Rhinoplasty, commonly referred to as a “nose job,” is surgery to
change the shape of your nose by modifying the bone or cartilage. Rhinoplasty
is one of the most common types of plastic surgery.
People get rhinoplasty to repair their nose after an injury, to
correct breathing problems or a birth defect, or because they’re unhappy with
the appearance of their nose.
Possible changes that your surgeon can make to your nose through
- a change in size
- a change in angle
- straightening of the bridge
- reshaping of the tip
- narrowing of the nostrils
If your rhinoplasty is being done to improve your appearance
rather than your health, you should wait until your nasal bone is fully grown.
For girls, this is about age 15. Boys might still be growing until they’re a
bit older. However, if you’re getting surgery because of a breathing
impairment, rhinoplasty can be performed at a younger age.
All surgeries carry some risks, including infection, bleeding, or
a bad reaction to anesthesia. Rhinoplasty may also increase your risk of:
- breathing difficulties
- a numb nose
- an asymmetrical nose
Occasionally, patients aren’t satisfied with their surgery. If
you want a second surgery, you must wait until your nose is fully healed before
operating again. This may take a year.
You must first meet with your surgeon to discuss whether you’re a
good candidate for rhinoplasty. You’ll talk about why you want the surgery and
what you hope to accomplish by having it.
Your surgeon will examine your medical history and ask you about
any current medications and medical conditions. If you have hemophilia, a
disorder that causes excessive bleeding, your surgeon will likely recommend
against any elective surgery.
Your surgeon will perform a physical exam, looking closely at the
skin on the inside and outside of your nose to determine what kind of changes
can be made. Your surgeon might order blood tests or other lab tests.
Your surgeon will also consider whether any additional surgery
should be done at the same time. For example, some people also get a chin
augmentation, a procedure to better define your chin, at the same time as
This consultation also includes photographing your nose from
various angles. These shots will be used for assessing the long-term results of
surgery and may be referred to during the surgery.
Make sure you understand the costs of your surgery. If your
rhinoplasty is for cosmetic reasons, it’s much less likely to be covered by
You should avoid painkillers containing ibuprofen or aspirin for
two weeks before and two weeks after your surgery. These medications slow down
the blood-clotting process and can make you bleed more. Let your surgeon know what
medications and supplements you’re taking, so they can advise you about whether
or not to continue them.
Smokers have more difficulty healing from rhinoplasty, as
cigarettes slow the recovery process. Nicotine constricts your blood vessels,
resulting in less oxygen and blood getting to healing tissues. Quitting smoking
before and after surgery can help the healing process.
Rhinoplasty can be done in a hospital, a doctor’s office, or an
outpatient surgical facility. Your doctor will use local or general anesthesia.
If it’s a simple procedure, you’ll receive local anesthesia to your nose, which
will also numb your face. You may also get medication through an IV line that
makes you groggy, but you’ll still be awake.
With general anesthesia, you’ll inhale a drug or get one through
an IV that will make you unconscious. Children are usually given general anesthesia.
Once you’re numb or unconscious, your surgeon will make cuts
between or inside your nostrils. They’ll separate your skin from your cartilage
or bone and then start the reshaping. If your new nose needs a small amount of
additional cartilage, your doctor may remove some from your ear or deep inside
your nose. If more is needed, you might get an implant or a bone graft. A bone
graft is additional bone that’s added to the bone in your nose.
The procedure usually takes between one and two hours. If the surgery
is complex, it can take longer.
After surgery, your doctor may place a plastic or metal splint on
your nose. The splint will help your nose retain its new shape while it heals. They
may also place nasal packs or splints inside your nostrils to stabilize your
septum, which is the part of your nose between your nostrils.
You’ll be monitored in a recovery room for at least a few hours
after surgery. If everything is okay, you’ll leave later that day. You’ll need
someone to drive you home because the anesthesia will still affect you. If it’s
a complicated procedure, you might have to stay in the hospital for a day or
To reduce bleeding and swelling, you’ll want to rest with your
head elevated above your chest. If your nose is swollen or packed with cotton,
you might feel congested. People are usually required to leave splints and
dressings in place for up to a week after surgery. You might have absorbable
stitches, meaning they’ll dissolve and won’t require removal. If the stitches
aren’t absorbable, you’ll need to see your doctor again a week after surgery to
get the stitches taken out.
Memory lapses, impaired judgment, and slow reaction time are
common effects of the medications used for surgery. If possible, have a friend
or relative stay with you the first night.
For a few days after your surgery, you might experience drainage
and bleeding. A drip pad, which is a piece of gauze taped below your nose, can
absorb blood and mucus. Your doctor will tell you how often to change your drip
You might get headaches, your face will feel puffy, and your
doctor might prescribe pain medication.
Your doctor may tell you to avoid the following for a few weeks
after your surgery:
- running and other strenuous physical activities
- blowing your nose
- excessive chewing
- laughing, smiling, or other facial expressions
that require lots of movement
- pulling clothing over your head
- resting eyeglasses on your nose
- vigorous tooth brushing
Be especially careful about sun exposure. Too much could
permanently discolor the skin around your nose.
You should be able to return to work or school in a week.
Rhinoplasty can affect the area around your eyes, and you might
have temporary numbness, swelling, or discoloration around your eyelids for a
few weeks. In rare cases, this can last for six months, and slight swelling
could persist even longer. You can apply cold compresses or ice packs to
decrease discoloration and swelling.
Follow-up care is important after rhinoplasty. Be sure to keep
your appointments and follow your doctor’s instructions.
Although rhinoplasty is a relatively safe and easy procedure, healing
from it can take a while. The tip of your nose is especially sensitive and can
remain numb and swollen for months. You might be fully recovered in a few
weeks, but some effects can linger for months. It could be a whole year before
you can fully appreciate the end result of your surgery.