The term rhinoplasty refers to surgery performed on the nose. Patients may have nose surgery to improve their breathing ability, alter the appearance of their nose, or both. Nose surgery is a specialized procedure, so choosing an experienced surgeon is crucial. Here's what you can expect when undergoing a "nose job."
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What Is Rhinoplasty?
Other than in the case of a car accident (or bar fight) nose surgery is a procedure that's typically scheduled in advance. You'll meet with your surgeon to discuss the plan, evaluate your expectations, and see examples of past patients.
When it comes time for surgery, you'll be placed under conscious sedation with local anesthesia. Most patients are able to return home on the same day of surgery.
During a rhinoplasty, the surgeon will carefully place incisions to minimize any scar visibility. There are two rhinoplasty techniques, usually referred to as closed or open. In a closed rhinoplasty, all the incisions are made inside the nose, leaving no visible scars.
During an open rhinoplasty, the surgeon makes a small incision between the nostrils in the area called the columella to gain access to different areas of the nose for operating.
Depending on the goal of your surgery, your surgeon will advise on the best technique for your procedure.
Contraindications
Patients age 16 and older may undergo rhinoplasty surgery. In certain cases, younger patients may qualify. A consultation with an experienced facial plastic surgeon is necessary to determine if a younger patient is suitable for surgery. Most healthy adults make good candidates for nose surgery as long as they have a realistic idea of what to expect.
As with any surgery, the benefits should outweigh the risks.
During the consultation, the surgeon will ask the patient about their breathing and what their feelings are about the size and shape of their nose. During this process, the surgeon will assess the whether the patient has realistic expectations about their appearance after the surgery. Once this is determined to be realistic, they can be accepted as a candidate for surgery.
Septorhinoplasty: Effects on Breathing and Nose Appearance
Potential Risks
Along with the risks common to all types of surgery (loss of sensation, infection, anesthesia risks, and bleeding) nose surgery risks include:
- Asymmetry: Nose surgery is a complex and high-specialized procedure, and the result may not be perfectly symmetrical.
- Runny or dry nose: Surgery may affect the function of nasal airways and produce undesirable sensations.
Under-eye bruising is common after nose surgery, but this should resolve as your nose begins to heal. Sometimes revision surgery is necessary to correct issues that arise after nose surgery. Choosing an experienced surgeon who specializes in rhinoplasty will help prevent complications or an unsatisfactory result.
Purpose of Rhinoplasty
There are several reasons for nose surgery, including:
- Aesthetic reasons (bring balance or symmetry to the face, change the nose shape)
- Birth defects that need correction
- Breathing problems, including sleep apnea
- Broken nose
- Cancer treatment, burns, or traumatic injuries that impact the nose's appearance or function
- Deviated septum
To improve your breathing ability, your healthcare provider can recommend less invasive alternative treatments. Sleep apnea treatment or nasal spray may be sufficient to address your issue without nose surgery.
Insurance Coverage Considerations
If you're having nose surgery to address a medical concern, your surgeon may be able to make aesthetic changes to your nose at the same time. However, it's possible that your insurance carrier will only cover the medical aspects of the surgery (not the elective parts).
Talk to your healthcare provider and insurance provider before surgery so you know what to expect.
To make sure you're healthy enough for nose surgery, your healthcare provider will order lab tests. You'll be advised to get chronic conditions under control, like high blood sugar or blood pressure. If you're a smoker, quitting before surgery will reduce your risk of complications and aid the recovery process.
How to Prepare
Before nose surgery, it is crucial to have a clear picture of what to expect. Your nose has a significant impact on your facial appearance. A change to your nose can affect your perceived attractiveness, physical links to your ethnic heritage, and the unique aspects of your face that make you look like you.
While it's always possible that surgery won't turn out as expected, your surgeon should be able to share before and after photos of real patients to help you visualize your potential results. Many surgeons use digital imaging to estimate how surgery might alter the nasal and facial appearance, but in no way can this guarantee the outcome of the procedure.
Having an idea of how nose surgery will affect your appearance can help you mentally and emotionally prepare for the potential shock of seeing a different face looking back at you from the mirror.
