Nasal Cosmetic Surgery

Rhinoplasty

Rhinoplasty, commonly known as a “nose job”, is a surgical procedure that many people pursue to change the appearance of their nasal tissue and structure. Year after year, rhinoplasty remains one of the most popular cosmetic surgeries around the world.

What Is Rhinoplasty?

Rhinoplasty is a surgical procedure that modifies the shape, size, and structure of the nose. This can involve altering the bone, cartilage, skin, or all three. The goal of cosmetic rhinoplasty is to change the look of the nose and achieve a balanced facial appearance.  Rhinoplasty can also be considered a functional procedure. The purpose of functional rhinoplasty is to correct breathing difficulties due to structural issues resulting in chronic nasal obstruction from a deviated septum or nasal valve collapse. Concurrent turbinate reduction is also possible, and if required, sinus surgery can also be performed in the same setting depending on the situation.

My nose was long and went down at the tip. When I smiled, it looked long and wide. I didn’t want a major change, and my surgery resulted in only a subtle improvement. Some people didn’t even notice the change, but it made a big difference to me. It made me feel a lot better about myself.
– jennifers., age 16

What Can Cosmetic Rhinoplasty Do?

Rhinoplasty can address a wide range of aesthetic concerns related to the nose. Here are some of the specific improvements cosmetic rhinoplasty can achieve:

  • Reshape the nose to improve facial symmetry
  • Reduce or increase the size of the nose
  • Change the angle between the nose and upper lip
  • Correct bumps or depressions on the nasal bridge
  • Refine the tip of the nose
  • Straighten a crooked nose
  • Narrow the width of the nose

What Doesn't Cosmetic Nose Surgery Do?

While rhinoplasty can address a wide range of issues, it is important to have realistic expectations. Here are some examples of what it cannot achieve:

  • Completely change your facial appearance
  • Guarantee a perfect nose
  • Address issues unrelated to the nose
  • Prevent future nasal injuries or changes

Am I a Good Candidate for Cosmetic Rhinoplasty?

Ideal candidates for cosmetic nose surgery are individuals who meet certain criteria. Here are some of the characteristics that make a good candidate for this procedure:

  • Are physically healthy
  • Are non-smokers
  • Have fully developed facial bones (usually 16 years old or older)
  • Have realistic expectations about the outcomes
  • Seek to change their nasal appearance

How Can I Find a Qualified Facial Plastic Surgeon Near Me?

Choosing the right surgeon is crucial for achieving the best results from your rhinoplasty. Look for a board-certified facial plastic surgeon who specializes in cosmetic nasal surgeries. These professionals have the expertise and artistic vision necessary for successful outcomes. The AAFPRS offers an interactive search feature to help you find a qualified facial plastic surgeon near you.

 

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What Should I Expect During My Cosmetic Rhinoplasty Consultation?

