A large nose with a deviated septum and an unsightly hump can make us very self-aware in social and professional situations, not to mention that it could be associated with breathing issues.

The surgery that aims to change the aesthetics of the nose is called rhinoplasty. This surgery also often has a functional aspect, solving a couple of important medical problems such as nose trauma, septal deviation, or weak cartilages.

The basic principles of rhinoplasty

Rhinoplasty is a surgical intervention to correct or change aesthetic or functional aspects of the external nose. The surgery can correct deviations in the nasal pyramid, it can also change the shape and size of the pyramid. A nose that is too long or too wide can be corrected; a nose hump can be reduced, a tip that is too bulky can be refined, a "saddle" in nose bridge can be restored, and complex breathing disorders can also be addressed etc.

The purpose of this surgery is to obtain a natural-looking nose that is in line with the other facial structures and the patient's personality. In other words, we are trying to achieve harmony and balance at the level of the facial features.

The basic principle of this surgery is to change the shape of the nasal cartilages and nasal bones with the help of incisions mostly hidden inside the nostrils. The skin in the area will then be re-drapped on the new architecture of the nose. If there is an associated nasal obstruction, it will also be treated during the surgery (e.g., correction of septal deviation and other issues).

When can rhinoplasty be performed?

Rhinoplasty can be performed at the same time with other plastic surgery procedures, such as genioplasty (chin shaping) or eyelid surgery. If the patient wants a facelift and a rhinoplasty, the facelift should be performed several months before the rhinoplasty, or vice versa.

Rhinoplasty can be performed at any time after the end of the growth process, when the nasal pyramid reaches the final shape and size, often after the age of 17-18 years old. There is no upper age limit for patients who desire to undergo this procedure.

What you need to know before the surgery

During the initial consultation, the surgeon will make a general assessment of your health, and you will get the chance to discuss the surgical technique in detail (inform the doctor about any other surgeries you have had, diseases, as well as allergies – including allergies to medications- that you suffer from).

  • Tell your surgeon about all medications you are taking (including oral contraceptives, aspirin, vitamins, and weight loss products).
  • Discontinue aspirin, non-steroidal anti-inflammatories such as Ibuprofen, and other blood thinning medications at least 7 days before the intervention.
  • Natural supplements containing high doses of vitamin E should not be administered in the days before the surgery.
  • It is recommended to avoid smoking and excessive sun exposure during this period.
  • On the day of the surgery, you will not eat or drink anything for at least 6 hours prior to the surgery.
Rhinoplasty surgery

Usually, the surgery is performed under general anaesthesia.

A 24-hour hospitalisation might be recommended for most patients, especially the ones with pre-existent health conditions. However, the procedure can be performed as a day case on selected cases. This means that the patient can leave the medical facility within hours after the intervention was performed, if no complications occur.

In most cases, rhinoplasty surgery takes between 2 to 4 hours, depending on the complexity of the procedure and the technique utilised. An external approach rhinoplasty is used by most experienced rhinoplasty surgeons. This involves a small external incision in the columella (the part of the nose separating the two nostrils), other incisions are positioned inside the nostrils and are not visible. It may also be necessary to make an incision in the fold that separates the nostrils from the rest of the face (alar base incision). All incision as designed so that they heal with minimal scarring and are exceedingly difficult to see at about one month.

When the procedure is over, the incisions are sutured, internal silicone splints are inserted on the inside of the nose where it needs to stay for a week. An external thermoplastic nasal splint is applied on the outside. All splints and sutures will be removed after seven to ten days.

Post-surgery care and the result

Post-rhinoplasty discomfort is surprisingly mild (mostly, we are talking about a blocked nose and flu-like symptoms rather than actual pain). Swelling and bruising are natural side effects that can occur after any type of surgical intervention, especially one targeting the delicate tissues of the face.

Post-surgery oedema (swelling) disappears gradually after approximately seven to fourteen days, but in rare cases, it can persist for up to several months. To reduce the swelling, patients are advised to sleep with the head in an elevated position (on two pillows).

Bruises may also occur on the lower eyelids and disappear completely after 10-14 days.

Patients should avoid any type of physical exercises for the first two weeks and intense physical activities and weight lifting for four weeks. Prolonged sun exposure is to be avoided for the first eight weeks after the surgery.

Glasses can be worn after six weeks (contact lenses can be used from the first day after the surgery).

The healing process is gradual. Generally, it takes two to three months to be able to evaluate the result of the intervention, but the final result is often visible after eight months to one year post-op.

Final words

The rhinoplasty intervention is performed to help create a more pleasant nose. This often means a smaller and contoured nose which is more in harmony with other features of the face. The procedure delivers permanent results, so you won’t have to worry about undergoing further intervention at a later date.

To make the most out of your rhinoplasty intervention, discuss your desires and expectations with your facial plastic surgeon during the initial consultation. It’s also important to follow the surgeons’ recommendations for after surgery care to avoid complications and minimize the risks associated with the procedure.