Rhinoplasty (Nose Reshaping)

Rhinoplasty, commonly referred to as a “nose job,” is a plastic surgery procedure that involves reshaping and/or resizing the nose to achieve balance and symmetry among facial features, to correct functional issues, or both. During the surgery, a board-certified facial cosmetic surgeon may change the shape of the nasal tip, straighten the nasal septum, or alter the size and contour of the nasal bones and cartilage. Learn the nuances, plus how to locate a skilled specialist, below.

Types of rhinoplasty

Open rhinoplasty

In an open rhinoplasty, the facial cosmetic surgeon makes an incision across the columella, the strip of skin that separates the nostrils. This incision pattern allows the surgeon greater access to the nasal skeleton. This approach is typically used for more complex cases, as it provides better visibility and control over the surgical process. While the scar is visible, it is hidden in the shadow of the nose, and proper scar care and sun protection can help scars fade to near invisibility over the course of about two years post-surgery.

Closed rhinoplasty

During a closed rhinoplasty, all incisions are made within the nostrils, leaving no visible scars. This technique may not be suitable for all patients or nasal concerns, so work with a board-certified facial cosmetic surgeon with extensive rhinoplasty experience to choose the technique that is ideal to meet your goals for your nose’s shape and size.

Non-surgical rhinoplasty

A non-surgical (liquid) rhinoplasty is a minimally invasive procedure that uses injectable dermal fillers to temporarily alter the shape and appearance of the nose. Fillers may smooth out divots or irregularities in shape, temporarily creating the appearance of a smoother nose shape. While it cannot address structural issues, it can provide a subtle, temporary enhancement for patients who are not yet ready to undergo surgery and whose goals do not include a reduction in size; filler is solely an additive procedure. 

Septoplasty (Functional rhinoplasty)

Functional rhinoplasty focuses on correcting issues that impact nasal function—such as a deviated septum, nasal valve collapse, or breathing difficulties—by treating the internal bone, cartridge, and other tissues. This surgery is sometimes combined with rhinoplasty for aesthetic and functional benefits.

Revision rhinoplasty

Revision rhinoplasty is a secondary surgery performed to address complications, functional problems, or simply a patient’s dissatisfaction after their initial surgery.

What can rhinoplasty correct?

Rhinoplasty may adjust the nose to address a wide range of aesthetic and functional concerns, including:

• Nose size
• Nose shape or width
• Nose that appears too masculine or feminine
• Nose with a flat appearance
• Crooked or asymmetrical nose
• Nose hump or bump
• Deviated septum (the wall between the nasal passages)
• Difficulty breathing due to a deviated septum
• Nostrils’ shape, size, or symmetry
• Nasal tip that curves up or down

Who is a good candidate for rhinoplasty?

Ideal candidates for rhinoplasty are those who:

• Are in good overall health
• Have realistic expectations for the outcome, and are not experiencing body dysmorphic disorder (BDD)
• Have completed facial growth (usually around age 16 for girls and 17 for boys)
• Are nonsmokers or willing to quit smoking before and after surgery

During your consultation, your surgeon will learn about your goals and review your medical history to determine if you are a suitable candidate for the procedure.

Preparing for rhinoplasty surgery

Before your rhinoplasty surgery, you will likely need to:

• Quit smoking
• Avoid certain medications, such as aspirin, Ibuprofen, or other blood thinners
• Arrange for a responsible adult to drive you home and assist you during the initial stages of recovery, about 24-48 hours
• Pick up any prescriptions your doctor ordered for the recovery period

Your surgeon will provide detailed preoperative instructions for things like icing your nose and caring for your incisions. You will also have 24/7 contact information for reaching out to your surgeon should concerning symptoms arise.

The rhinoplasty procedure

Rhinoplasty is most often performed under general anesthesia, but local anesthesia with sedation is also an option. General anesthesia puts you to sleep completely, where local anesthesia with sedation allows you to remain awake but sedated.

Rhinoplasty takes anywhere from 1-3 hours, depending on your existing anatomy, desired outcome, and the complexity of the surgical plan.

