic surgery. But that was kind of like his evolution. He went from helping
soldiers to kind of helping, you know, wealthy citizenry in Europe. And because of that,
because of 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, charlatans, ne'er-do-wells, shiftless slackers.
Snake-hole salesmen. Sure. Who figured out like, hey, I'll just give this a shot. How hard can it
be? And the rise of the beauty doctor came along. Yeah, the beauty doctor, it's sort of a contradictory
name, I would imagine, because these were the unlicensed practitioners, outpatient nose 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. Right. And it's also carcinogenic. So this was, you know, a very sort
of cut rate job that you didn't have to pay a lot of money for. And it's probably, 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's nuts to me, Chuck, is this still going
on today with butt augmentation? There's a lot of underground, like, unlicensed people who use
non-medical stuff like silicone and pump it into people's butts to, like, make your butt bigger.
And it's cheaper. Like you said, it's much cheaper because they're 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 this in the hospital. And some people have died. I read about a mother-daughter
team who killed a woman because they injected silicone and they accidentally got it into her
muscle, which introduced it to the bloodstream and killed her within an hour. So it's really sad.
And apparently there've 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 affordable enough
that people aren't going to underground surgeons like they were in the 19th 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? Yeah. So things boomed in the 1950s in the U.S.,
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. 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 profile of the nose that's
labeled for the different parts, which Dave Ruse put this together for us, right? Yeah, he did.
He 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. You've got your upper third of the nose, which is
the nasal bone and is 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 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,
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 pictures
right now, you can feel the difference. Like if you pinch the bridge of your nose and just kind
of slide it down past about a third of the way down toward the tip and just kind of move it,
wiggle it back and forth, you can feel that's bone. It's not moving. That's cartilage. That's,
that's going to move. It's going to do the Indian flap if you move it enough. No, I want to sneeze.
Don't make me sneeze. Just put your tongue up against the roof of your mouth.
Is that supposed to work actually? Yeah, it also works for ice cream headaches too.
Oh, okay. Man, we're just slinging the knowledge today. Here we are.
So then you've got your radix, R-A-D-I-X. This is the built up cartilage 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 going
to be on that radix. And this might be something that people choose to get flattened out. Yep.
You also have 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 collumella, which is the little skin between your two nostrils,
the little kind of vertical strip of skin that separates your nostrils.
I thought that was a septum. I learned all kinds of stuff when I did that.
The septums inside your nose, the collumella is the part you can actually touch.
Yeah. So just touch the little piece of skin between your nose and my friend.
You're touching your collumella. That's right.
The septums up inside your nose above that, and it actually continues the separation of your nostrils
in your nose. Yeah. 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 septum
meant that the septum was actually like had a hole in it. It can. That's perforated really,
though. That can happen through habitual cocaine use. Well, yeah. You always heard that story
about Mick Jagger, which is probably not even true. But his septum fell out or something?
Yeah. He had it. It was completely dissolved at some point.
No, that can't happen. I saw a study where out of like 104 cocaine users who used 10 or more
times a month, just a pretty heavy cocaine user, like 10 of them, 10% had a perforated
septum, and that eventually gets so perforated that your septum can just kind of fall in and
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 because it just seemed like one of those far out celebrity rumor
things. Yeah. But who knows? He certainly was familiar with that drug at one point in his life.
Right. It's like the time Reggie Jackson slash Eddie Murphy slash Lionel Richie told that lady
in the elevator to sit down, but it was actually his dog he was talking to. Yeah. Referred our
episode on Urban Legends from a gazillion years ago. And then, wait, we're missing one more piece.
Oh, just the tip. Yeah. Just the LAR, A-L-A-R cartilage is the tip there. And that's where,
you know, if your tip turns up a little bit, they call that the pug deformity or they did back
then. Right. I'm not sure what they would call it now. A cute button nose. A cute button nose,
or if it has a little tiny hook at the end. A cute little hook. Some people might want to
get that done. Who knows? Who knows? I mean, there's few more personal decisions to whether
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 them because they all
kind of come into play depending on what you're going to do. But, you know, one of the leading
reasons people go in for rhinoplasty is to get their nose reduced in size in some way, shape,
or form. You can also increase the size of your nose. One very common type of rhinoplasty
is where you actually elongate the nose to have it come further off of your face so that in relation
to your face, your 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 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 know. Who knows? But yeah, they definitely do.
