Commonly referred to as a ‘nose job’, rhinoplasty is a surgical operation that will make adjustments to the size or shape of the nose. A common surgical intervention for anyone who would like to improve the appearance of the nose, rhinoplasty is often required to rebuild the nose after a facial injury.
If you are considering having rhinoplasty surgery for cosmetic reasons because you’re not happy with your nose, you’re not alone. In the USA it’s been stated that some 350,000 rhinoplasty operations are carried out every year.
How old before having rhinoplasty?
If you are thinking of having cosmetic surgery during your teen-years you need to be aware that your nose will, most likely, be still developing until you reach your late teens. Unless you need surgery to reconstruct a nose after an injury during your teen-years, cosmetic rhinoplasty is best left until your early twenties onwards.
What can surgeons do?
Surgeons will assess each case that comes to them. They will advise either a reduction-rhinoplasty, to make your nose smaller, or an augmentation-rhinoplasty to enlarge your nose. Both processes will allow an opportunity to make changes to the shape of your nose. Changes can be made to any part of the nose, including the nostrils and the figuration between the nose and top lip.
Take advice from a rhinoplasty surgeon
Most rhinoplasty surgery is done for cosmetic reasons. You need to take your time over making any decision about cosmetic surgery. Find a surgeon who has a good track-record and is registered with the required body that qualifies him or her as a competent rhinoplasty surgeon.
In the US check that the surgeon is registered with a body such as The American Society of Plastic Surgeons. In the UK, look for those that have registered with either the General Medical Council or the British Society of Rhinoplasty Surgeons. There is also the British Association of Aesthetic Plastic Surgeons, Facial Plastic Surgery of the ENTUK (ear, nose and throat) and the British Society of Rhinoplasty Surgeons. Most other countries have professional bodies with the list of registered surgeons, to be sure that the surgeon and the clinic is experienced and monitored in their work.
You should have no difficulty in finding rhinoplasty surgeons that belong to an official association or society that will qualify them as specialists in the field.
Try to find people who have had Rhinoplasty surgery
When you find a rhinoplasty surgeon who you feel happy with, dig a little deeper to find out how experienced he or she is. Knowing how many operations have been performed and seeing ‘before and after photos’ will help you to make a decision. A surgeon may have access to people on whom he or she has carried out rhinoplasty surgery, who may be prepared to share their experience.
What to expect from your first meeting with a surgeon
It would be helpful to you to talk to someone who has had nose-surgery because you can then draw up a list of questions that you may want to ask your rhinoplasty surgeon. Insist on meeting with the surgeon who will be performing the operation rather than a manager or nurse.
The surgeon is the one who has the experience to assess whether nose surgery is suitable for you. You need to see the surgeon and the surgeon will need to see you.
To do a full appraisal your surgeon will need to have access to your medical records. Your age, physical and emotional health will also be considered when deciding whether rhinoplasty is a good choice for you.
Explain to the surgeon how you would like your nose to look after the rhinoplasty operation. Take some photo-examples of a nose shape that you would like.
To help you make the important decision to go ahead with rhinoplasty surgery, expect your surgeon to suggest that you meet again before conducting the operation. This will give you a chance to get a full understanding of what the rhinoplasty operation involves. The surgeon will want you to know how to manage your post-rhinoplasty condition. This will include How to sleep, how to wash and habits that you may have to refrain from until recovery has completed.
Wearing glasses after rhinoplasty
If you wear glasses, you may find this to be the first of many problems that will come up after the rhinoplasty operation. See the Specs-Delight. This has been designed to hold glasses off the nose and will be ideal for post-rhinoplasty wearing of glasses.
When you make the decision to go for the operation, it would be wise to get your Specs-Delight and start wearing it straight away. This will give you plenty of time to get used to it in readiness for when you will need it. You will also see the benefit of the Specs-Delight as a simple device that holds your glasses off your nose, thus preventing those marks on the nose that many people tend to get.
Preparing for the rhinoplasty procedure
Some surgeons use imaging software to show you how your nose may look after the operation. Photos will be taken of your nose at one of your meetings with the surgeon. Images will be generated from those photos that will give an indication of how your nose will look after rhinoplasty. It’s important to understand that, as with any computed prediction, the results that are shown should only be taken as a guide. Some rhinoplasty surgeons avoid using such software as it can lead to unrealistic expectations.
The surgeon will advise you on how to prepare for the operation. Much of this advice will be about avoiding infections. A big issue will be avoiding catching a cold just before going for the procedure. If this happens you will need to consult your surgeon. The advice, in this event, will most certainly be to postpone the operation.
There will be considerations about what you need to do to avoid complications during the recovery phase. If you’re a smoker you will need to stop the habit as smoking may allow an infection to happen during the delicate recovery time.
The operation will take place under a general anaesthetic which means that you will be asleep throughout the entire operation. You will receive instructions on when to stop eating food and drinking liquids. At the preparation stage you may be advised to wear compression stockings to reduce the risk of blood clots from developing in your legs. An alternative to this may be to receive an anti-clotting injection.
Depending on your medical assessment the rhinoplasty surgeon may suggest that you wear the stockings and have the anti-clotting injection. When everything has been explained to you and you’re happy with all the answers to the questions that you have, you will be asked to sign a form that will give consent to the surgeon to proceed with the entirety of the rhinoplasty operation.
The operation can take just one hour to complete but in some cases it can take up to three and half hours.
Don’t make a rushed decision
Take your time. The surgeon won’t expect you to make a quick decision after explaining the process at your first meeting. Have a think and talk it over with family, friends and, if possible, others who have had the operation.
