What is rhinoplasty?
Rhinoplasty is surgery that changes the aesthetic appearance of the nose and, at the same time, improves nasal airflow when needed.
The upper part of the nasal structure is made of bone, while the lower part is made of cartilage. With rhinoplasty, it is possible to modify the bony structure, the cartilage, and even the nasal skin.
When planning a rhinoplasty, other facial features are also considered, and it is essential to know which aspects you want to change and which you want to preserve.
Why have a rhinoplasty?
Rhinoplasty can change the shape, size, or proportions of your nose. It can be performed to correct deformities secondary to previous trauma, correct congenital anatomical defects, or improve nasal airflow.
What are the risks/complications of rhinoplasty?
Like any surgery, rhinoplasty may present complications, the most common being:
- Bleeding
- Infection
- Risks related to anesthesia
Other possible risks after rhinoplasty include:
- Difficulty breathing through the nose
- Loss of sensation in and around the nose
- Persistent pain, discoloration, or swelling
- Septal perforation
- Very noticeable scarring
- Dissatisfaction with the aesthetic result
- Need for additional surgery
Before surgery
Before scheduling a rhinoplasty, it is important for the patient to meet with the surgeon to discuss key aspects of the procedure and to align expectations.
During this visit, the following will be carried out:
- Medical history: The surgeon will emphasize understanding the reasons for surgery and the patient’s goals. They will also ask about nasal breathing quality, medications, any history of trauma or previous nasal surgery, and other factors such as a history of bleeding disorders, etc.
- Physical examination: A facial examination will be performed, including both external and internal nasal inspection. This allows the surgeon to evaluate skin thickness and cartilage firmness—both important factors for the final result.
- Photographs: Authorization may be requested to take photos of your face from different angles. These can be used to simulate possible outcomes on a computer. Photographs are also used for before-and-after comparisons and, most importantly, allow the surgeon to discuss surgical goals with the patient.
During surgery
Rhinoplasty is usually performed under general anesthesia, although it can also be done under local anesthesia with sedation.
There are two main types of rhinoplasty depending on the approach:
- Closed technique, performed entirely inside the nose.
- Open technique, which involves a small incision in the skin at the base of the nose.
The surgeon then reshapes both the bone and the cartilage structures beneath the skin.
The surgeon may change the shape of the nasal bones and cartilage in various ways, depending on how much needs to be removed or added, the patient’s nasal structure, and the availability of possible grafts.
For minor changes, grafts using the patient’s own septal cartilage are usually sufficient. When there is not enough septal cartilage, cartilage can be taken from the ears, and less frequently from the rib, or synthetic implants may also be used.
Finally, the skin is repositioned and sutures are placed. Depending on the surgeon’s preference and experience, the nose may be packed and a splint placed on the nasal bridge, more for protection than immobilization.
After surgery
After rhinoplasty, relative rest is recommended. It is preferable to sleep with the head elevated above the chest to reduce swelling and the risk of bleeding.
It is normal to experience increased nasal congestion due to swelling or nasal packing. Bruising around the eyelids is also common due to nasal bone fractures performed during surgery.
In the days following surgery, increased nasal mucus—sometimes blood-tinged—is common and will gradually improve.
Additional recommendations include:
- Avoid smoking
- Avoid sports or strenuous physical activity
- Avoid blowing your nose in the first few days; wait until your doctor indicates when it is safe
- Avoid wearing glasses for at least the first 4 weeks after surgery to prevent pressure on the nose
- Use sunscreen with at least SPF 30 to prevent discoloration or permanent hyperpigmentation
Finally, keep in mind that the nose changes throughout life regardless of surgery. After rhinoplasty, the final result is typically achieved up to one year later.
Frequently Asked Questions
What is the difference between rhinoplasty and septoplasty?
Rhinoplasty is surgery aimed at changing the external appearance of the nose. Because there is a relationship between nasal shape and airflow, rhinoplasty is often performed not only to change appearance but also to improve breathing.
Septoplasty is a surgery intended to improve nasal airflow by correcting deviations of the nasal septum, without altering the external appearance of the nose.
Does health insurance cover rhinoplasty?
Private health insurance usually does not cover rhinoplasty, as it is considered cosmetic surgery. Therefore, the patient must cover the full cost of the procedure. However, it is recommended to contact your insurer to learn about your specific coverage.
How much time off work is needed?
At least 7 to 10 days off work are recommended, as this is the period with the greatest swelling. Improvement is noticed progressively during the first week after surgery. You should wait at least one month before resuming sports or significant physical activity.
Is rhinoplasty very painful?
Rhinoplasty is not considered a painful surgery for most people. The day after surgery, patients typically report pain between 0 and 4 on a 10-point scale.