During your consultation, you will have the opportunity to discuss your goals and concerns in detail with your surgeon. This initial meeting is essential for developing a personalized treatment plan and ensuring that you are well informed about the procedure. Here’s what you can expect during your rhinoplasty consultation:
  • Discussion of Your Goals: The consultation will begin with a detailed conversation about your motivations for considering rhinoplasty. Be prepared to discuss specific concerns, desired outcomes, and overall aesthetic goals. The surgeon will listen attentively and ask questions to understand your unique needs and preferences.
  • Medical History Review: Your surgeon will review your complete medical history, including any previous surgeries, medical conditions, allergies, and current medications or supplements. This information is crucial for determining your candidacy for rhinoplasty and identifying any potential risk factors.
  • Physical Examination: The surgeon will perform a thorough physical examination of your nose and facial structure. This may include evaluating the skin quality, nasal bones, and cartilage. Photographs may be taken for reference and surgical planning purposes.
  • Exploration of Rhinoplasty Options: Based on your concerns and goals, the surgeon will discuss the different rhinoplasty techniques that may be suitable for you. They will explain the benefits and limitations of each option, helping you make an informed decision about the procedure.
  • Realistic Expectations: The surgeon will provide an honest assessment of what rhinoplasty can achieve for you. They may show you before-and-after photos of previous patients who have undergone rhinoplasty to help you understand the potential results and the surgeon’s aesthetic style.
  • Explanation of Risks and Complications: Every surgical procedure carries risks. Your surgeon will discuss the potential risks and complications associated with rhinoplasty, such as infection, scarring, asymmetry, and breathing difficulties. It’s important to understand these risks before proceeding.
  • Overview of the Recovery Process: The consultation will also cover the typical recovery process after rhinoplasty. The surgeon will explain what to expect in terms of downtime, discomfort, and activity restrictions. Detailed instructions on post-surgical care will be provided.
  • Cost and Financing Options: Your surgeon will discuss the costs associated with rhinoplasty and any available financing options. Understanding the financial aspects of the procedure is important for making an informed decision.
  • Q&A Session: Come prepared with a list of questions. The surgeon should take the time to address all your concerns thoroughly. Don’t hesitate to ask about the surgeon’s experience, credentials, complication rates, and anything else you want to know.

By the end of your consultation, you should have a clear understanding of the rhinoplasty procedure and what it can realistically achieve for you. You should also feel confident in your choice of surgeon. This sets the stage for a positive surgical experience and optimal results.

What Are the Different Types of Nasal Cosmetic Surgery?

Cosmetic rhinoplasty can be performed using various techniques, each tailored to address specific concerns and patient needs. Understanding the different types can help you and your surgeon decide on the most appropriate approach for your situation.

Closed Rhinoplasty

Closed rhinoplasty involves making incisions inside the nostrils, which means there are no visible external scars. One of the main advantages of this technique is the absence of visible scarring, as all incisions are hidden inside the nose. Additionally, closed rhinoplasty typically results in reduced swelling and faster recovery compared to open rhinoplasty.  However, the limited visibility and access to the nasal structures can make intricate adjustments more challenging for the surgeon. Closed rhinoplasty is ideal for patients requiring minor to moderate adjustments to the nasal tip or bridge.

Open Rhinoplasty

Open rhinoplasty involves making incisions in the nostrils and connecting them with a small incision across the columella, the narrow strip of tissue between the nostrils. This technique provides the surgeon with better visibility and access to the nasal structures, allowing for more precise modifications. It is ideal for precision and needed in complex cases, such as significant reshaping or reconstruction.

The potential disadvantage of open rhinoplasty is the small, visible scar on the columella, although it usually fades over time and becomes less noticeable. The recovery period and swelling are generally longer compared to closed rhinoplasty. Open rhinoplasty is suitable for patients undergoing straightforward primary rhinoplasty, as well as those requiring significant changes to the nasal structure to correct severe asymmetry or previous nasal trauma.

Preservation Rhinoplasty 

Preservation rhinoplasty is a technique that can be performed with either the open or closed approaches. What makes this technique different from other rhinoplasty techniques is the “preservation” of the dorsum of the nose. Instead of reducing the hump from the top down, preservation rhinoplasty relies on techniques that allow pushing down the septum and reduction of the size of the nose from the inside-out.

Revision Rhinoplasty

Revision rhinoplasty, also known as secondary rhinoplasty, is performed to correct or improve the results of a previous rhinoplasty. This procedure can address issues such as breathing difficulties, nasal asymmetry, or dissatisfaction with the initial outcome. Revision rhinoplasty helps restore both function and aesthetics.

This is a more complex procedure than primary rhinoplasty due to the presence of scar tissue and altered anatomy, leading to a higher risk of complications and longer recovery time. Revision rhinoplasty is ideal for patients who have had one or more previous rhinoplasty surgeries and are experiencing functional or aesthetic issues.

Ethnic Rhinoplasty 

Ethnic rhinoplasty is tailored to preserve the unique ethnic features of the patient while achieving the desired aesthetic improvements. This approach maintains cultural and ethnic identity and is customized to meet specific anatomical and aesthetic needs.

