Rhinoplasty

Rhinoplasty, AKA a nose job, is performed to alter or change the size, shape and look of the nose.

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What is Rhinoplasty ?


Rhinoplasty, AKA a nose job, is performed to alter or change the size, shape and look of the nose. Rhinoplasty makes desired changes to the bone, skin or cartilage of the nose in order to improve the ability of patients to breathe as well as balance out the facial features so they are in proportion with the other features of the face. Many patients look to straighten a crooked nose, narrow the bridge of the nose or alter the angle that is located between the nose and the upper lip. The two types of rhinoplasty surgery that will be discussed below are open and closed rhinoplasty. In addition, there are multiple variations of rhinoplasty and they include ethnic rhinoplasty, reduction rhinoplasty, reconstructive rhinoplasty, revision rhinoplasty, augmentation rhinoplasty and nonsurgical rhinoplasty.

Medically Reviewed by: Kian Karimi, MD

Types of Rhinoplasty


Open Rhinoplasty   

During an open rhinoplasty procedure, a small incision is made under the tip of the nose (between the nostrils). This rhinoplasty technique allows the surgeon greater visibility when working as well as gain complete access to the nasal structure so it can be altered or sculpted into the desired final shape. In general, open rhinoplasty is a better option for patients that are looking to make larger or more dramatic changes to the shape or size of the nose or for patients who have a crooked nose. While there might be some visible scars after the surgery, they are normally hidden in the natural contours of the nose and are typically not visible after they have healed.

Closed Rhinoplasty   

During a closed rhinoplasty procedure, the surgeon makes the incisions on the inside of the nostrils. Closed rhinoplasty is most commonly performed on patients that hope to make changes that are more minor in nature to the nasal structure of the nose. The reason it is a better option for minor alterations to the nose is that the surgeon does not have as much visibility or access to the nasal structure since the incisions are made on the inside of the nose. Patients will not have any visible scars after the surgery since the incisions are not on the outside of the nose, unless the nostrils need to be brought in.

Rhinoplasty videos


Rhinoplasty videos

Am I a Candidate for a Rhinoplasty ?


Ideal candidates for Rhinoplasty include:
People who feel their nose is too large compared to their other facial features
Patients with a nose that is considered to have a look that is wide or crooked
Those who feel their nose is too small in comparison to their other facial features
Someone with a nose that is asymmetrical or off-center in appearance
Patients that want a more refined appearance to the tip of the nose instead of a more bulbous tip
Someone that is having trouble breathing due to an issue such as a deviated septum

Rhinoplasty costs


Nationwide
$5000-$12,000
Los Angeles
$6000-$25,000

The total cost of rhinoplasty depends on the amount of work that needs to be done to make the desired changes, if the rhinoplasty procedure is being performed for aesthetic or functional reasons (or both), any fees charged by the doctor or the facility and the area of the country where the cosmetic procedure is being performed. The cost of rhinoplasty is usually not covered by insurance unless it is being performed to help correct breathing issues.

Rhinoplasty Procedure Explained


Open Rhinoplasty Steps

1.
Incison
An incision is made at the columella which is located in the narrowest portion between the nostrils
2.
Dissect
A flap of skin on the nose is lifted in order to dissect the nose cartilage while taking care not to incise the cartilage that separates the nostrils
3.
Reshaping
The doctor performs the desired reshaping and alterations to the targeted areas of the nose such as the nasal tip, nostrils, bridge or septum
4.
Re-draped
Once the desired changes are made, the flap is re-draped over the nose in order to perform any external reshaping or contouring
5.
Closure
The incisions are closed by the surgeon and an external splint is placed over the nose
Closed Rhinoplasty Steps

1.
Reshaping
The doctor performs the desired reshaping and alterations to the targeted areas of the nose such as the nasal tip, nostrils, bridge or septum
2.
Closure
Once the desired changes are made to the nose, the doctor will close the incisions and an external splint will be placed on the nose

Rhinoplasty Downtime and Recovery


The amount of downtime and recovery after rhinoplasty depends on the individual patient as well as the amount of changes made to the nose by the surgeon. In terms of rhinoplasty recovery time, there is typically a downtime of one to two weeks for both open and closed rhinoplasty patients. The splint on the nose will normally be removed after seven days and patients will be able to go out in public once it is removed.

Patients should sleep with their head elevated for the first few nights after surgery and they should not sleep on their side as this can alter the bones that have been reshaped.

Patients are advised not to blow their nose for a few weeks after rhinoplasty as it can cause bleeding and disrupt the healing process.

Patients can expect to see some bruising and swelling around the nose and eyes for two or three weeks after the surgery. Once the swelling and bruising starts to disappear, the nose will begin to settle and take its final shape. It can take up to a year for the swelling to completely subside.

The amount of downtime and recovery after rhinoplasty depends on the individual patient as well as the amount of changes made to the nose by the surgeon. In terms of rhinoplasty recovery time, there is typically a downtime of one to two weeks for both open and closed rhinoplasty patients. The splint on the nose will normally be removed after seven days and patients will be able to go out in public once it is removed.

Patients should sleep with their head elevated for the first few nights after surgery and they should not sleep on their side as this can alter the bones that have been reshaped.

Patients are advised not to blow their nose for a few weeks after rhinoplasty as it can cause bleeding and disrupt the healing process.

Patients can expect to see some bruising and swelling around the nose and eyes for two or three weeks after the surgery. Once the swelling and bruising starts to disappear, the nose will begin to settle and take its final shape. It can take up to a year for the swelling to completely subside.

Rhinoplasty complications


Anesthesia risks

Scarring

Infection

Swelling

Poor wound healing

Numbness

Skin discoloration

Difficulty breathing

Typical Rhinoplasty results


Patients should be aware of the fact that it can take up to a full year to see the final results. Since the incisions are placed inside the nose during closed rhinoplasty, they will not be visible to others. Open rhinoplasty places the incisions on the outside of the nose so they might be seen by others that view the nose.

The final results of rhinoplasty are considered to be permanent unless the patient suffers some sort of trauma or injury to the nose.

Typical Rhinoplasty results

Patients should be aware of the fact that it can take up to a full year to see the final results. Since the incisions are placed inside the nose during closed rhinoplasty, they will not be visible to others. Open rhinoplasty places the incisions on the outside of the nose so they might be seen by others that view the nose.

The final results of rhinoplasty are considered to be permanent unless the patient suffers some sort of trauma or injury to the nose.

Alternatives to Rhinoplasty


In addition to open rhinoplasty and closed rhinoplasty, here are some other common rhinoplasty procedures:

Ethnic Rhinoplasty

This rhinoplasty technique is performed to provide results that are natural in appearance to patients of East Asian, African American, Middle Eastern and Hispanic ethnicities. Ethnic rhinoplasty, which can be performed as either open or closed rhinoplasty, takes the unique features of each ethnicity into account when performing rhinoplasty in order to properly balance the facial features of the patient. In treating non-Caucasian patients, doctors often need to perform cartilage grafting or place artificial implants in the bridge of the nose to provide greater nasal definition. In cases where these patients have an overly large or bulbous nose, a surgeon can perform nasal tip reshaping. 

Reduction Rhinoplasty

A rhinoplasty technique that means exactly what it says in that it reduces the size of the nose. The reduction can be in the overall size of the nose or it can be a reduction of a specific area of the nose like a hump or a bump. Reduction rhinoplasty is often performed by removing bone and/or cartilage from the nose in order to achieve the desired shape to the nose.

Reconstructive Rhinoplasty

This rhinoplasty technique is performed to repair or rebuild the nose due to damage or trauma or to place a skin graft in areas of the nose impacted by skin cancer. Reconstruction rhinoplasty can be performed for aesthetic or functional reasons and often involves reshaping the nose, replacing missing skin with skin grafts or repairing damaged bones and cartilage.

Revision Rhinoplasty

When a person is not happy with the results of a previous rhinoplasty surgery, the patient can have revision rhinoplasty to try and further alter the shape, size or appearance of the nose. The person might be unhappy with the size or shape of the nose after the first rhinoplasty procedure. However, the surgeon must take great care when performing revision rhinoplasty in order to maintain symmetry between the nose and the rest of the facial features.

Augmentation Rhinoplasty

Much like reduction rhinoplasty, augmentation rhinoplasty also means what it is says in that the procedure is performed to enlarge the nose by adding materials to the nose. Functional reasons for augmentation rhinoplasty include the need to provide structural support to certain areas like the lower or upper lateral cartilage. Augmentation rhinoplasty for aesthetic reasons is often performed to increase the projection of the nasal dorsum in the profile view, augmentation of the nasal tip and the placement of grafts to conceal irregularities of the dorsum or the upper and lower lateral cartilage. Materials that can be added to the nose for augmentation purposes include synthetic implants and autologous implants harvested from the tissue of the patient.

Nonsurgical Rhinoplasty

The nose can be reshaped through the injection of dermal fillers in certain areas of the nose. Dermal fillers can reshape the nasal tip, smooth out any bumps and also improve the overall nasal symmetry. While nonsurgical rhinoplasty can provide the results desired by patients, the final results are not permanent so the patient will need to have a follow-up treatment to maintain the results.

Rhinoplasty Questions & Answers By Expert Doctors

Rhinoplasty Q&A By Expert Doctors


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Find more Rhinoplasty doctors near you

The next step in the rhinoplasty process is finding the right surgeon in your area that is experienced in providing natural, long-lasting rhinoplasty results. In order to help you find the best cosmetic doctor for your rhinoplasty procedure of choice, please use our “Find a Doctor” search page.

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