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Rhinoplasty is the surgery that changes the shape and structure  of the nose. It is done to repair deformities from an injury, correct a birth defect ,improve some breathing difficulties or to improve the existing appearance. Theoperative goal for a rhinoplasty procedure may be, to change the appearance of the nose, improve breathing or both. Hence Rhinoplasty is not necessarily a cosmetic procedure, but also a functional procedure as it improves the breathing function of the nose.

The structure of the upper portion of the nose is formed by 2 nasal bones and the lower portion is  formed by cartilages.  The skin over the nose also different in different area with thin mobile skin on the upper half of nose and thicker fixed skin with more glands on the lower half of nose. Rhinoplasty can change the form of bone, cartilage, skin or all three.

Nose as such is not an isolated structure and it is closely related to the other dimensions and structures of the face. Rhinoplasty is performed in such a way that the nose shape is in harmony with the rest of the face. Hence the  planningof rhinoplasty, involves the analysis of the nose and also the face propositions to achieve a perfect combination.  The plastic surgeon will discuss with you regarding your concern and the expectations. He will consider other facial features, the skin on your nose and what you would like to change. Then after the detailed examination, you will be informed about the customised plan and the possible result that can be expected.  The extent of correction of the nasal skeleton and the skin has limitations. Therefore  the result achieved in every patient might not be the same as the his/her expectation and this will be discussed.

Rhinoplasty surgery

Locations of the nasal bone and cartilage

Nose surgery before and after

Before-and-after results of rhinoplasty

Process of Rhinoplasty:


Possible risks specific to rhinoplasty include but are not limited to:

  • Difficulty breathing through your nose
  • Permanent numbness in and around your nose
  • The possibility of an uneven-looking nose
  • Pain, discoloration or swelling that may persist
  • Scarring
  • A hole in the septum (septal perforation)
  • A need for additional surgery

As with any major surgery, rhinoplasty also has  risks such as:

  • Bleeding
  • Infection
  • An adverse reaction to the anesthesia

Talk to your doctor about how these risks apply to you.

How you are prepared for Rhinoplasty:

When  youwish to undergo Rhinoplasty , you must meet your surgeon to discuss important factors that determine whether the surgery is likely to work well for you.

The Surgeon will discusswith you regarding the reason for opting rhinoplasty and your expectations. History about any trauma, previous surgery, medical problems (Bleeding disorder, Asthma etc), any medication will discussed. History of taking Ayurvedic / homeopathic / Herbal  medications,  blood thinners like Aspirin , Clopilet should be revealed to the surgeon. These medications will cause increased bleeding during surgery and you will be advised to stop it a few days before surgery after having appropriate cross consultation with the concerned specialist. Smoking  decreases blood supply and advised to be stopped 3-4 weeks before surgery. Active and long time smokers have increased chances of wound healing  and anaesthesia related problems and hence this should be revealed to the surgeon .

Then the surgeon does a thorough clinical examination  of your both externally and inside the nostrils. Certain measurements will also be taken  which will be useful to plan the surgery and for post op assessment. The entire facial dimension will also be assessed since the nose has to be corrected in relation to the face. The position and the strength of the soft bones (Cartilage ) of the nose, thickness of the skin, position of the  nasal septum, width of the nasal bone , location and quality of previous surgical scars etc will be assessed. The physical exam is also critical for determining the impact of rhinoplasty on your breathing.Generally a cross consultation with ENT specialist will be asked for an endoscope examination of the inside of the nose.

Photographs of the nose / face will be done in certain positions. This will be very useful for planning the road map for surgery , intra op assessment and post op Comparison.

Then the surgeon discusses about the plan for surgery and what you can expect out of it. All your expectations may not be fulfilled as the surgeon will explain you what is practically possible. You might be explained with few illustrations , what will be the appropriate procedure for your  appearance that is practically possible. Sometimes you will be suggested of additional procedures in the cheek / Chin / Lip which can improve or enhance the appearance. It’s very important that you’re open with your surgeon about your desires and goals for surgery and the surgeon could reciprocate the same with the possible options based on the medical knowledge and his experience.

Rhinoplasty does not have an ordered series of steps. Each surgery is unique and customized for the specific anatomy and goals of the person having the surgery.

During the surgery

Rhinoplasty is generally done General Anaesthesia where you are totally asleep and not aware of the surroundings. In patients requiring minor corrections, local anaesthesia with sedation might be given or general anaesthesia, depending on how complex your surgery is and what your surgeon prefers. The surgeon and anaesthetist will discuss before surgery which type of anaesthesia is most appropriate for you.

Sometimes, Your nose will be packed with gauze pieces dipped in solution containing blood vessel constrictor. This will reduce the size of the mucosa and have a better visibility inside the nose. This will also reduce the surgical bleeding. Rhinoplasty may be done in 2 ways:

Open Rhinoplasty: An external incision is made through a small external cut at the base of your nose, between your nostrils. Rest of the incision will be inside the nose.

Closed Rhinoplasty: All the incisions will be inside the nose and there will be No external incision.

The type of Rhinoplasty is based on the plan of surgery, the correction needed, patient’s preference and the surgeons experience.

Additional minute incisions may be made on the face close to the nose, if correction of bone (Osteotomy) is done. These are very small incisions and the scar will be barely noticeable.

