Last fall, after decades of vision so poor I couldn’t recognize my closest friends across a small room without glasses, I paid $10,000 for ICL surgery, a newish LASIK alternative in which permanent contact lenses are installed in one’s eyeballs. Besides the somewhat daunting, monthlong course of prescription eye drops that followed, recovery was swift. I’ve had no major medical complications, only subtle psychological ones: Improving my vision, I realized, impaired the way I saw myself.
For the first time in as long as I could remember, I looked in the mirror and saw only my face staring back at me. No brow-hiding frames, no eye-distorting lenses. And most crucially, perhaps, was my nose: bare, no longer horizontally bifurcated by a ridge of black acetate.
In a good mood, on a good day, my nose is “striking” or “distinguished.” It has “character,” to quote my mother. In a bad mood, on a bad day, it is simply crooked. “I’m so glad she never fixed it,” a famous artist recently told a mutual friend, upon meeting me. Meant as a compliment, I, of course, interpreted it as insult.
Should I have fixed it? A basketball to the face in middle school left a hairline fracture and with it a slight asymmetry I was always aware of without really caring about. But now the asymmetry shone (sometimes, especially in photographs, literally: reflecting a spot of glare back at the camera). My friends and family all called me crazy whenever I mentioned it, but their reassurances were of little value. It wasn’t that I didn’t believe them—I didn’t care what they looked like either!—but I wanted a professional opinion.
One drizzly spring morning, I entered the sprawling, multistory Park Avenue office of plastic surgeon Lara Devgan, MD, whose Instagram follower count approaches 1 million and whose proprietary skin-care fans include Kim Kardashian and Jennifer Aniston. Known for what she calls “facial optimization,” Devgan tends toward an approach made up of “tweaks,” as she refers to them—the facial equivalent of having an old dress tailored rather than getting a fabulous new one custom-made.
“So you have a ‘deep radix,’ ” she said, petting the depression at the top of my nose with her index finger. There was also, she went on, a “widening of the dorsal nasal aesthetic lines”: the bridge, in lay terms. There was “some crookedness,” which she said was “likely the site of prior trauma.” Lastly, I suffered from what she described as “a little bit of a bulbous and slightly droopy nasal tip.”
Finally, some honesty, I thought to myself.
A good, old-fashioned rhinoplasty could, of course, make my nose smaller and less crooked. It would also cost close to $20,000, require general anesthesia, take up to a full year to see the final results, and turn me into a person who got a purely elective nose job at an age (37) that was, in my opinion, decades past the point of utility.
But there were other methods. “One of the hallmarks of modern plastic surgery is customizability,” Devgan said. Some well-placed injections of hyaluronic acid—which functions almost like a cartilage graft—at the top of the nose (to lessen the prominence of the bump) might “optimize” my appearance, as she put it. “We don’t have to have you look textbook to be happy.”
Devgan was describing, essentially, a nonsurgical nose job—or a “liquid rhinoplasty”—a procedure that has been growing in popularity without being, in itself, new. (The practice of injecting the nose with various liquids dates back to the turn of the 20th century, when precarious substances including oils and waxes were used.) The first filler made of hyaluronic acid—which is also used topically for its moisturizing properties—was approved for cosmetic use by the FDA in 2003, and in the years since its effects can be seen everywhere from the enviably sculpted cheekbones of influencers to the trout-y mouths of the ladies populating Bravo and so many of the women who love to hate them.
Like anyone living in a major city in 2025, I had grown wary of the surreal effects of facial fillers. Sometimes, I’d take the subway, or go to a Pilates class, look around me, and be surrounded by slightly swollen-looking faces of indeterminate age that seemed a little too taut and almost tender to the touch. But I had yet to see—or at least had yet to notice—any noses whose shapes I’d attribute to filler.
For much of the 20th century, rhinoplasties were used—and seen—as a method of assimilation, often within immigrant communities. The procedures often involved a dramatic removal of cartilage, the results being small, angular, and upturned. But Raj Kanodia, MD, a Beverly Hills–based plastic surgeon, told me that he has seen “a noticeable shift in what patients are asking for” in recent years. “People are looking to refine—not change—their features,” he said. Kanodia, who approaches filler with “extreme caution” and prefers rhinoplasties of the kind he has performed on celebrities like Khloé Kardashian and Ashlee Simpson (internal stitches only), said that he tries to honor and embellish patients’ cultural identities, rather than erasing them. His surgical motto is: “Fool the mother’s eye.” Kanodia, surprisingly, attributes this shift to social media, which provides a vastly larger sample size of aspirational beauty. “People are embracing uniqueness and seeking procedures that help them look like the best version of themselves—not someone else,” he said.
This was what I wanted, and as I sat in Devgan’s office, she assured me that I would “not be burning any bridges” were I to go the more subtle route. It would feel like getting Botox, Devgan promised—some numbing cream, a few pricks, perhaps a tiny bit of redness—but the results would be instant and last for up to a year. She compared the procedure to “magical, three-dimensional makeup,” a real-life Facetuning. Magic was indeed what I was looking for—to look both better and exactly the same—or maybe it was more that I was engaged in magical thinking. Isn’t that always what we want? To somehow change our life, without changing anything about our lifestyle?
