Rhinoplasty Procedure
Main Facts
Rhinoplasty, also called a nose job or nose reshaping, is a type of plastic surgery that changes the nose’s shape, size, or angle. Surgeons perform this procedure for cosmetic reasons, health reasons (like improving breathing), or both.
Key Aspects of Rhinoplasty:
- The nose has two main parts: the upper part, made of bone, and the lower part, made of cartilage.
- Changes may focus on the nasal tip, nasal bone, or the angle between the nose and upper lip.
- Surgeons work to create balance, symmetry, and proportion among the nose and other facial features.
Common goals of rhinoplasty include:
- Reducing a bump or hump
- Adjusting a bulbous or upturned tip
- Achieving a more symmetrical look
Doctors plan the rhinoplasty procedure based on the patient’s needs, facial proportions, and nasal structure. In certain cases, insurance may help cover costs, particularly if the surgery addresses breathing issues.
Reasons People Choose This Procedure
- Corrects nasal shape or size
- Fixes crooked or asymmetrical noses
- Improves breathing through nostrils
- Addresses issues from injury or birth defects
- Can fix a deviated septum, sometimes with septoplasty
- Reshapes cartilage and changes nose appearance
Possible Complications
Rhinoplasty involves several risks. Common risks include bleeding, infection, and side effects from anesthesia, such as allergic reactions. Injuries can lead to nosebleeds or scarring. Lasting numbness, pain, or swelling may also occur.
Breathing through the nose can become difficult, or the nose may appear uneven. Other less common issues include septal perforation (a hole between the nostrils) and changes in the sense of smell. Some people may need additional surgeries if results are not as expected.
Table: Common Risks of Rhinoplasty
| Risk | Description |
|---|---|
| Bleeding | Blood loss during or after surgery |
| Infection | May require antibiotics |
| Scarring | Visible marks around the nose |
| Nosebleeds | Bleeding from nasal injury |
| Anesthesia issues | Allergic reactions possible |
Getting Ready for Surgery
Eating Habits and Medicine Guidelines
Proper planning about what you eat and which medicines you take is very important before rhinoplasty. Surgeons often tell patients to stop taking certain over-the-counter medications and supplements before and after surgery.
Most importantly, anything containing aspirin or ibuprofen should be avoided for at least two weeks before and after the procedure. These types of medicine can thin your blood and cause more bleeding during or after surgery. Below is a table showing which medicines to avoid and which are usually allowed:
| Type | Allowed Before Surgery? |
|---|---|
| Aspirin | No |
| Ibuprofen | No |
| Herbal Supplements | No |
| Surgeon-Approved Meds | Yes, if approved by surgeon |
Only take medicines your plastic surgeon has said are safe. If you take daily medications for your health, like for blood pressure or diabetes, discuss these during your consultation. Never stop or change your regular medication schedule without your doctor’s advice.
If you use herbal remedies, diet pills, or extra vitamins, talk to your surgeon as well. Some natural remedies can make you bleed more or could interact with anesthesia. For these reasons, skip all non-essential supplements and over-the-counter remedies for at least two weeks before surgery unless your surgeon instructs otherwise.
Smoking and vaping can delay healing and increase the risk of infection or tissue problems after rhinoplasty. Surgeons always recommend quitting all tobacco products well before the surgery date. They may even request that you stop at least several weeks in advance. Eat regular, healthy meals leading up to the procedure.
Good nutrition supports recovery and helps your immune system. Drink enough water and stay hydrated, but do not eat or drink after the time your surgeon says. This is vital for safety if you receive general anesthesia. Bring a list of all your current medications to every appointment.
This helps your care team check for any unsafe combinations and helps protect your health during surgery. If you have specific health needs or unique situations, your plastic surgeon or the surgical team may adjust or give special instructions on eating, drinking, or medications for you. Always follow these specific directions to avoid problems and help your body heal as expected.
Key Reminders
- No aspirin or ibuprofen starting two weeks before surgery.
- Skip all herbal and vitamin supplements unless approved.
- Stay away from tobacco and vaping to help healing.
- Only take medicines your surgeon has cleared.
- Bring an updated medication list to every visit.
Ask questions if unsure about any food, drink, or medication before your rhinoplasty. The surgical team is there to help and keep you safe.
What You Can Expect
What Happens During Surgery
Rhinoplasty is tailored for each patient to meet specific needs. Before the operation, patients receive anesthesia to prevent pain and help them relax or sleep through the procedure. The type of anesthesia—either local anesthesia with sedation or general anesthesia—depends on the complexity of the case and the patient’s health.
- Local Anesthesia with Sedation: Surgeons inject numbing medicine into nasal tissues. Patients stay relaxed but usually do not fully fall asleep.
- General Anesthesia: Medical staff give medicine through a mask or IV, making the patient fully unconscious. This approach often needs a breathing tube.
The surgeon can operate from inside the nose (closed approach) or by making a small cut at the base of the nose between the nostrils (open approach). The choice between open or closed rhinoplasty depends on what needs to be corrected. For example, if more access to the nasal structure is needed, the surgeon uses open rhinoplasty.
During the procedure, surgeons reshape bone and cartilage. For minor changes, they may take cartilage from inside the nose or from the ear. If bigger changes are necessary, they use cartilage from a rib or even bone from another part of the body. Sometimes, surgeons also correct the septum—the wall between the nasal passages—to improve breathing.
After completing all changes, the surgeon repositions the skin and tissue and closes any incisions with stitches. Afterward, the patient spends some time under observation in a recovery area before going home or, if needed, being admitted overnight.
Key Points During Surgery
| Step | Description |
|---|---|
| Type of anesthesia | Local with sedation or general, based on patient and procedure needs |
| Incision location | Inside the nose or across nostrils |
| Tissue reshaping | Bone and cartilage adjusted as required |
| Graft materials | May use patient’s own cartilage or bone if needed |
| Septum correction | Can straighten the septum |
| Closure | Stitches close the cuts |
| Observation after surgery | Recovery room for monitoring |
Recovery After Surgery
Once surgery ends, recovery begins. Patients should keep their head raised higher than their chest to reduce swelling and bleeding. The nose often feels blocked, either from swelling or from splints placed inside the nose for support. What recovery looks like:
- Splints and Bandages: Internal splints and soft bandages usually stay inside the nose for around one week. An external splint made of plastic or metal may also be fixed to the nose for the same period to help protect it as it heals.
- Bruising and Swelling: Swelling and dark bruises can show up around the eyes and nose, often appearing within the first couple of days. This swelling may peak before it gradually gets better. A black-and-blue color around the eyes might last for up to two to three weeks, while swelling inside and outside the nose can last for several months or even up to a year.
- Bleeding and Drainage: Bloody mucus or old blood often drains from the nose during the first couple of days. Some patients use a drip pad—a piece of gauze—under the nose to absorb this drainage.
Guidelines for Healing
- Do not blow your nose for several weeks.
- Sleep with your head elevated to minimize swelling.
- Avoid exercise and heavy physical activities.
- Switch to baths instead of showers while bandages are on.
- Open your mouth when sneezing or coughing to reduce pressure on the nose.
- Brush your teeth gently to avoid shifting the upper lip.
- Eat plenty of fruits and vegetables to lower the risk of constipation.
- Wear front-fastening clothes to avoid pulling garments over the head.
Protection and Comfort Tips
- Avoid wearing eyeglasses or sunglasses directly on the nose for at least four weeks after surgery. Use cheek supports or tape glasses to the forehead if necessary.
- To prevent sun damage, use sunscreen (at least SPF 30) because sun can cause discoloration while the new skin heals.
- Do not place ice packs or cold compresses directly on the nose—let swelling subside naturally.
The areas around the nose may feel numb or sore for a short while, which is typical as nerves can be temporarily affected by the surgery. Mild pain or discomfort after surgery is normal but can be managed with medications prescribed by the doctor.
Common Symptoms After Surgery
| Symptom | How long it may last |
|---|---|
| Swelling | Several weeks to a year |
| Bruising | 2–3 weeks |
| Numbness | Days to weeks (sometimes longer) |
| Pain and soreness | Several days, controlled by medicine |
| Stuffy sensation | Until swelling goes down and splints removed |
Things to Avoid Post-Surgery:
- Intense physical activity (running, aerobics).
- Pulling shirts or sweaters over the head.
- Making exaggerated facial expressions (such as wide laughing).
- Placing pressure on the nose with glasses or fingers.
Most people feel well enough to return to their normal routines—including work or school—after about one to two weeks, but complete healing and final results take much longer. While swelling usually goes down in the first few months, subtle changes in the nose’s appearance can keep happening for up to a year after the operation.
Summary of Post-Surgery Care
- Splints/Stitches: Usually removed after one week.
- Swelling/Bruising: Reduces significantly after two to three weeks, though minor swelling can last up to a year.
- Recovery Time: Most daily activities possible after a week or two, but strenuous actions require a longer wait.
- Final Results: Most changes are visible in weeks, complete results visible after about a year.
Careful support during the first few weeks helps protect the surgical site and makes healing smoother. Following the surgeon’s specific instructions is the best way to reduce swelling, avoid problems, and get the safest results.
Outcomes
A nose surgery can lead to visible improvements, even with very small adjustments, sometimes only a few millimeters. Most patients see a noticeable difference in the look of their nose soon after the initial healing period.
Many are satisfied with the outcome, but in certain situations, further changes may be needed. Revision rhinoplasty may be chosen if the first operation does not meet the desired goals. Wait at least 12 months before considering this, to allow the nose to fully settle and heal.
Key Points
- Small structural changes can have a big visual impact.
- Some may need a second operation, but only after one year.
- Satisfaction rates are generally high with skilled surgeons.