Your surgeon can change the shape of your nasal bones or cartilage in several ways, depending on how much needs to be removed or added, your nose’s structure, and available materials. When small quantities are required the cartilage from inside the nose (septal cartilage) or the ear (Conchal Cartilage). When a large grafts are required , then cartilage from the chest is harvested. Harvesting of cartilage from ear or chest  will have additional scars in the respective areas.  When patients doesn’t want additional scars, then synthetic materials / grafts will be used. Generally the chances of infection and rejection is less with grafts from our body than synthetic grafts. After these changes are made, the surgeon places the nose’s skin and tissue back and stitches the incisions in your nose.

After the closure of the incisions, the nose will be packed with a sterile gauze / sponge to absorb / reduce the bleeding. Also tapes / a splint will be applied over the nose to retain the attained shape.

After the surgery, you’ll be in a recovery room, where the staff monitors your return to wakefulness. Except for minor corrections , we generally advice  one day stay in the hospital.

Post Op Care

You will be advised to have the head at an elevated level above your chest level. This can be done by adjusting the cart or having an additional pillow. This will reduce the swelling of the nose.

Your nose may be congested because of swelling that happens following surgery.After the surgery you need to rest in bed with your head raised higher than your chest, to reduce bleeding .

In most cases, the internal dressings remain in place for one to two after surgery. The external splint will be retained for 1- 2 weeks depending on the procedure done.

Sometimes there might be blood stain while coughing. AlsoSlight bleeding and drainage of mucus and old blood are common for a few days after the surgery or after removing the dressing. This is because of the blood clots in the nasal cavity / sound over the nasal mucosa that have occurred during the Rhinoplasty Procedure.

To further lower the chances of bleeding and swelling, your doctor may ask that you follow precautions for several weeks after surgery. Your doctor may ask you to:

  • Avoid strenuous activities such as aerobics and jogging.
  • Do not wet the dressing / splint over the nose. A shoulder bath is always allowed.
  • Do Not blow your nose.
  • Eat high-fibre foods, such as fruits and vegetables and sufficient amount of fluids to avoid constipation. Constipation can cause you to strain, putting pressure on the surgery site.
  • Avoid hard foods and extreme facial expressions.
  • Brush your teeth gently to limit movement of your upper lip.
  • Wear clothes that fasten in the front. Don’t pull clothing, such as shirts or sweaters, over your head.
  • Avoid spectacle or In addition, don’t rest eyeglasses or sunglasses on your nose for at least four weeks after the surgery, to prevent pressure on your nose. You can use cheek rests, or tape the glasses to your forehead until your nose has healed.if absolutely needed , wear a lighter model and remove when not needed.

Use SPF 30 sunscreen when you’re outside, especially on your nose. Too much sun may cause permanent irregular discoloration in your nose’s skin.

Some temporary swelling or black-and-blue discoloration of your eyelids can occur for two to three weeks after nasal surgery. Swelling of the nose sometimes takes longer(3-6 months) to resolve.

Your nose changes throughout your life whether you have surgery or not. For this reason, it’s difficult to say when you have obtained your “final result.” However, most of the swelling is gone within a year.


Very slight changes to the structure of your nose — often measured in millimeters — can make a large difference in how your nose looks. Most of the time, an experienced surgeon can get results both of you are satisfied with. But in some cases, the slight changes aren’t enough, and you and your surgeon might decide to do a second surgery for further changes. If this is the case, you must wait at least a year for the follow-up surgery, because your nose can go through changes during this time.

Frequently Asked Questions

No. Rhinoplasty is a challenging operation. This is due to several factors. First, the nose is a complicated 3D shape that is in the middle of the face. Changes made during rhinoplasty are often very small. But these changes can make a major difference in the way the nose looks and functions. Because these changes are small, so is the margin for error.

Swelling and the placement of local anaesthetic in the skin distort the nose during surgery, hiding many of the subtle changes made. Rhinoplasty also doesn’t have a standard plan or set order of steps. Doctors tailor each operation to the needs of the patient.

Plan to take a week off from worker other obligations. You will feel progressively better each day during the first week. One week after surgery, people usually feel like they are themselves again. The swelling can take many months to resolve, although most people stop noticing it after a couple of months.

All surgeries have risks. Fortunately, rhinoplasty risks are small and complications are rare. Your doctor will talk to you about the surgery’s risks and benefits in detail before the operation. The list is enumerated above . the complication differ depending on the type of nose correction done, osteotomy , blood loss , presence of risk factors  & Comorbidities, H/O Previous Surgery etc.

Yes. Before your consultation, your doctor will take standardized photographs of multiple views of your face. These photos can be manipulated to give you an idea of what your nose might look like after surgery using specialised software. But this is not a false proof technology and may not be always right.

Not for most people. One day after surgery, most people rate their pain between 0 and 4 out of 10.

Bruising is uncommon. If you do have some minor bruising, it usually lasts a week or so.

Undesired results though rare can happen because of bleeding , infection , cartilage quality and displacement etc.

In some cases like gross displacement of the cartilage graft , immediate resurgery could be done . but in majority of cases corrective / resurgery will be done after a minimum of 6-12 weeks for the edema (swelling) to settle andthe scar matures.

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