Rhinoplasty

Rhinoplasty (nose surgery)

Rhinoplasty, also known as a nose job, is one of the most popular types of cosmetic surgery. Rhinoplasty reshapes your nose to improve your appearance or to correct medical problems that affect your breathing. It can correct a deviated septum or a broken nose.

Overview of the procedure

What is rhinoplasty?

Rhinoplasty is a form of plastic surgery that changes the shape and size of your nose. Some people undergo cosmetic rhinoplasty to improve the appearance of their nose and face. Others undergo functional rhinoplasty to improve breathing and nasal function. Surgeons who perform this procedure are trained in plastic surgery or facial plastic surgery. Rhinoplasty is generally referred to as a nose job.

Who is eligible for rhinoplasty?

You can opt for a rhinoplasty to:

Correct a congenital anomaly (birth defect).
Improve your overall appearance.
Open blocked nasal passages (deviated septum).
Repair a facial fracture, such as a broken nose.
Restore respiratory function after illness, cancer treatment, traumatic injury or burns.

Who is a candidate for rhinoplasty?

A candidate for rhinoplasty should:

Have completed growth and be physically healthy.
Not be a smoker.
Understand the limitations of rhinoplasty and have reasonable goals for the procedure.
Want the procedure for their own reasons and not because someone else thinks they look better.

What does rhinoplasty do?

Rhinoplasty reshapes your nose. The procedure can:

Correct a nose that looks bulbous, upturned, hooked or drooping.
Correct a deviated septum.
Correct nostrils that are too wide, too small, too large or curved upwards.
Eliminate noticeable depressions or bumps on the bridge of your nose.
Reduce or enlarge your nose to maintain facial balance.
Open blocked nasal passages.

What are the different surgical approaches to rhinoplasty?

There are two main types of rhinoplasty:

Open: Open rhinoplasty is a procedure to comprehensively reshape the nose. Your surgeon will make incisions to completely separate the skin of your nose from the bone and cartilage, allowing them to clearly see the underlying anatomy of your nose.
Closed: Closed rhinoplasty is a smaller procedure to reshape the nose. Your surgeon will make incisions in your nose to separate the skin from the bone and cartilage and reshape the nose.

Other types of rhinoplasty include:

Cosmetic rhinoplasty: improves the appearance of your nose and face.
Non-surgical rhinoplasty (filler rhinoplasty): This type of cosmetic rhinoplasty uses dermal fillers to temporarily fill depressions and irregularities in the nose. This can be used to lift the tip of a drooping nose or correct a small bump.
Functional rhinoplasty: Restores the shape and function of the nose after illness, cancer treatment or traumatic injury. This type of reconstructive surgery can also be used to correct congenital defects and curvature of the nasal septum.
Secondary rhinoplasty: Revises or corrects problems that occur after the initial rhinoplasty surgery. These problems may be minor, but are often more complex for your surgeon to correct.

What is the difference between rhinoplasty and septoplasty?

Rhinoplasty is a procedure that improves the appearance and/or structure of your nose. Septoplasty is a similar procedure to rhinoplasty that repairs the deep, internal structural complications within your nose — the nasal septum. Complications in the septum can affect your breathing. Both procedures can be performed at the same time to improve both the appearance and function of your nose.

Details of the procedure

What happens before a rhinoplasty?

Before your rhinoplasty, you will meet with your surgeon for an initial consultation. At this meeting, you will have the opportunity to ask questions and explain the results you want. Your doctor will examine and measure your face and take photographs. The two of you can discuss the surgical options, the results and the risks.

You should bring:

A list of current medications and supplements, including dosages.
Photos (if you have any) of how you would like your nose to look after surgery.

What happens during a rhinoplasty?

Rhinoplasty is usually an outpatient procedure, which means that you can go home the same day after the procedure. Someone will need to drive you home and stay with you overnight. You may be given a general anesthetic (you will be asleep). Or you may receive local anesthesia (your nose will be numbed) and intravenous sedation (you will be relaxed but not completely asleep). The procedure may take place in a hospital or in an outpatient medical facility.

During your rhinoplasty, your surgeon will:

Make an incision on the inside of your nostrils (closed rhinoplasty). You may also have an incision at the base of your nose (open rhinoplasty).
Lifts the skin covering your nasal bones and cartilage.
Reduces, adds to or moves the underlying bones and cartilage to create a new shape or correct a deviated septum.
Replaces the skin covering your nasal bones and cartilage.
Small sutures are used to hold the skin in place.

Your rhinoplasty can take between one and three hours.