You need to feel confident that the surgeon knows clearly how you want your nose to look after the operation. Most important of all, you need to feel confident in yourself about going ahead with having rhinoplasty surgery. To this end, your surgeon may suggest that you meet with a trained psychologist who will be able to advise you on what the operation will involve and how to cope with any post-rhinoplasty emotional issues.
Reduction or Augmentation rhinoplasty?
This is to make your nose smaller which will involve either closed rhinoplasty or open rhinoplasty.
Closed rhinoplasty for reduction
This method involves an intervention that’s approached through the nostrils. There will be no cuts made to the outside of the nose. The surgeon will be able to reach the bone and cartilage from within the nostrils. The closed rhinoplasty operation takes less time to perform compared to open rhinoplasty. The recovery time from this should be shorter because there’s likely to be less swelling to deal with. Closed rhinoplasty isn’t an option for all cases. The surgeon will advise on this.
Open rhinoplasty for reduction
This method usually involves a cut to the outside of the nose and, possibly, inside the nostrils. The cut to the outside of the nose is kept to a minimum.
An incision is made along the columella which is the area underneath the nose and between the nostrils. When everything has healed, this is the point where there will be a very slight scar which will be almost undetectable. It’s through this opening and from inside the nostrils, that the surgeon will gain access to the bone and cartilage that needs to be realigned.
With both methods of open or closed rhinoplasty the skin needs to be raised away from the bone and cartilage. After the procedure has been completed the skin must be allowed time to settle over the bone realignment.
Augmentation rhinoplasty – nose enlargement
Nose enlargement surgery can involve either open or closed methods of rhinoplasty. Nose enlargement will require importing bone or cartilage from elsewhere which will involve grafting. Bone or cartilage may be taken from an ear, rib or, where possible, from the nose to construct the realignment.
When the procedure has been completed, dissolvable stitches will be applied to cuts made inside the nose. Any stitches on the outside of the nose will be removed about a week after the procedure by a nurse or the surgeon.
Short-term recovery from rhinoplasty
You will need the time that it takes to come round from the general aneasthetic injection. There will be discomfort which can be reduced by pain-relief medication. Due to the inflammation from the procedure, your nose will be blocked for the first week, possibly two or longer.
Depending on the type of operation you’ve had, there are likely to be splints and dressings arranged inside your nostrils. This will need to be left in place for at least a week to hold rearranged bones in the required positions.
Depending on your condition at the time, you may be able to go home on the same day as the operation but the facility will be there if you feel the need to stay at the hospital for longer.
On leaving to go home, a nurse will explain all that you need to know about how to care for your nose and give you some general advice to help you through this early delicate stage. You will be encouraged to make an appointment to go back to the hospital for a follow up inspection to see how it’s all progressing.
It would be wise to pre-arrange for a family member or friend to take you home and to stay with you for a couple of days to help with the short-term effects of the procedure.
Recovering from rhinoplasty
- Take the ongoing recovery phase seriously. You need to allow yourself all the time that you need and don’t be surprised at some of the after effects.
- Slight nose-bleeds may occur during the first couple of days.
- You may experience blackness around the eyes and nose from the bruising of the rhinoplasty operation. This may remain for a couple of weeks.
- Breathing through the nose will gradually improve as the swelling reduces.
- Some patients experience discomfort from strong sunlight after a rhinoplasty operation. You may need to wear a sun-hat for a few months after the operation.
Always be ready to take over-the-counter pain-killers if you need them. The operation will take a lot out of you. Don’t be tempted to take on any extra duties or responsibilities. You may find life to be difficult and tedious for a couple of weeks. It would be wise to not drive or use machinery at this early phase of recovery. Leave out alcohol and don’t allow yourself to be drawn into agreeing to fall in with the wishes of others until you can think more clearly.
Things that may help speed up your recovery
If you wear glasses, now is when you will appreciate the Specs-Delight. This is so much more effective than taping your glasses to your forehead. This will allow you to have good vision without your glasses touching your nose.
Don’t do any exercise or heavy work as this will increase blood-flow to your face. Contact sports involving balls or anything else must be strictly avoided.
Don’t be tempted to blow your nose, just wipe it carefully. If a sneeze happens, allow it to come out through your mouth. Keep away from dust or smoke.
Don’t be tempted to pick or scratch your nostrils. The healing phase must progress without any extra trauma to the injured area.
Arrange extra pillows to be able to stay upright when sleeping. This may only be necessary for a few nights after the rhinoplasty operation.
Be prepared for a full recovery to take months. This will most likely impinge on any plans that you may have to fly or drive.
Monitor your condition
Consult a Doctor or your surgeon if the healing isn’t progressing as you would expect. If there is any sign of an infection, unexpected swelling or redness that feels unduly uncomfortable, take these as warning signs that need extra attention.
The splint assembly can be taken away by your surgeon after about a week. This will be an opportunity for the surgeon to assess your recovery.
Be prepared to take some time off work. Do what is best for you. Most patients benefit from waiting to go back to work until the swelling and bruising has reduced to a comfortable level. This can take two to three weeks.
Possible complications from rhinoplasty
Before making the final decision to go ahead with a rhinoplasty operation, ask your surgeon about possible complications so that you can make a fully informed decision.
How much does rhinoplasty cost?
This will depend on how complicated the procedure is likely to be. Here is a guide to the fees that may be charged for rhinoplasty operations, dated 2023
In the USA expect to have to pay between $8,000 and $10,000.
In the UK expect a charge of £3,000 to £6,000. If you need a rhinoplasty operation because of an injury or breathing difficulties, the cost may be covered by the NHS. Operations that are carried out for cosmetic reasons are usually charged for.
The information contained on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment.