Aesthetic Surgery

Rhinoplasty

Rhinoplasty reshapes the bone and cartilage of the nose, and in the same operation can correct the breathing problems that often accompany a deviated structure. It is among the most technically demanding operations in plastic surgery — which is why the surgeon's specific experience matters more here than almost anywhere else.

What is rhinoplasty?

Rhinoplasty is surgery to change the shape, size or angle of the nose by reshaping the bone at the top, the cartilage in the middle and lower third, and the soft tissue that covers them. Because the nose sits at the centre of the face, small changes read as large ones — a millimetre matters here in a way it does not elsewhere.

When the operation also straightens the septum — the wall dividing the two nasal passages — it is called a septorhinoplasty. This is common: a nose that looks crooked from the outside is frequently crooked on the inside too, and correcting only the appearance would leave the breathing problem in place.

Techniques: open, closed and preservation

There is no universally superior technique. The right one depends on what needs changing and on which approach your surgeon performs most often.

Closed (endonasal)

All incisions are inside the nostrils, so there is no visible scar. Swelling settles somewhat faster, but the surgeon works with less direct exposure. Best suited to smaller, well-defined changes.

Open (external)

Adds a small incision across the columella, the strip of skin between the nostrils. It gives full visibility and precise control, which matters for tip work, marked asymmetry and revision cases. The scar is a few millimetres and usually becomes hard to see within a year.

Preservation rhinoplasty

A newer approach that lowers the existing nasal dorsum rather than removing and rebuilding it. It preserves the natural contour and can mean less bruising, but it does not suit every anatomy and requires specific training.

Revision rhinoplasty

Surgery on a nose that has already been operated on. Scar tissue is unpredictable and cartilage is often depleted, so grafts from the ear or rib are frequently needed. It is markedly harder than a first operation and should be done by a surgeon who does them regularly.

Who is a good candidate?

Facial growth is complete — around 16 for girls and 17–18 for boys
You are in good general health, and any chronic condition is well controlled
You do not smoke, or can stop for at least four weeks before and after
You have a specific, describable concern rather than a general dissatisfaction
Your expectations are of an improved version of your own nose, not someone else's
You can stay in the country for about a week after surgery
If you have had previous nasal surgery, you accept that revision is a harder operation

Preparation and pre-operative work-up

Photographic analysis from standard angles, often with computer simulation to agree on goals
Examination of the inside of the nose, and a CT scan if the septum or sinuses are involved
Blood tests, ECG and an anaesthetic review
Stopping aspirin, anti-inflammatories, fish oil and vitamin E about ten days before
Stopping smoking and nicotine products at least four weeks before — this affects healing directly
Arranging a companion for the first 24 hours after discharge

How the operation is performed

After general anaesthesia, the surgeon lifts the skin off the underlying framework through the chosen incisions. A hump is reduced or the dorsum lowered; the bones are narrowed with controlled cuts (osteotomies); the tip cartilages are trimmed, repositioned and sutured; and cartilage grafts — usually from the septum, sometimes from the ear or a rib — are added where structural support or symmetry is needed.

If the septum is deviated it is straightened in the same operation. At the end an external splint is taped over the bridge, and soft internal splints or dissolvable packing may be placed for a few days. Rigid packing that has to be pulled out is largely a thing of the past.

Anaesthesia, duration and hospital stay

Anaesthesia: general, administered by a consultant anaesthetist
Operating time: about 2–3 hours for a primary rhinoplasty; 3–5 hours for a revision or when rib cartilage is used
Hospital stay: one night is usual; some primary cases are same-day discharge
Stay in the country: 6–8 days, so the splint can be removed before you fly
Time off work: 7–10 days for desk work; 3–4 weeks before anything strenuous

Recovery, week by week

Days 1–7

Splint in place, congestion, and bruising around the eyes that peaks around day three. Sleeping propped up and using cold compresses helps. Pain is usually modest — more pressure than sharp pain.

Week 2

Splint removed at 6–8 days. Bruising fades and most people feel presentable, though the nose looks swollen and the tip sits high. Light activity resumes; glasses must stay off the bridge.

Weeks 3–6

Swelling continues to fall and breathing improves as internal healing settles. Cardiovascular exercise restarts around week three, contact sport not before six weeks.

Months 3–18

About 80% of the swelling is gone by three months, but the tip is the last area to settle and continues to refine for a year or more — longer in thick skin and after revision. Judge the result at twelve months, not at three.

Results and how long they last

The structural change is permanent. Once bone and cartilage have healed in their new position they stay there; the nose then ages as the rest of the face does, with gradual softening of the tip over decades.

Published revision rates for primary rhinoplasty sit at roughly 5–15% depending on the series and how revision is defined. That is normal for this operation, not a sign of poor surgery — and it is a question you should ask your surgeon directly rather than a reason to avoid the procedure.

Risks and complications

Rhinoplasty is generally safe, but it is surgery under general anaesthesia and carries real risks that should be explained to you before, not after:

Bleeding, infection and reaction to anaesthesia — uncommon but possible in any operation
Persistent swelling or asymmetry, particularly at the tip
Nasal obstruction that is unchanged or, rarely, worse
Numbness of the tip, usually temporary but occasionally lasting
Visible irregularity of the bridge as swelling resolves
Septal perforation — rare, and more likely after previous septal surgery
Need for a revision procedure after twelve months

Cost and what should be included

Price varies with the surgeon's experience, whether the case is primary or revision, whether rib cartilage is needed, and the hospital. A revision using rib cartilage is a substantially longer and more expensive operation than a straightforward primary case — quotes that ignore that distinction are not describing your operation.

Ask for the quote in writing, itemised, and confirm each of the following is inside it:

Surgeon's fee, named — not a clinic package with an unnamed operator
Anaesthesia and the anaesthetist's fee
Operating theatre and the overnight hospital stay
Pre-operative blood tests, ECG and imaging
Splints, dressings and post-operative medication
All follow-up visits during your stay, including splint removal
The written revision policy: what is covered, for how long, and what you would still pay

Judge the surgeon by their revisions, not their best photographs

Any surgeon can show you their best result. Ask instead how many rhinoplasties they perform each year, what proportion need revision, and to see cases with a starting point like yours — thick skin, a previous operation, a marked deviation. We ask these questions on your behalf before recommending anyone.

Frequently asked questions

How long before I look normal in photographs?

Most people are comfortable in photographs about two to three weeks after surgery, once the splint is off and bruising has faded. The nose will still be swollen at that point — refinement continues for a year, and the tip is the slowest part. If you have an event, plan for at least three months, and preferably six.

Will rhinoplasty fix my breathing?

Only if the operation addresses the cause. Purely cosmetic reduction can even narrow the airway if the internal valve is not supported. If you have obstruction, say so at the consultation: the surgeon should examine the septum and turbinates and plan a septorhinoplasty with structural grafts rather than reduction alone.

Open or closed — which should I choose?

This is the surgeon's decision, not the patient's. Both give excellent results in the right hands and for the right anatomy; the columellar scar of an open approach is a few millimetres and rarely an issue. A surgeon who performs one approach almost exclusively and does it very well is a safer choice than one who switches to match a patient's preference.

When can I fly home?

After the splint is removed and the surgeon has checked the wound — typically day seven or eight. Cabin pressure is not itself dangerous, but flying before that check means nobody has looked at your nose at the point when early problems appear. Book a flexible return ticket rather than a fixed one.

Can I see a simulation of the result?

Yes, and it is a useful tool for agreeing on direction — but it is a drawing, not a promise. Simulations cannot model how your skin thickness, cartilage strength and healing will behave. A surgeon who presents a simulation as a guaranteed outcome is overselling; one who uses it to show what is and is not achievable is using it properly.

Have your case reviewed before you decide anything

Send photographs from the standard angles and tell us what bothers you. A board-certified plastic surgeon reviews them and comes back with an honest assessment of what is achievable, which technique suits your anatomy, and an itemised written quote.

Get a FREE Second Opinion

This page provides general information about rhinoplasty; it is not medical advice, a diagnosis, or a treatment recommendation. Capital Oncology Group is a care-coordination service and not a medical provider. All procedures are performed by independent, accredited hospitals and licensed physicians, and the decision to operate must be made by a qualified surgeon after examining you individually.