Rhinoplasty is the operation that reshapes the nose, one of the most common operations in plastic surgery. In a rhinoplasty you can decrease or increase the size of one’s nose, you can reshape the tip of the nose or the hump of the nose, you can narrow the nostrils or alter the angle between the nose and the upper lip. A congenital deformity or a post-trauma deformity can be corrected. Finally, the nasal septum can be modified and thus restore nasal breathing.

The best candidates for a rhinoplasty

A rhinoplasty can enhance your appearance and self-confidence but it won’t create a perfect face. Before you decide to undergo the operation, think carefully about your expectations and discuss them thoroughly with your surgeon.

The best candidates for a rhinoplasty are people who seek for improvement and not perfection in their appearance. Physical and mental well-being are required together with realistic expectations.

A rhinoplasty can be performed for cosmetic or reconstructive reasons, to correct congenital deformities or problems related to breathing.

Age is of paramount importance.

Many surgeons prefer not to operate on adolescents, before the body has fully grown. It is important to assess the social and emotional status of young individuals. Finally, the surgeon should estimate which one, the parents or the teenager, really want this operation to be performed.

Every operation carries risks. When a rhinoplasty is performed by a certified plastic surgeon, complications are rare and usually minor.

All risk is significantly reduced when the patient follows the surgeon’s orders both before and after the operation.

The operation is usually performed through the nostrils or via a small incision at the base of the nose (columella), so no obvious scars are visible.

Very rarely (even with the most experienced surgeons) can some imperfection to the final shape of the nose occur. It can easily be treated via a minor procedure later on.

Arranging your operation

Good communication with your surgeon is essential. You have to describe in the beginning how you would like your nose to look like after the operation. The surgeon will in turn evaluate the structure of your nose and face and explain to you the available possibilities. Many factors can affect the procedure and the result such as the structure of your bones and nasal cartilages, the overall shape of your face, skin thickness, your age.

The surgeon will explain to you the procedure and the anesthesia you will receive, the hospital where the procedure will take place, the risks and the cost of the operation. Most health insurance policies do not cover the expenses for a cosmetic procedure of the nose. If, however an adjuvant procedure to your nasal septum in order to improve your breathing is performed, some of the expenses could be paid for by your insurance.

Make sure to tell your surgeon if you had any type of surgery or trauma in your nose, even if this was many years ago. You should also state if you have any allergies, difficulty in breathing, if you are under any medication, food supplements, if you smoke or consume alcohol.

Preparation for surgery

Your surgeon shall provide you with specific instructions for your operation regarding what to eat & drink, smoking, taking or not certain vitamins and medication. If you follow those instructions, your operation should end in success without any complications.

Make sure there is a friend or member of the family to dive you back home after the operation is over and the doctor discharges you from the hospital

Where does the procedure take place

Rinoplasties are performed in a hospital. Later that day you should be able to return home.

Anesthesia

Rhinoplasty is performed under general anesthesia

The operation

It usually takes 1-2 hours to perform a rhinoplasty. More complex cases of nasal reconstruction (especially after trauma) could take longer. During the procedure, the skin of the nose is separated from its frame (bones and cartilages) which in turn is shaped to the desired form.

Many rhinoplasties are performed through an incision from the inside of the nostrils and hence no scar is visible. However, a small incision at the base of the nostrils can be alternatively performed which allows for better access to the surgeon.

A splint is usually placed over the nose after the operation is completed and special Vaseline soaked gauges are placed in the nostrils to help the nose maintain its new shape and prevent post-operative bleeding.

After the operation

During the first few days you may feel your face swollen, your nose might hurt a bit and headache can occur. A simple pain killer can deal with it. It is better if you stay at bed with your head held up high under a couple of pillows.

Swelling and bruising around the eyes almost always occurs and subsides completely within 10 days. Cold packs always help.

The gauges that are inside your nostrils might get bloody. That is why they are placed there after all. You will probably feel your nose congested for quite a while. Avoid blowing your nose for at least a week.

Back to everyday activities

Most patients are able to get out of bed and function properly the next day of surgery. In a week one can return to school or office-based work.

Heavy exercise (e.g. swimming, running, contact sports, sports with a ball) should be avoided for a month. Blowing one’s nose and sneezing should also be avoided, together with exposure to sun-light. Facial skin care should be performed gently.

Contact lenses are ok to use, but glasses should be avoided for the first six weeks.

Your new look

During the first days after surgery the face is swollen. It is difficult to understand the difference.

Your nose will look better by the day. After a couple of weeks, one cannot tell that surgery has been performed.

Healing is a long and gradual process. It could take many months for the final result to settle in.