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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 rhinoplasty include:
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:
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 rhinoplasty.
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 insurance.
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 two.
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 pad.
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:
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.
Written by: Teresa Bergen
Medically reviewed on: Feb 22, 2016: Deborah Weatherspoon, Ph.D, MSN, RN, CRNA
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