A few days later, I paid a visit to the office of Michael Bassiri-Tehrani, MD, another plastic surgeon, whose “tip stitch” had recently gone viral on TikTok. The procedure—a few sutures inside the nose to pull the tip upward a few millimeters—is a standard part of a traditional rhinoplasty, but Bassiri-Tehrani was now routinely performing it à la carte, often for men who otherwise might be too embarrassed to get a nose job, but also for women in advance of special events where they knew they’d be photographed smiling (which draws the nose downward). Would lifting the tip of my nose up somehow disguise what I was now privately calling “my basketball bump”?
It might, Bassiri-Tehrani told me, but he wouldn’t recommend it. If the choice were only his to make, he’d prefer to perform a true, “well-balanced” rhinoplasty that, he said, would have the “ironic” effect of looking “more natural” than a “bunch of minor half-steps.”
He proceeded to take a series of photographs of my face, and then we relocated to his office where he began to tinker on Photoshop. He would bring the radix up, reduce the bump, and add a bit of volume. The results, when he flipped around his screen, were surprising. From straight on, I looked almost exactly like myself; from a three-quarter angle my nose was still large but now perfectly straight—something no amount of filler could have achieved.
I started to squirm, and began to speak in a voice that was not unlike whining. I was almost 40, I told him. I was married. I had a baby. I had lots of friends. How could I possibly justify a major facial surgery? The hesitancy wasn’t really rational, I knew: I exercised; I highlighted my hair; I dressed myself in expensive, flattering clothing. “Everyone draws the line somewhere,” he said.
High up on a kitchen shelf, wedged between many linear feet of neglected media (DVDs—we have no DVD player; expensively produced coffee table books—we have a toddler), sits a plaster reproduction of a bust of Hermes, originally carved in 340 BC. It has peered at me while I made dinner for years now, and only recently did it occur to me to actually take it down. My grease-stained god’s nose looked remarkably like mine, though—whether by the forces of his mythic power or the anonymous hand of the sculptor who rendered him—perfectly straight. It had never occurred to me to seek aesthetic inspiration in the face of a deity before, but here it was, all along, in my own kitchen.
The office of Melissa Doft, MD, is located behind the kind of discreet Park Avenue door seemingly only ever entered by women in sunglasses. Doft, a friend had said, was gentle in manner, exquisite in her taste, and—most importantly perhaps—had a face that appeared untouched. “It’s kind of like going to the makeup floor at Bergdorf, right?” Doft herself said. “If you don’t have a brand that you want to patronize, you wander around looking for the lady behind a counter whose makeup looks like how you’d want yours done.”
Looking at my face, she agreed with Bassiri-Tehrani that the most suitable version was a proper rhinoplasty. There was “enough mass to work with,” as she tactfully put it. Once again, I started in about my age, but she cut me off.
“The age range for rhinoplasties is now actually much larger than one might think.” She said she frequently performed rhinoplasties on 20-somethings only to have their middle-aged mothers come in afterward wanting one too. To this end, she said she tried to avoid results that were, as she put it, “too cute.” The nose, she went on, should look good not just on a 17-year-old girl but on an older woman as well.
“When you’re thinking about noses,” Doft elaborated, “you want to look at the beautiful noses over the ages. What has been idealized across time, what have we gravitated toward not just today but in the past too? It’s symmetry, it’s straightness, it’s a bit of a flare at the bottom, like the open wings of a bird.”
It sounded lovely. And not too far from what my own nose looked like. “But it’s sort of like going into a pool,” Doft said. “Some people dive right in, others go down the ladder, and some people never want to go in at all.”
I felt myself cowering at the shallow end, one toe hovering above the surface. And then she offered me an inner tube.
“We could try a bit of filler,” she said. “Like, right now.” The immediacy hadn’t occurred to me—Doft could apparently see my hesitation. “It’s dissolvable, if you don’t like it.”
Doft left the exam room to retrieve a syringe of what she called “one of the newer fillers.” Introduced to the US market in 2020, RHA (or resilient hyaluronic acid) is, in Doft’s experience, more natural-looking in its effects than some of the older varieties. The doctor propped my chin in her slender hand, pricked the top of my nose twice, massaged the area for a few moments, and then added an additional drop to the side of my nose to help disguise the asymmetry. She rubbed again, blotted, and handed me a mirror. My nose looked no smaller, but there was a smoothness that there wasn’t before, more like a child’s drawing of a mountain than a topographical map of one. “Nobody is going to know but you,” she said.
“So did you get a nose job?” my husband asked later that evening, when I walked in the door. “No,” I told him. “I didn’t do anything.”
My quest was over, and with it the desire to look in the mirror—not because I was afraid of what I would see, but because I was tired of thinking about my face. The doctors I spoke to all described the perfect nose as one that recedes into the background of the face, but the perfect nose, I discovered, is also one that recedes into the background of one’s mind.