Learn more about rhinoplasty, a surgical procedure used to alter the shape or appearance of the nose

What is a rhinoplasty and a septoplasty?

Rhinoplasty is a surgical procedure used to alter the shape or appearance of a person’s nose. This operation can be performed to restore the nose after an injury, to correct a congenital condition or birth defect affecting the nose, to improve the appearance of the nose, or to improve the harmony of how the nose fits within the rest of the face. 
Septoplasty is a procedure performed to correct a deviated septum that may be causing nasal obstruction or difficulty breathing. This procedure may be performed alone or as part of a rhinoplasty.

Who can undergo rhinoplasty or septoplasty?

Patients who are unsatisfied with the shape of their nose or the way their nose fits within their face may be good candidates for rhinoplasty. Patients are candidates for rhinoplasty surgery if they have suffered an injury to their nose which resulted in a visual change to the shape of the nose. Additionally, children often suffer minor nasal injuries early in childhood and then develop abnormal growth after these injuries.

Patients who are born with a birth defect that affected the development of the nose such a cleft lip, craniosynostosis, frontonasal dysplasia, Tessier clefts, Treacher Collins syndrome, Apert syndrome, hemangiomas, and vascular malformations often benefit from rhinoplasty as well. Children considering rhinoplasty need to have finished growing. This is typically in the mid-teenage years for girls, and late teenage years for boys.

How are patients evaluated for rhinoplasty or septoplasty?

Patients undergoing evaluation for rhinoplasty will have a thorough evaluation by their plastic surgeon. This will include consideration of any medical conditions you might have. A complete examination of the outside and inside of the nose will be completed as well as an evaluation your facial proportions. Your plastic surgeon will ask you about your breathing, history of allergy or sinus problems, and history of nasal injuries, birth defects, or previous surgery. A full set of facial photographs, including a 3D image of your face will be taken to help with planning your operation. 

When evaluating you for surgery, your surgeon will assess the size and shape of your chin and lower jaw. The goal of rhinoplasty is to create a well-shaped nose that fits your face well. When patients have a small chin, a genioplasty may also be beneficial to improve the proportions of the nose and face. 

What should patients expect after having rhinoplasty surgery?

Patients having rhinoplasty surgery may go home following surgery or may remain in the hospital one night. Most patients will have a nasal cast on their nose and either nasal splints or nasal packing inside their nose. The nasal cast will be removed 7-10 days after surgery. Nasal packing will be removed several days after surgery and nasal splints are removed 7-10 days after surgery.

You will be given an antibiotic to take while you have packing in your nose. All the incisions inside your nose will be closed with absorbable stitches. The incision across the base of the nose (the columella) will be closed with removable stitches that will be removed around 7 days after surgery.

Most patients have increased stuffiness and difficulty breathing after rhinoplasty, particularly while nasal packing or splints are in place. It is common to have bloody drainage from the nose for a few days after surgery. A gauze pad will be placed under your nose to help keep this area clean. It is important to sleep with your head elevated and to avoid strenuous activity or heavy lifting to allow the swelling to go down. You may return to your regular activities 6 weeks after your operation.

Patients may develop bruising under the eyes if the nasal bones are repositioned. This typically resolves in 1-2 weeks. Swelling will dramatically improve in the first 2 weeks after surgery and will improve even more in the first 6 weeks afterward. There is subtle swelling that remains 1 to 2 years after surgery and gradually decreases. You will see the final result of your procedure approximately one year surgery, but the greatest changes can be appreciated shortly after the operation.