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To Smell or Not to Smell… city, state

Among the amazing features and functions of the nose, in the world of plastic surgery we frequently overlook the sense of SMELL. As a nose specialist, I have worked with many patients suffering from smell-loss (called hyposmia if the sense is present but reduced, and anosmia if all meaningful sense of smell is gone). This deficit is not as debilitating as the loss of vision or hearing, nor is it as easily apparent to others around us. Rather, anosmia carries with it a unique burden and very real detriment in quality of life – diminishing our relationship with food, with our intimate partners, and even with our memories. I recently came across a short documentary film made by a sufferer of anosmia, and it was captivating. Jacob LaMendola, an independent filmmaker, created this piece, and it can be found in the Op-Docs archives on the New York Times website (

Interestingly, the loss of smell does not only affect quality of life in an Epicurian sense, but can also detect and predict neurological diseases before the hallmark symptoms develop. Elegant neuroscience research has shown that olfaction (processing of smells) works a little differently than the other four senses (vision, hearing, touch, and taste). It turns out that the olfactory nerves (nerve endings, or fillae) are directly linked to the memory processing circuitry in the basal forebrain; whereas other sensory input follows a much longer path (it’s sent to the thalamus first, and then to the cerebral cortex, and finally to “memory areas”).

This direct, intimate relationship between smell and memory is corroborated by our everyday experiences – just ask Marcel Proust, who famously wrote about this in Remembrance of Things Past. (Remember that cake that your grandmother used to make? One whiff takes you immediately back to her kitchen.) For this same reason, the loss of olfaction correlates with a loss of the “memory areas” and other specialized neurons in the forebrain (frontal lobe). As such, standardized smell tests have been employed in early diagnosis of diseases like Alzheimer’s, Parkinson’s, and other degenerative disorders.

Another way that a person can lose their sense of smell has to do with the anatomy and function of the nose. In order to smell, you need two things: working neurons (see above) and airflow through the nose. There are lots of reasons why the nasal airway may become obstructed – some of these are “medical” diseases (upper respiratory infection, allergies, sinusitis), but others may be amenable to surgery. For patients who have had trauma to the nose (e.g., a softball to the face, a right hook, a motor vehicle accident, etc.), there may be an anatomic obstruction from a fractured nasal septum or nasal bones. In other patients, their nasal structure (cartilage and skin) may be such that the air passageways are too narrow or collapse even with normal breathing. In each of these cases, a surgical cure may be possible. This is achieved through septoplasty or functional rhinoplasty. You can check out more information on these procedures on our website.

Our Patient Reviews

San Francisco Center for Facial Plastic, Reconstructive & Laser Surgery

5 / 5.0

Based on 23 reviews

Christina G.

I had several nasal/sinus issues including a severely deviated septum and a dorsal hump, which I wasn't crazy about. Dr Ransom did both the medical and aesthetic parts of my surgery and he did a wonderful job! While I did have some swelling, I didn't experience much bruising at all. I loved that he left the natural look of my nose just making small corrections. My breathing has GREATLY improved. His office staff was super helpful in scheduling and making sure payment and everything was very clear. I am very, very, very pleased with my results!!

Tk I.

I had a terrible surf accident in Bali and needed to get 50 stitches to repair what the reef did to my face. I had emergency cosmetic surgery in Bali the day of the accident. Immediately when i got back to the states i was introduced to Dr Ransom through some mutual friends. I was searching for the best cosmetic surgeon in San Francisco to help in my recovery. He and his team have been amazing! he helped establish a plan for my post-op wound care/treatment and administered some initial laser treatments. Dr Ransom and his team are extremely knowledgeable and very patient / helpful. I am very grateful for their help and support. I am finally looking normal again!

Joey B.

I had three issues with my nose - which inhibited my breathing: 1- broken nose, 2 - narrow nostrils that collapsed when I inhaled through my nose, 3 - deviated septum. When I was living in New York, I went to see a doctor about my breathing issues, and he said my skin was too thin and there was likely nothing he could do to rectify the problem. Dr. Ransom was recommended by an ENT I saw through One Medical. As soon as he saw him, he said he could easily fix my nose, and remove the bump that had formed from the trauma. His confidence and strong sense of self immediately put me at ease, and I had little doubt that he could accomplish exactly what he promised. He showed me a modified picture of my nose , and really liked what he proposed. The end result very closely matched what he promised. Not only can I now breath much more easily through my nose, it looks much better. He managed to make it look like an improved version of itself, however I still look like me, and unless I tell anyone I had it done, it's not overly noticeable, which I prefer. I'm pretty vain and very critical, and I can say that Dr. Ransom is great, and comes highly recommended.

Edward T.

Doctor Evan Ransom took my surgery on relatively short order and did a wonderful job. He is very talented and has a nice friendly professional support staff. I can not thank him enough, he was calm, caring, professional and interested in the follow results of his work . He seemed to bring a certain artistry to the profession.

Lisa C.

Dr. Ransom is a talented physician. He is knowledgeable, professional and goes the extra mile to make you feel comfortable during your treatments. He has been blessed with an artistic eye which brings wonderful results. I highly recommend Dr. Ransom and would refer all of my friends and family members to choose him as their physician.

Cheryl H.

Dr Ransom is very kind, honest, and conscience doctor. I was referred by my best friend, she is also Doctor Ransom patient. She has so much good things said about Doctor Ransom. So I had a face lift done by Doctor Ransom on July 2015. He did a wonderful job on my face and I have a lot of compliments on my face. So if anyone want to get their face done. I would highly recommended Doctor Ransom to you. I give Doctor Ransom a five stars.

Jill P.

I have currently been getting botox regularly with Dr. Ransom and he does a fantastic job. My previous doctor's office moved to another location where it was no longer convenient. I didn't realize what I was missing until I went to Dr. Ransom. I felt really comfortable, but most important he did a terrific job blowing my previous doctor out of the park. (Sometimes it's good switch it up a bit to make sure you are getting the best treatment.) On top of that, Dee the office manager is an incredible asset to the office. She personalizes your visit and relationship with the office to an extent I have never experienced before. I even get follow up calls to see how I am doing after a treatment. I highly recommend Dr. Ransom for his great work, and his team's impeccable customer service.

Arielle C.

Dr. Ransom and Dee are the BEST! Whether it's aesthetic or reconstructive, I'd trust him over and over again with my face.