They'll use that from cadavers. They can use it from rib cartilage, septum cartilage, ear
cartilage. There's a lot of places they can harvest cartilage from, and you don't need a lot.
I get the very distinct impression that a little bit of rhinoplasty goes a very long way.
I think that's true. I don't know if we really kind of harped on this or not, Chuck,
but remember when you said plasticose 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 plastic stuff in there. Yeah. I think a lot of
people think that. I never thought that. Yeah. Interesting. All right. No, they mean plastic
in the term of something being able to be molded or bent or changed or shaped. That's what they're
using the term plastic for. There's no plastic use. They're using cartilage. They're using bone.
They're removing cartilage. They're removing bone. And depending on where you remove cartilage or
where you remove bone, it has a huge effect on the overall appearance and shape and size of your
nose. That's right. It's a bit of a misnomer that you have to have your nose broken to have
rhinoplasty. That is usually not true, although it can be. They've really come a long way over
the years and kind of like with every surgery. It's as non-invasive as it can get these days.
And there are a couple of different types. There are open and closed rhinoplasties,
and they each have their advantages. But with the open type, you're going to make that incision
and the Columula? Columula, I think. Columula, man. I really messed that up.
And that is that thin strip of skin that you talked about between your nostrils.
So a little incision there. And then you can access the cartilage from that point and the bone
through that single incision. They like this when it takes a little longer for the swelling to go
down, I think. And you might 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 Columula 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 going to make it
easier for them, which just the thought of that 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 the bone along the nose. And that has a much quicker recovery time compared to the open rhinoplasty,
like you were saying. Right. And you're not going to have a visible scar because it's up in your
little nastras. Right. That is something, like even though you're not getting your nose broken,
if you get an open rhinoplasty and probably just about any type of cosmetic rhinoplasty,
you 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 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 recovery is to avoid blowing your nose. The thought of that makes
me want to faint too. Blowing your nose after a rhinoplasty. You want to eat soft foods,
brush your teeth gently. For sneezing. Yeah. You don't want to sneeze because again,
you're going to have stents in your nose that are holding the shape that are keeping the
sutures from coming out. And you basically have to mouth breathe. And that's, I mean,
that's from the really cosmetic rhinoplasty, but there's actually other reasons to get
rhinoplasty too 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 that internal wall is instead of kind of straight,
vertically down the center, which you have 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, to an advantageous way,
but I guess it can. It depends on what's going on with the septum. But yeah, I guess it's like
a three car garage, you know, with you. So I'm actually getting this done.
All right. Yeah. That's what that was the idea that sparked this episode, actually.
Oh, okay. So I went in for a consult, Chuck, and I saw my septum and one of them, the,
the PA was like, I, I can't even get the camera back there. Your septum is so pressed up against
the inside of your nose. 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 be getting it.
And I'm scared to death because it turns out a friend of mine didn't know this,
Wes, his name is Wes, he just got it done. And he said that recovery was like some of
the worst days of his entire life. Oh no. He said it was so rotten. He said his, his throat was
like gravel for mouth breathing. His nose was in pain. He had these stents in his nose. And
apparently his doctor didn't tell him that he'd put stents in. So Wes had no idea what was wrong.
He just knew his nose felt all screwed up. And then he finally went in for the, the, um, like
the week later follow up and the doctor pulled the stents out and he said it was just a whoosh of
air through his nose. Like he's never experienced before. He said he almost fainted from hyper
ventilating breathing. So I'm like, that's what I want. I'm willing to go through this for that.
So, um, Wes 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 down plays it. And so I guess hopefully it's
going to help me a little bit knowing to expect it. I think maybe it was so bad 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 going to 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. Oh, sure. Uh, so if you like hold the good side, if you pinch the
good side down, can you breathe it all through 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 a deviated septum. And then I was like, oh, okay.
