Rhinoplasty

Surgery Overview

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Rhinoplasty is surgery to reshape the nose. It can make the nose larger or smaller; change the angle of the nose in relation to the upper lip; alter the tip of the nose; or correct bumps, indentations, or other defects in the nose.

During rhinoplasty, the surgeon makes incisions to access the bones and cartilage that support the nose. The incisions are usually made inside the nose so that they are invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added (either from another part of the body or using a synthetic filler). After the surgeon has rearranged and reshaped the bone and cartilage, the skin and tissue is redraped over the structure of the nose. A splint is placed outside the nose to support the new shape of the nose as it heals. Nasal packing may be used inside the nose to provide additional support.

Rhinoplasty may be done using general or local anesthesia. It is usually done as an outpatient procedure but sometimes requires a 1-night stay in the hospital or surgery center.

Surgeons who perform rhinoplasties typically have training in either plastic surgery, otolaryngology (ear, nose, and throat specialty), or both.

What To Expect After Surgery

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All surgical packing inside your nose will be removed within 2 days after surgery. The splint and bandaging around your nose will be removed in about a week.

Your face will feel puffy and the area around your eyes and nose will be bruised and swollen for several days. Cold compresses can help minimize the swelling and reduce pain. Your doctor may also recommend pain medicine. It takes about 10 to 14 days before most of the swelling and bruising improves.

You may need to keep your head elevated and relatively still for the first few days after surgery. It may be several weeks before you can return to strenuous activities.

Why It Is Done

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Rhinoplasty can change the size, shape, and angle of your nose and bring it into better proportion with the rest of your face.

Rhinoplasty may also correct structural problems with the nose that cause chronic congestion and breathing problems.

How Well It Works

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The results of rhinoplasty may be minor or significant, depending on what kind of correction you want. It is important that you and your plastic surgeon agree on the goals of the surgery: if your expectations are realistic and your plastic surgeon shares them, he or she will probably be able to give you the results you want.

The results of rhinoplasty are permanent, although subsequent injury or other factors can alter the nose's appearance. Cosmetic surgery should only be done on a fully developed nose: complete development has usually occurred by age 15 or 16 in females and by age 17 or 18 in males. If surgery is done before this time, continued development of the nose can alter the surgical results and possibly cause complications.

Risks

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You can always expect temporary swelling and bruising around the eyes and nose after rhinoplasty. Other problems that may occur include:

• Bleeding.
• Skin problems, including breakdown of skin tissue (skin necrosis) and irritation from the tape and bandaging.
• Infection. Preventive antibiotics may be given after surgery to reduce the risk of infection.
• Serious nasal blockage caused by swelling inside the nose.
• Complications of anesthesia.

It is also possible that the cosmetic results of the surgery will not be what you wanted.

What To Think About

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One of the prominent features of the face, the nose can have a big impact on your self-image and appearance. If you're unhappy with your nose and have been so for a long time, rhinoplasty is a reasonable option to consider. As with other cosmetic procedures, you are more likely to be happy with the results of rhinoplasty if you have clear, realistic expectations about what the surgery can achieve and you share these with your plastic surgeon.

Most insurance companies will not cover the costs of rhinoplasty unless it is being done to correct a functional problem or a defect caused by disease or injury. Even in these cases, be sure to check with your insurance company to find out what portion of the costs it will cover. Costs of surgery include not only the surgeon's fee but fees for the operating facility, the anesthesiologist, medicines, splints, packing, and other services and materials.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Credits

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Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Keith A. Denkler, MD - Plastic and Reconstructive Surgery
Last Updated	August 4, 2008