Rhinoplasty

Cosmetic nose surgery; Nose job - rhinoplasty

Rhinoplasty is surgery to repair or reshape the nose.

Description

Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the 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 3 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 often used to perform work on the tip of the nose or if you need a revision surgery. If the nose needs to be narrowed, the incision may extend around the nostrils. Small incisions may be made on the inside 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 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 nasal 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
Worsening of breathing through 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 revision 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 blood thinning medicines. Your surgeon will give you a list of these medicines.
See your regular health care provider to make sure it is safe for you to have surgery.
To aid with healing, stop smoking at least 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, if present, is usually removed in 3 to 5 days, after which you will feel more comfortable.

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

Outlook (Prognosis)

Full recovery takes a year, but most swelling will have improved by 2 to 3 months.

Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for several months but will improve with time. You may not be able to see the final results for up to a year and sometimes longer.

Open References

References

Sclafani AP, Thomas JR, Tardy ME. Rhinoplasty. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 31.

Winkler AA. Functional and cosmetic rhinoplasty. In: Scholes MA, Ramakrishnan VR, eds. ENT Secrets. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 61.

Septoplasty - series - Septal anatomy
Presentation

<strong>Septoplasty - series - Septal anatomy</strong><p>The septum is the cartilage and bony partition that separates the two nasal chambers (nostrils).</p>

<strong>Indications - Septal deviation</strong><p>The main indications for nasal surgery are Nasal airway obstruction, Septal spur headache, Uncontrollable nosebleeds, Nasal septal deformity in the presence of other intranasal surgery. Nasal airway obstruction is usually the result of a septal deformity that causes breathing by mouth, sleep apnea, or recurrent nasal infections that are slow to respond to antibiotics. A septal spur headache is defined as a headache secondary to pressure from the nasal septum on the linings in side the nose (septal impaction) and relieved by topical (applied to a localized area of the skin) anesthesia on the septal impaction. Other intranasal surgery indicating septoplasty includes polypectomy (removal of a polyp), ethmoidectomy (operation on the ethmoid bone at the superior part of the nasal cavity), turbinate surgery (operation on the concha nasalis), and tumor removal.</p>

<strong>Procedure - Septoplasty</strong><p>The goal of the surgery is to straighten out the nasal septum, to relieve obstructions, or other problems related to the deviation of the septum. An incision is made internally on one side of the nasal septum. After the mucous membrane is elevated away from the bone, obstructive parts of bone and cartilage are removed, and plastic surgery is performed as necessary. Then the mucous membrane is returned to its original position.</p>

<strong>Aftercare</strong><p>Other intranasal surgery indicating septoplasty includes polypectomy (removal of a polyp), ethmoidectomy (operation on the ethmoid bone at the superior part of the nasal cavity), turbinate surgery (operation on the concha nasalis), and tumor removal.</p>

Nose surgery - series
Presentation

<strong>Nose surgery - series</strong><p>The nose is made up of bone and cartilage. The size and relationship of the bone and cartilage which make up the nose determine the size and shape of the nose.</p>

<strong>Indications</strong><p>Nose surgery (rhinoplasty) offers improvement in the appearance in cases in which the nose is cosmetically unappealing. Age may also be a consideration. Many surgeons prefer not to perform cosmetic (elective) rhinoplasties until the growth of the nasal bone is completed (around 14 or 15 for girls, a bit later for boys).</p>

<strong>Procedure</strong><p>With local anesthesia, the nose and the surrounding area is numbed. The patient will usually be lightly sedated but awake during the surgery, and relaxed and insensitive to pain. The surgery is usually done through the incision inside the nostrils. Instruments inserted through the nostril, are used to reshape the bones which make up the nose.</p>

<strong>Aftercare</strong><p>The results of surgery are variable, depending on the initial shape of the nose, but rhinoplasty offers significant improvement in appearance in many cases.</p>

Septoplasty - series - Septal anatomy
Presentation

Nose surgery - series
Presentation

Review Date: 3/2/2023

Reviewed By: Tang Ho, MD, Associate Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Health Library