What happens after a rhinoplasty?

After a rhinoplasty, you may receive

A small plastic splint to minimize swelling and maintain the new shape of your nose while it heals. You will wear the splint for one to two weeks.
A cotton gauze (packing) may be placed in your nose. You can remove the packing according to your surgeon’s instructions, usually within 24 to 48 hours after surgery.
Swelling and bruising may occur around the nose and eyes, which will take a few weeks to subside. Slight swelling of the face, especially in the morning, can occur up to a year after the procedure.

At what stage does swelling occur after rhinoplasty?

You will experience swelling immediately after rhinoplasty. Swelling occurs when your nose is larger than it normally is because fluid accumulates in and under the skin. Swelling after rhinoplasty occurs in the following stages:

Four to six weeks after surgery: your nose will be swollen for four to six weeks after surgery. It will look and feel larger than normal. There may be bruising or changes in the color of the skin around your nose as it heals.
Three months after the operation: The swelling will slowly subside between one and three months. After three months, most of the swelling will have subsided (about 90%).
One year after the operation: Minimal swelling in the nose may still be present for up to a year after the operation. You will not see the full results of the procedure until the swelling has completely subsided.

Everyone heals differently after rhinoplasty. The amount of swelling and the length of time it takes to see your results may vary. Follow your doctor’s treatment plan after surgery and keep your follow-up appointments to ensure your nose heals properly.

What is asymmetric healing after rhinoplasty?

It is normal for your body to react to the surgery in different ways, for example with asymmetric healing. Asymmetric healing is swelling that affects one side of your nose and not the other. This makes your nose look crooked and can be unsettling. This is not a mistake. Asymmetric healing is one way your body recovers after surgery. This may be the case for the first few weeks after surgery.

Will I be in pain after rhinoplasty?

After your rhinoplasty, your surgeon may administer a long-acting anaesthetic at the end of the procedure. You should only feel mild to moderate pain or discomfort. The pain should subside or disappear a few days to a week after the procedure. During this time, you can take over-the-counter pain medication as directed by your doctor to relieve your discomfort.

Risks / benefits

What are the benefits of rhinoplasty?

The benefits of rhinoplasty include:

Changing the shape and size of your nose.
Improving your facial expression.
Correcting structural abnormalities of your nose such as a deviated septum.
Improving the way you breathe out of your nose.

What are the risks of rhinoplasty?

All surgical procedures, including rhinoplasty, carry a certain amount of risk. Possible complications after rhinoplasty include

A hole in your nasal septum (perforation of the nasal septum).
Infections.
Nosebleeds.
Poor wound healing or scarring.
Skin discoloration.
Unsatisfactory appearance.
Change in your sense of smell.
Pain.
Scarring.
Additional surgery.

Recovery and outlook

How long does recovery take after rhinoplasty?

It can take up to a year for you to fully recover from your rhinoplasty. You will have swelling around four to six weeks after the operation, which will slowly subside after three months. Between three months and a year, your nose will still be healing and the swelling may still be present. You will see the full result when your nose is completely healed, which is usually after one year. The time frame for recovery is different for each person.

How can I speed up healing after a rhinoplasty?

To support the healing of your nose in the first few weeks after rhinoplasty, you should:

Place cool compresses (not ice) on your cheeks or under your eyes (not directly on your nose).
Avoid any impact on your face.
Be careful not to put too much pressure on the bridge of your nose when wearing glasses or sunglasses.
Keep your head elevated, especially when sleeping.
Minimize exposure to the sun.
Do not blow your nose.
Do not lift heavy objects.
Take over-the-counter pain medication if you feel sore, as directed by your surgeon.

When can I return to my normal activities after rhinoplasty?

After rhinoplasty, follow your doctor’s recommendations as to when you can return to work or your normal activities. You should be able to return to work or school in one to two weeks. You can do light exercises within four to six weeks. You should not lift heavy objects for four to six weeks.

When will I see the results of the rhinoplasty?

You should notice a difference in the appearance of your nose about a week after rhinoplasty when the splint is removed. It can take up to a year for your nose to fully adjust to its new shape. During this time, some facial swelling is normal. Most people who undergo functional rhinoplasty to correct a deviated septum see improvements within six weeks. About 15% of patients require a follow-up surgery (revision) to make minor changes after the initial surgery.

How long does a rhinoplasty last?

Rhinoplasty is a permanent procedure to change the body. The result lasts a lifetime. You may wish to have a second rhinoplasty to adjust the cosmetic changes to your expectations after complete healing.