And I actually asked the doctor who diagnosed me like, dude, how did I 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 friend, Sami 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. Oh,
Sami, we got to track that guy down. Yeah. Make him pay for this. Yeah. Yeah. He should at least
cover like, okay. Financially, you know, not, not rough him up. Right. Right. No, of course.
We got to make him pay. Right. This is like, I'm like Kanye and Sami'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 medical portion, the actual deviated septum.
But while people are in there, sometimes they will choose to get a little work done
that you have to fit 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 talk about not liking your nose. You're going to 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, because like, it's not like I don't
like my nose. 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 cool with it. This is what I look like. I like your nose.
Thank you. If you look at it a certain way in profile, I look like a cartoon gangster,
like from a Dick Tracy strip. It kind of looks a little bit like that. But yeah, so I actually was
like, nope, I'm not going to. It's fine. I like my nose. I'm probably less opposed to it than I
was before I researched this episode. 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. As you're going
under, you just slip a little sticky note into the surgeon's hand. They'll unfold it and it just says,
if you happen to get rid of a little extra while you're in there by accident, I won't be mad at
you. Are you telling me that I should get a nose job? Is that what I'm hearing from you? No, no,
I was just joking around. I like your nose. I never thought 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 a hump or anything. So 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, yeah, I look how I look. I see myself in a picture and I'm sometimes horrified
at like the kind of shape I'm in right now. But you know, your friends and family walk around
and they're just like, oh, that's what you look like right now. Well, that's funny because 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'd put cards 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 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. That's true. That's true. I guess not. Although I think
people are starting to talk about it more and more. Yeah. All right. So before we take a break
and finish up about this whole idea of what's called racial passing, we will just quickly mention
how much these things cost. All in generally about five to nine to $10,000 is what I've seen
for rhinoplasty. It depends on where you are. Yeah. In Atlanta, it's 6,500 to 8,500. In LA,
the same thing's going to cost you 10 grand to 15 grand. And that's an average cost. So
there's definitely much higher. But from what I'm seeing, 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 10 grand on your nose, you probably can swing a couple hundred bucks,
maybe twice to go fly out to somewhere else in 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 rhinoplasty right
after this.
Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. The hardest thing
can be knowing who to turn to when questions arise or times get tough or you're at the end of the
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to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast or wherever you listen to
podcasts. I'm Mangesh Atikular. And to be honest, I don't believe in astrology. But from the moment
I was born, it's been a part of my life in India. It's like smoking. You might not smoke, but you're
going to get second hand astrology. And lately, I've been wondering if the universe has been
trying to tell me to stop running and pay attention. Because maybe there is magic in the stars, if
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it got weird fast. Tantric curses, major league baseball teams, canceled marriages, K-pop. But
just when I thought I had a handle on this sweet and curious show about astrology,
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And my whole view on astrology, it changed. Whether you're a skeptic or a believer,
I think your ideas are going to change too. Listen to Skyline Drive and the I Heart Radio app,
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All right. This is 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, and there's really no other way to
say it, then they will augment your nose to look more European or Caucasian, if that's something
that you're looking for. Yeah. And I mean, today it's just kind of, I think in some ways it still
ties into this idea of, 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 a husband like it was in America
in the 50s and 60s as a big driver for nose jobs. But then I think if we trace it back to the 19th
century was Jacques Joseph, there was this idea that 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 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 immemorial.
Yeah. And nose Joseph was one of, like you said, he was one of those doctors that, and these are
their words that they're using, but they called it the defect of Jewish nostrility, which is an
actual word. Oh, is it? And it would help people pass at a time when being Jewish was either looked
down upon or could threaten your life or like you said, maybe lead you to not getting a job
as easily as you should based on your qualifications. Yeah. Drop the burger, the
steam from your last statement. All of a sudden you're just a plain Jane, average American,
mid-century Joe or Jane. That's right. So that was actually like Jacques Joseph. And then the
advent of like readily available plastic surgery was like hugely helped along by this idea that
Jewish people just kind of needed to do this. And apparently became such a rite of passage, Chuck,
that by like the 50s, 60s, 70s, 80s, like it was a pretty routine sweet 16 gift for Jewish
girls in America to get their parents would buy them a nose job. That was just kind of how it
went, which is extraordinarily sad. But 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 16 are like going to
offer it to their kids, their daughters is in particular now. And their daughters are like,
what are you crazy? No, I'm fine with my nose. I love my nose. Why do you not like my nose?
Leave me alone. That seems to be like getting more increasingly prevalent.
Yeah. I mean, I think Generation Z is leading the charge on accepting who you are and what you
look like and what you're shaped like. And it's great. I mean, we're Generation X, so we see
that underneath us. And we came from seeing boomers above us that had the moms and the dads
who are 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 no man's land almost of this generational shift, it seems like.
Yeah. But I think there are plenty of Gen Xers that followed in that tradition of getting the
nose job around age 16 or something like that. Well, yeah, I think because of the influence of
the boomers. I'm not blaming boomers for everything, but you know, you sent that article about the
actress Jennifer Gray and very famously had a larger nose that I thought looked great. Yeah.
And then had a surgery where she had a very different nose, 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 roles. And she did. And I think
she feels like, and 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. She says she regretted her
nose job. Actually, two of them, she got two of them because she wasn't happy with the first one.
And she, 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 trend among people who are dissatisfied with having gotten a nose job,
who are going back 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 that's
something that like a Jennifer Gray is considering anymore because she's kind of,
you know, closed the loop on that. But I think it's a pretty cool thing that people are saying,
go back and give me, you know, like embracing themselves now. As far as Jennifer Gray goes,
I mean, there's, she was the crush of a lot of dudes our age, thanks to dirty dancing and
genie Bueller. And I remember when that happened, like she just, the new cycle wasn't as invasive
back then and in a lot of ways. So I didn't, I think I didn't even know Jennifer Gray just kind
of went away. And then when I saw pictures of yours, you know, when it, I finally saw a photo
of her with a new nose, it's like, Oh my God, is that even Jennifer Gray? Right. Because it was
just such a signature look for her. And anyway, I loved genie Bueller is what I'm saying. It is
startling the difference that a nose job can make. Like if you look at, and there is a lot of
before and after pictures on the internet of rhinoplasty, it's incredible, the difference
that it makes, that 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 Gray is 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. She's not the only one who regretted
getting a nose job famous person. I believe Bella Hadid did as well. I read 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. Right. And so, I mean, at least there's options
of going back and getting it redone the way it was before, but it definitely gives you pause to
say like, okay, if you're going to do this, ask yourself, is somebody pressuring you to do this?
Are you old enough to really 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? Yeah, for your face.
There's a lot of questions for you to really consider. And if you go to a decent plastic
surgeon, they should be helping you consider these questions. And then lastly, you got anything else?
Well, I do think we should mentor Iranian women because you kind of tease that out of the beginning.
They have some of the highest rates of rhinoplasty in the world at 180 cases per every 100,000
people. I don't know if that's, this is people and not women, but either way, a very high rate.
And, you know, there was an article in the LA 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. Right. And, but apparently even there, there were much more
severe rhinoplasty to perform in Iran in previous generations, much more dramatic reshapings.
And now there are more subtle changes that still embrace the ethnic look of Iranian and Persian
women. And that seems to be the trend. It's sort of happening everywhere. Yeah.
So what I was hoping to bring up at least to finish on is that because of all those questions
that you need to ask yourself, like there's a lot of concern about 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 targeting,
like ads for plastic surgeons targeting users as young as 14. I think Business Insider set up
like a fake profile and set their age to 14 and they scrolled for eight minutes before they
started getting plastic surgery videos served to them. And I guess TikTok banned outright
plastic surgeon ads, 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. So it's a, it's a huge problem. And you can understand, like if you're 14 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. Without the help of a social media giant pushing you one way or another, you know?
That's right. Well, Chuck said that's right. And he already said he doesn't have anything else. So
if you want to know more about rhinoplasty, go read up on it, especially if you're considering
getting it yourself. Inform yourself. And since I said that, it's time for Listener Mail.
That's right. The Listener Mail we teased. And I think we should,
do you have it pulled up? We should both kind of go through these. Okay. Yeah.
Since it's a long win, 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 grill cheeses, I make them using
manchego cheese or Oaxacan cheese grilled olive oil, tomato with butter on rye or sourdough
paired with either tomato soup, clam chowder. Oh my God. Lentil soup or even chili, depending on
the occasion. Pablo, you're doing it right. Yeah. Pablo knows what he's doing. 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 melts very evenly, so it's perfect.
The syrup gives a nice sweetness balanced by the salt and the cheese. And then as an aside,
just to show off, also, if you ever eat fresh, squeaky cheese curds, get them in cocktail
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 serve at a cocktail party. Yeah. It sounds so delicious. Canapes.
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. Nice. The cheese
inside is Gouda or Munster. Both are delicious. 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 umptiousness. Yeah, I'm not into the mustard,
but I bet mustard lovers would love that. For sure. Barrett Swedman says, press a couple of garlic
cloves into a small bowl of cream cheese and mix. 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. It does and it ties into what a couple of other people have
said and including Virginia Bestwick of Alberta, Canada. She says, I like my grilled cheese with
old cheddar and garlic borson. And I think garlic borson is like a, it's like a cream cheese spread
with garlic in it. So that's kind of like Allison's doing the deconstructed version.
This makes me so hungry. Mike Franks says this, mayo on one side, butter on the other.
Cream cheese spread, or better yet, borson. Is it borsin 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. I also love trough TRUFF hot sauce on the grilled cheese.
It's a unique hot sauce made with truffles and truffle oil, although we know that synthetic
Mike feels 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 out
with your next one and thank me later. Nice, simple, simple, but awesome. I bet that's really good.
This is a professional chef, and I'm going to go to this restaurant when I go to Savannah.
The Belle Weather House in Savannah, Georgia, and chef Ryan White Buck explains why mayo is better.
This is a little bit of a J. Kinchi Lopez alt food science explanation, which I always love.
Butter contains dissolved milk solids that when melted separate and can sogg up a slice of bread.
Mayo, however, is oil emulsified 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 tart elements. These flavors paired with the
hints of sweet from the bread and the unctuous savory quality of cheese paint a complete taste
profile for the palate in a fashion similar to how complimentary colors work. Very nice.
The more you know. All right, go to the Belle Weather House in Savannah.
Yeah, first check out the food. And then the last one is from Kayla Rower,
and she does not have a tip, but she has a recollection from playing the Sims.
She said, starting in early 2008, 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. And in their backlog of precious memories, you'd see where they finally
remembered a time where they ate grilled cheese. And the comment underneath would read, grilled
cheese, my favorite. Too funny. Agreed, Kayla. That is too funny. I'm pretty interesting. I never
knew that. And she actually said she's not sure if it's related to that 2007 craft money. Remember
craft spent like a billion plus on grilled cheeses? Yeah, the astute listener, by the way,
unless Jerry cuts it out, will literally hear my stomach growl right then during that flight.
Jerry, I hope you don't cut that out. Oh, that's it. If you want to be like Kayla, Ryan, Jesse,
Mike, Virginia, Baird, Ruthanne, Erica, Robin, and Pablo, and write to us with whatever you have
to say, you can send it via email to stuffpodcast.iheartradio.com.
Stuff you should know is a production of iHeartRadio. For more podcasts,
my heart radio, visit the iHeartRadio app, Apple podcasts, or wherever you listen to your favorite
shows. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you
ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this
situation? If you do, you've come to the right place because I'm here to help and a different
hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, everybody
about my new podcast and make sure to listen so we'll never ever have to say bye bye bye. Listen
to Frosted Tips with Lance Bass on the iHeart Radio app, Apple podcast, or wherever you listen to
podcasts. I'm Munga Chauticular and it turns out astrology is way more widespread than any of us
want to believe. You can find it in Major League Baseball, international banks, K-pop groups, even
the White House. But just when I thought I had a handle on this subject, something completely
unbelievable happened to me and my whole view on astrology changed. Whether you're a skeptic or a
believer, give me a few minutes because I think your ideas are about to change too. Listen to
Skyline Drive on the iHeart Radio app, Apple podcast, or wherever you get your podcasts.