Location
Plan to go to the hospital, an accredited office-based surgical facility, or a licensed ambulatory surgical center for nose surgery.
What to Wear
You'll be provided with a hospital gown to wear during your nose surgery procedure. Choose something comfortable that's easy to change in and out of before and after surgery. Go for a top with buttons or zippers that doesn't have to be pulled over your head.
Some blood may drip from your nose after surgery, so you'll want to wear clothing that doesn't stain easily. To avoid bending down after surgery, slip-on shoes are best.
Some surgery centers have specific rules regarding things like nail polish, make-up, and piercings. It's usually best to avoid these items altogether, but you can ask your healthcare provider before the procedure date if you have any questions.
You should always plan to leave valuable jewelry at home when going in for surgery. If you use contact lenses, wear your glasses to the procedure instead.
Food and Drink
Include lots of nutritious foods in your meal plan before having a rhinoplasty. You don't need to make specific changes to your normal way of eating, but equipping your body with a variety of nutrients provides ample resources to draw on for recovery.
If you're having general anesthesia, you'll need to follow your healthcare provider's instructions on fasting before surgery. You'll be given an eating cut-off time to ensure there's no undigested food in your system before sedation. Local anesthesia does not require fasting.
Medications
Medications that thin the blood (including aspirin and anti-inflammatory drugs) should be discontinued before surgery to reduce the risk of bleeding. If you are taking a blood thinner, you must get first get clearance from your healthcare provider that says whether the medication can be stopped and for how long. If you've taken isotretinoin for acne treatment, you should wait six to 12 months after discontinuing the medication before having elective surgery to prevent excessive scarring.
Always inform your healthcare provider of all your medications and supplements before nose surgery to avoid any complications.
What to Bring
Be sure to bring any required paperwork on your surgery date as well as a list of all prescription and over-the-counter medications you take. You should have your identification and insurance information with you. Make arrangements for a trusted friend or family member to drive you to and from surgery. This person should be available to stay with you for at least the first night after your procedure.
What to Expect on the Day of Surgery
It's normal to a bit anxious on the day of your rhinoplasty. Here's how you can expect the big day to unfold.
Before the Surgery
It's essential to arrive at your nose surgery on time to avoid any delays. If you're not familiar with the facility, leave a few extra minutes to find parking and check-in. When it's time for surgery, you'll be taken into an exam room to have your vitals checked and ask any last-minute questions.
You'll be provided a hospital gown to change into as you wait for the healthcare provider to enter. If you're having general anesthesia, the anesthesiologist will meet with you and review the medications you'll be given, along with potential risks and side effects. Next, your surgeon will enter to perform the operation.
During the Surgery
Once you're sedated, your surgeon will begin with an incision to raise the skin and expose your nasal bones and cartilage. Your surgery may involve shaving down bone and cartilage, repositioning tissues, or adding a cartilage graft.
Will You Break My Nose?
It is a common misconception that rhinoplasty involves breaking the nasal bones. The bones are never broken, they are cut to reduce a hump and narrow the nose.
A deviated septum can be straightened for better breathing before the skin is redraped and sutured closed. Your healthcare provider may place additional incisions to reshape your nostrils as well.
After the Surgery
Once you've had a chance to regain consciousness, you'll likely be sent home the same day as your nose surgery. A patient may or may not have gauze packing in the nose. Internal splints may be used. Casts are seldom used, but a nasal splint over the nose is common. These are precut from a material that is hard. The splint is placed in hot water for a minute or so. Tape is placed over the nose and the splint is molded onto the nose. It hardens as it cools.
Pain medication can cause nausea, so some patients prefer to stick with clear liquids until their stomach is ready to handle regular food again. For the initial days after surgery, it's best to eat soft, bland foods.
Good choices include yogurts, soft cooked vegetables, soup, soft fruits, or oatmeal. You won't be able to chew easily, so crunchy or chewy foods should be avoided.
Stay away from alcohol and caffeine until you've had some time to recover. Foods that are very hot or cold can cause discomfort when healing from nose surgery. