Rhinoplasty

Definition

Rhinoplasty is surgery to repair or reshape the nose.

Alternative Names

Cosmetic nose surgery; Nose job - rhinoplasty

Description

Rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the person's preference. It is performed in a surgeon's office, a hospital, or an outpatient surgery center. Complex procedures may require a short hospital stay. The procedure often takes 1 to 2 hours. It may take longer.

With local anesthesia, the nose and the area around it are numbed. You will probably be lightly sedated, but awake during the surgery (relaxed and not feeling pain). General anesthesia allows you to sleep through the operation.

The surgery is usually done through a cut (incision) made inside the nostrils. In some cases, the cut is made from outside, around the base of the nose. This type of cut is used to perform work on the tip of the nose or if you need a cartilage graft. If the nose needs to be narrowed, the incision may extend around the nostrils. Small incisions may be made on the side of the nose to break, and reshape the bone.

A splint (metal or plastic) may be placed on the outside of the nose. This helps maintain the new shape of the bone when the surgery is finished. Soft plastic splints or nasal packs also may be placed in the nostrils. This helps keep the dividing wall between the air passages (septum) stable.

Why the Procedure Is Performed

Rhinoplasty is one of the most common plastic surgery procedures. It can be used to:

  • Reduce or increase the size of the nose
  • Change the shape of the tip or the nasal bridge
  • Narrow the opening of the nostrils
  • Change the angle between the nose and the upper lip
  • Correct a birth defect or injury
  • Help relieve some breathing problems

Nose surgery is considered elective when it is done for cosmetic reasons. In these cases, the purpose is to change the shape of the nose to one that the person finds more desirable. Many surgeons prefer to perform cosmetic nose surgery after the nasal bone has finished growing. This is around age 14 or 15 for girls and a bit later for boys.

Risks

Risks for anesthesia and surgery in general are:

  • Reactions to medicines, problems breathing
  • Bleeding, infection, or bruising

Risks for this procedure include:

  • Loss of support of the nose
  • Contour deformities of the nose
  • Need for further surgery

After surgery, tiny blood vessels that have burst may appear as tiny red spots on the skin surface. These are usually minor, but are permanent. There are no visible scars if the rhinoplasty is performed from inside the nose. If the procedure narrows flared nostrils, there may be small scars at the base of the nose that are not often visible.

In rare cases, a second procedure is needed to fix a minor deformity.

Before the Procedure

Your surgeon may give you instructions to follow before your surgery. You may need to:

  • Stop any medicines that thin your blood. Your surgeon will give you a list of these medicines.
  • See your regular health care provider to have some routine tests and make sure it is safe for you to have surgery.
  • To aid with healing, stop smoking 2 to 3 weeks before and after surgery.
  • Arrange to have someone drive you home after surgery.

After the Procedure

You will usually go home on the same day as your surgery.

Right after surgery, your nose and face will be swollen and painful. Headaches are common.

The nasal packing is usually removed in 3 to 5 days, after which you will feel more comfortable.

The splint may be left in place for 1 to 2 weeks.

Outlook (Prognosis)

Full recovery takes several weeks.

Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for months. You may not be able to see the final results for up to a year.

References

Ferril GR, Winkler AA. Rhinoplasty and nasal reconstruction. In: Scholes MA, Ramakrishnan VR, eds. ENT Secrets. 4th ed. Philadelphia, PA: Elsevier; 2016:chap 59.

Tardy ME, Thomas JR, Sclafani AP. Rhinoplasty. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 34.

Version Info

  • Last reviewed on 1/10/2017
  • David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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