During surgery, your surgeon will make an incision either at the base of the nose (open rhinoplasty) or within the nostrils (closed rhinoplasty), depending on the approach best suited for your individual needs. They will then reshape the nasal bones, cartilage, and soft tissues to achieve the desired result. For some patients, a tissue graft (i.e. from the ears) may be taken, reshaped, and used to achieve the desired nose shape and size. 

After reshaping tissues, the surgeon closes the incision(s) using carefully placed sutures (typically dissolvable sutures). Your surgeon may apply a nasal splint and/or a cast to support the new nasal structure during the healing process. Your surgeon will typically remove these supports, during one of your post-operative appointments.

Rhinoplasty recovery

Swelling, bruising, and pain management

Following rhinoplasty, patients can expect some swelling, bruising, and discomfort. Pain can be managed with prescribed medications or non-blood thinning over-the-counter pain relievers (i.e. Tylenol), as recommended by your surgeon. Applying cold compresses and keeping your head elevated are important to help reduce swelling, but you should be careful to follow your surgeon’s instructions regarding best practices, as it is possible to apply too much cold.

Wound care

It is essential to follow your surgeon’s wound care instructions, including keeping the surgical site clean and dry and avoiding touching your nose. If you have gauze packing inside your nose, your surgeon may want you to wait and let a medical professional remove this for you at a follow-up appointment.

Wearing glasses

Wearing glasses across your nasal bridge after rhinoplasty can have a negative effect on your results; most surgeons recommend waiting several weeks before putting pressure on the nasal bridge. Eyeglasses may be safe to wear after the nasal splint is removed, but you may need to wait longer if you have heavy glasses, or use a lightweight alternative. 

Talk with your surgeon about their best recommendations if you need to wear glasses in the meantime, as there are many tricks such as taping glasses to the forehead or placing a cast between your nose and glasses. Discuss this with your surgeon ahead of time, and they can provide advice based on your specific circumstances.

Returning to daily activities

Most patients can return to work or school within 1-2 weeks after surgery, but it is crucial to avoid strenuous activities and heavy lifting for at least 4-6 weeks. Your surgeon will provide specific guidelines based on your individual recovery progress. Many surgeons will also recommend a longer break from contact sports or activities that may result in trauma to the nose.

Long-term recovery and results

While initial swelling will subside within a few weeks, it may take up to a year for the final results of your rhinoplasty to be fully visible. This is because rhinoplasty is a highly refined procedure, so even a small amount of residual swelling may affect or conceal your final results. It is important to be patient during this time, live a healthy lifestyle, and follow your surgeon’s instructions to promote a healthy healing process.

Potential risks and complications of rhinoplasty

As with any surgical procedure, rhinoplasty carries some risks, including:

• Infection
• Bleeding
• Scarring
• Anesthesia complications
• Difficulty breathing
• Dissatisfaction with cosmetic results
• Need for revision surgery

Choosing an experienced, board-certified facial cosmetic surgeon can minimize these risks, as surgeons certified by the American Board of Facial Cosmetic Surgery (ABFCS) have passed a comprehensive vetting process, including oral and written exams and ongoing certification maintenance requirements. ABFCS-certified surgeons dedicate all or a significant portion of their practice to the art of safe, aesthetically sound cosmetic surgery of the head, face, and neck.

Cost of rhinoplasty

Rhinoplasty surgery cost can range from around $5,000 to $20,000. The cost will vary depending on factors like:

• The complexity of the procedure required to meet your goals
• The surgeon’s experience and qualifications
• The geographic area where you live

Be sure to discuss the total cost of your rhinoplasty with your surgeon or their staff during your consultation. The cost estimate you receive should be comprehensive, including anesthesia, facility fees, surgeon’s fees, and other related expenses. 

Your safety, satisfaction, and results will all be strongly influenced by the expertise of your surgeon, so settle for nothing less than a surgeon who is board-certified and has a proven track record of successful rhinoplasty procedures.

The American Board of Facial Cosmetic Surgery (ABFCS) is a certifying board for the specialty of facial cosmetic surgery that carefully vets all member surgeons for skill, safety, and aesthetic mastery. Schedule a consultation with an experienced, skilled, board-certified facial cosmetic surgeon with extensive experience in rhinoplasty to learn about your options.

Frequently Asked Questions