Cosmetic nose surgery, also known as rhinoplasty, can improve the appearance and proportion of your nose – enhancing facial harmony and self-confidence. Cosmetic nose surgery may also improve a breathing problem or correct abnormalities caused by trauma or a birth defect, and the procedure can change your nose’s overall size, tip, bridge and nostrils.

WHAT TO EXPECT

How is cosmetic nose surgery (rhinoplasty) performed?

To reshape the nose, surgery is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, or the narrow strip of tissue that separates the nostrils. The rest of the incision is similar to the closed technique. Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Cosmetic nose surgery can reduce or enlarge nasal structures with the use of cartilage grafted from other areas of your body. Typically, pieces of cartilage from the septum (the division in the middle of the nose) are used for this reason. Occasionally, a piece of cartilage from the ear and, rarely, a section of rib cartilage can be used for revision rhinoplasty surgery.

If your nose’s septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing. Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Your cosmetic surgeon may place splints and internal tubes to support the nose as it begins to heal for a week following surgery if the septum is operated on. Cosmetic nose surgery usually takes one to two hours to complete, although it may take longer based on the procedure being completed.

What are the different types of cosmetic nose surgery (rhinoplasty)?

The two primary types of rhinoplasty include “open” and “closed,” though there are other types of cosmetic nose surgery:

Open Rhinoplasty is used for major nose reshaping. Incisions are made in the vertical strip of skin separating the nostrils, called the columella. The skin and soft tissue are then lifted off the underlying structures of the nose so the surgeon can see the nasal anatomy.

Closed Rhinoplasty is used for minor nose reshaping. Incisions can be made within the nose. The skin of the nose is then separated from the bone and cartilage, which form its supporting framework. Once exposed, bone and cartilage can be removed, reshaped, augmented or rearranged to achieve the desired new shape.

Secondary Rhinoplasty. Also called revision rhinoplasty, this is performed to correct problems that persist or develop after a previous nose surgery. Although the problems may be minor and easily corrected, the problems may be more complex, which makes the secondary rhinoplasty more difficult. Secondary rhinoplasty can also be done as an open or closed procedure.

Filler Rhinoplasty. This involves the use of injectable fillers to “fill” depressions, smooth out sharp angles or change the angle of the tip of the nose to restore symmetry. For instance, instead of removing a bump, your surgeon would use an injectable filler to make the nose more even. While effective, injectable fillers do not offer permanent results. Learn more about Injectable Fillers.

HOW TO PREPARE

Am I a candidate for cosmetic nose surgery (rhinoplasty)?

Cosmetic nose surgery is a highly individualized procedure, with the best results achieved through a thorough consultation with your cosmetic surgeon. While almost any physical change is possible through cosmetic nose surgery, a plastic surgeon will be able to recommend the best approach to achieve a balanced result based on your nose’s unique characteristics as they relate to the context of the entire face.

The best candidates for nose surgery include:

• Individuals whose facial growth is complete; generally, surgery is performed on individuals age 18 or older
• Individuals who are physically healthy
• Individuals with a positive outlook and specific, but realistic goals in mind for the improvement of their appearance

How do I prepare for cosmetic nose surgery (rhinoplasty)?

Preparing for your cosmetic nose surgery may include:

• Medical evaluation
• Taking photos of your nose to allow for computer images to demonstrate potential post-operative results
• Taking certain medications or adjusting your current medications
• Stopping smoking well in advance of surgery
• Avoiding taking aspirin, anti-inflammatory drugs and herbal supplements due to increased risk of bleeding

RESULTS

What results can I expect?

Cosmetic nose surgery can dramatically change your appearance. It is common to feel dissatisfied with the appearance of your nose immediately after surgery. At this point, the nose is still quite swollen and it may take up to a year for your new nasal contour to fully refine.

During this time, there may be gradual changes in the appearance of your nose as it refines to a more permanent outcome. While the results of cosmetic nose surgery are permanent, the surgery won’t prevent the effects of aging.

What is involved in recovery?

Cosmetic nose surgery is performed as an outpatient procedure. Your recovery will depend on the type of procedure completed.

If the nose is being reduced in size, a splint will be used or the nose will be packed lightly with medicated gauze. An external splint may also be used as the primary support while the nose is healing. Your stitches are self-absorbing and will not need removed.

If an incision is made across the vertical strip of tissue separating the nostrils (columella), skin stitches are used and will need removed in four to seven days.

Swelling and stuffiness of the nose is common for several weeks following surgery. Most patients usually resume light activities after a few days, but it will take several weeks before the nose is completely healed to allow for full physical activity.