Ethnic rhinoplasty requires a surgeon with expertise in ethnic rhinoplasty to ensure culturally sensitive and satisfactory results. It is ideal for patients of diverse ethnic backgrounds who wish to enhance their nasal appearance while retaining their ethnic characteristics.

Nonsurgical Rhinoplasty 

Nonsurgical rhinoplasty involves using injectable fillers to temporarily alter the shape of the nose without surgery. This minimally invasive procedure requires no downtime and provides immediate results that can be adjusted easily.

The results are temporary, typically lasting six to 12 months, and the procedure cannot address functional issues or make significant structural changes. Nonsurgical rhinoplasty is ideal for patients seeking minor adjustments to the nasal shape and those who prefer a non-permanent solution.

Each type of rhinoplasty has its own set of benefits and considerations. Your facial plastic surgeon will recommend the most suitable technique based on your individual facial anatomy, the extent of the changes desired, and your overall goals.

What Are the Steps of a Rhinoplasty Procedure?

Rhinoplasty involves a series of meticulously planned steps to ensure the best possible outcome. Each stage is crucial for achieving the desired aesthetic and functional results. Here’s a detailed overview of the typical steps in a rhinoplasty procedure:

1. Anesthesia

The first step in the rhinoplasty procedure is administering anesthesia to ensure patient comfort and safety throughout the surgery. The type of anesthesia used can vary depending on the complexity of the surgery and surgeon preference. Local anesthesia with sedation numbs the nose and surrounding area while the patient is awake. With general anesthesia, the patient is asleep during the procedure. This anesthesia is provided by a qualified anesthesia provider. Your surgeon will discuss the best anesthesia option for you during the consultation, considering factors like the extent of the surgery and your medical history.

2. Incisions

For a closed rhinoplasty, the surgeon makes incisions inside the nostrils, resulting in no visible external scars. In an open rhinoplasty, the surgeon makes a small incision across the columella, the narrow strip of tissue between the nostrils, along with internal incisions. This provides better access to the nasal structures but leaves a small visible scar that typically fades over time. The choice of incision type is based on the specific needs of the surgery and the surgeon’s preferred technique. Your surgeon will explain the rationale behind their choice during the consultation.

3. Reshaping the Nose Structure

Depending on the desired outcome, the surgeon may remove or add bone and cartilage. This reshaping is done with precision to create a balanced and symmetrical appearance. If the goal is to reduce the size of the nose, the surgeon will remove bone or cartilage. If the nose needs to be built up, the surgeon may use cartilage grafts, often taken from the septum, ear, or ribs. The surgeon reshapes the nasal tip by modifying the cartilage, ensuring it suits the overall facial structure. For a crooked nose, the surgeon will carefully straighten the nasal bones and cartilage.

4. Correcting a Deviated Septum

If the patient has a deviated septum causing breathing issues, this is corrected during the rhinoplasty. The surgeon will straighten the septum and adjust the nasal structures to improve airflow. This step not only enhances the appearance but also significantly improves nasal function, allowing for better breathing. If you are considering a septoplasty to repair a deviated septum and desire cosmetic changes to your nose, it is best to do these at the same time, otherwise your rhinoplasty can be more difficult in the future.

5. Closing the Incisions

Once the reshaping is complete, the surgeon carefully closes the incisions. Fine sutures are used to minimize scarring and ensure a natural appearance. Internal sutures are typically dissolvable and used for incisions inside the nostrils. External sutures, used for open rhinoplasty, may need to be removed during a follow-up visit. The surgeon gently redrapes the skin over the new nasal structure, ensuring it lays smoothly and naturally.

6. Bandaging and Dressing

After the incisions are closed, the nose is bandaged to help protect it and maintain its new shape during the initial healing phase. An external splint is often placed on the outside of the nose to support and protect the newly shaped structures. In some cases, internal splints or nasal packing may be used to stabilize the septum and support the nasal passages. The patient is then taken to a recovery area where they are monitored as the anesthesia wears off. Most patients can go home the same day, but they will need someone to drive them.

7. Post-Operative Care

Your surgeon will provide specific instructions on how to care for your nose in the days following surgery. This includes managing swelling, bruising, and discomfort. You will need to attend follow-up appointments to ensure proper healing and address any concerns. During these visits, the surgeon may remove any non-dissolvable stitches and check the progress of your recovery. Full recovery from rhinoplasty can take up to a year, with gradual changes occurring as swelling subsides and the nose settles into its new shape. Your surgeon will give you guidelines on activities to avoid and how to maintain your results.

Understanding these steps helps ensure you are well-prepared for the procedure and have realistic expectations about the process and recovery. Your surgeon will guide you through each stage, providing support and expertise to achieve the best possible outcome.

What Should I Expect After Rhinoplasty?

The recovery process after rhinoplasty involves several stages and requires careful attention to your surgeon’s instructions. Here are some general expectations for the post-operative period:
  • Some swelling and bruising are normal and will subside over time
  • Your surgeon will provide specific instructions on how to care for your nose post-surgery
  • Keep your head elevated to reduce swelling
  • Avoid strenuous activities for a few weeks
  • Follow-up appointments will be necessary to monitor the healing
  • Expect that it will take at least a year or longer to see your final results

What Results Can Be Achieved With Cosmetic Rhinoplasty?

The goal of cosmetic nose surgery is to enhance the appearance of your nose while ensuring that the results look natural and harmonize well with your overall facial features. Here are the detailed results you can expect from a successful rhinoplasty procedure:

Improved Nasal Shape and Size

Rhinoplasty can address various aesthetic concerns by reshaping and resizing the nose. If you have a nose that is too large or too small in proportion to your other facial features, rhinoplasty can help achieve better balance. The procedure can also refine the nasal tip, making it less bulbous or more defined. Additionally, adjustments can be made to the nasal bridge to remove humps or depressions, resulting in a smoother and more aesthetically pleasing contour.

Enhanced Facial Harmony

Rhinoplasty can significantly enhance overall facial harmony by bringing the nose into better proportion with the rest of the face. The nose plays a central role in the appearance of the face, and even small changes can have a profound impact on how balanced and symmetrical your features appear. A well-proportioned nose can complement other facial features, such as the eyes, cheeks, and mouth, creating a more cohesive and attractive look.

Increased Self-Confidence

Many patients experience a significant boost in self-confidence following rhinoplasty. Feeling self-conscious about the appearance of your nose can affect your self-esteem and social interactions. By achieving a nose that better aligns with your aesthetic goals, you may feel more confident in your appearance. This increased confidence can positively impact various aspects of your life, from personal relationships to professional opportunities.

Long-Lasting Results

The results of rhinoplasty are typically long-lasting, with many patients enjoying their new look for a lifetime. While the natural aging process will continue to affect your face, the changes made during rhinoplasty are permanent. Maintaining a healthy lifestyle and following your surgeon’s post-operative care instructions can help ensure that your results remain stable over time.

Natural-Looking Outcomes

A key objective of rhinoplasty is to achieve results that look natural and subtle. A skilled facial plastic surgeon will aim to make changes that enhance your appearance without making it obvious that you have had surgery. The goal is to create a nose that fits well with your other facial features and does not draw undue attention.

Customized Results

Every rhinoplasty procedure is tailored to the individual patient’s needs and goals. Whether you are seeking dramatic changes or subtle refinements, your surgeon will customize the approach to achieve the best possible results. This personalized approach ensures that the outcomes align with your specific aesthetic preferences and functional requirements.

Improved Nasal Symmetry

Rhinoplasty can correct nose asymmetries, making the nose more symmetrical and balanced. This is particularly important for patients with congenital asymmetries or asymmetries resulting from trauma or previous surgeries. Achieving better symmetry can greatly enhance the overall attractiveness of the face.

Enhanced Profile and Side View

Rhinoplasty can improve the profile view of your face by adjusting the angle and projection of the nose. This can involve altering the nasal tip, smoothing out a dorsal hump, or refining the bridge of the nose. The result is a more attractive side profile that complements the rest of your facial features.

Rhinoplasty Before & After Images

Most patients report little or no pain after nasal surgery, and any discomfort is easily controlled with mild pain medication.

 

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Cosmetic Rhinoplasty FAQs

What are the risks of rhinoplasty?

Rhinoplasty surgery, like any surgical procedure, carries certain risks. It is important for patients to be aware of these potential complications before deciding to proceed with the surgery. Here are some of the specific risks associated with rhinoplasty:

  • Infection: Infection can occur at the incision sites or within the nasal structures. Proper post-operative care and following your surgeon's instructions can minimize this risk.
  • Unfavorable Scarring: Scarring is an inherent part of any surgery involving incisions. While skilled surgeons aim to place incisions in inconspicuous locations and use techniques that minimize scarring, noticeable scars are still possible. In open rhinoplasty, a small scar on the columella is common, but it typically fades over time.
  • Nasal Asymmetry: Achieving perfect symmetry is challenging, and there is a risk that the nose may appear asymmetrical after surgery. This could be due to factors such as swelling, healing patterns, or subtle differences in the nasal structures.
  • Changes in Skin Sensation: Alterations in the nasal structure can affect the nerves, leading to temporary or permanent changes in skin sensation. Patients may experience numbness, tingling, or reduced sensitivity in the nose and surrounding areas.
  • Difficulty Breathing: Rhinoplasty aims to improve nasal function, but there is a risk that changes to the nasal structure could lead to breathing difficulties. This may occur if the nasal passages become too narrow or if there is excessive swelling during the healing process.
  • Anesthesia Risks: As with any surgery requiring anesthesia, there are risks associated with its use. These can include allergic reactions, respiratory issues, and complications related to the patient's overall health. An experienced anesthesiologist will carefully monitor the patient to minimize these risks.
  • Need for Revision Surgery: In some cases, the initial rhinoplasty may not achieve the desired results or may lead to complications that require further surgical intervention. Revision rhinoplasty can address these issues but involves additional risks and recovery time.
  • Other Potential Risks: Additional risks include prolonged swelling, excessive bleeding, hematoma (collection of blood under the skin), and unsatisfactory aesthetic outcomes. Each patient’s risk profile can vary based on factors such as their health, anatomy, and the complexity of the procedure.
What is the best age for rhinoplasty?

There is no specific best age for rhinoplasty, as the ideal timing can vary based on individual circumstances. However, it is generally recommended that individuals wait until their facial growth is complete before undergoing the procedure. For most people, this occurs between 16 and 18 years old. Performing rhinoplasty on a nose that is still growing can lead to unpredictable results and potential complications as the nose continues to develop.

Waiting until facial growth is complete ensures that the structural changes made during the surgery will be stable and long-lasting. Additionally, by this age, individuals are often more emotionally mature and better equipped to make informed decisions about having plastic surgery.

It is also important to consider the patient's psychological readiness. Adolescents and young adults should have realistic expectations about the outcomes of rhinoplasty and understand that the procedure is aimed at enhancing their natural features rather than achieving perfection. Consulting with a qualified facial plastic surgeon can help determine the right timing and approach for rhinoplasty based on individual growth patterns and aesthetic goals.

There is no upper age limit for rhinoplasty as long as the patient is in good overall health and can safely undergo surgery. The motivations for rhinoplasty in older adults may include correcting age-related changes, such as a drooping nasal tip or a previously untreated nasal injury.

Can I have a non-surgical rhinoplasty?

Yes, there are non-surgical options available for individuals looking to temporarily change the shape of their nose. Non-Surgical rhinoplasty, also known as liquid rhinoplasty, involves the use of injectable dermal fillers to add volume to certain areas of the nose to conceal humps and smooth the profile of the nose. This procedure is typically performed by an experienced injector in a physician’s office and can provide immediate results. Given the purpose of fillers, patients wanting a “smaller nose” typically would not want additional volume added to the nose. Consult with a physician to ensure this is a safe and effective option for what you want to achieve.

How much does rhinoplasty cost?

The cost of rhinoplasty can vary widely based on several factors, including the surgeon’s experience, the complexity of the procedure, and the geographic location of the practice. Here’s a detailed breakdown of what influences the cost and what you can expect:

  • Surgeon's Experience and Reputation: One of the most significant factors affecting the cost of rhinoplasty is the surgeon’s experience and reputation. Highly experienced and board-certified facial plastic surgeons who have a strong track record of successful rhinoplasty procedures typically charge higher fees. Their expertise can be crucial for achieving optimal results, especially in complex cases.
  • Complexity of the Procedure: The complexity of the rhinoplasty procedure also plays a critical role in determining the cost. Simple adjustments, such as minor tip refinement or small dorsal hump removal, tend to be less expensive than more complex surgeries that involve significant reshaping, structural corrections, or revision rhinoplasty. Functional improvements, such as correcting a deviated septum, can also add to the overall cost.
  • Geographic Location: The location of the surgeon’s practice can significantly influence the cost of rhinoplasty. Practices in major metropolitan areas or regions with a higher cost of living tend to charge more for surgical procedures. For example, rhinoplasty in cities like New York, Los Angeles, or San Francisco is often more expensive than in smaller towns or rural areas.
  • Anesthesia Fees: The type of anesthesia used during the procedure (local anesthesia with sedation or general anesthesia) can impact the cost. General anesthesia is typically more expensive due to the need for an anesthesiologist or a certified nurse anesthetist to administer and monitor it.
  • Facility Fees: The fees associated with the surgical facility where the procedure is performed also contribute to the total cost. Accredited surgical centers or hospitals may charge higher fees compared to office-based surgical suites.
  • Pre- and Post-Operative Care: The cost of rhinoplasty includes pre-operative consultations, medical tests, and post-operative care. Follow-up visits, medications, and any necessary post-surgical garments or splints are typically factored into the total cost.
  • Average Cost Range: On average, rhinoplasty costs in the United States range from $7,000 to $15,000. This range encompasses all the above factors and can vary based on individual circumstances. It is essential to obtain a detailed quote from your surgeon during the consultation, which will outline all the components of the cost.
  • Financing Options: Many plastic surgery practices offer financing options to help manage the cost of rhinoplasty. Payment plans, medical credit cards, and healthcare financing companies can make the procedure more affordable by allowing you to spread the cost over several months or years.
Does insurance cover cosmetic rhinoplasty?

Rhinoplasty performed for purely cosmetic reasons is generally not covered by insurance. However, if the procedure is performed to correct functional issues, such as a deviated septum or breathing problems, part of the cost may be covered by insurance. It is important to check with your insurance provider to understand what is covered and what documentation is required.

How long does a rhinoplasty last?

The results of rhinoplasty are long-lasting and often considered to be permanent, though natural aging and changes in facial structure may affect the outcome over time.

Will I have scars after my rhinoplasty?

With closed rhinoplasty, there are no visible scars. Open rhinoplasty leaves a small scar on the columella, which usually fades over time due to the nature of the surrounding tissue and nasal structure.

Will people know I had a rhinoplasty?

A well-performed rhinoplasty by a skilled surgeon should result in natural-looking changes. In most cases, people who know you will notice a subtle difference, while people who did not know you prior to the surgery will not be able to tell if any work was done.

Even a minor correction can make a difference in overall facial harmony.

Medical content written by the AAFPRS Multimedia Committee
Medical content reviewed/approved by Dr. Samuel M. Lam and Dr. Albert J. Fox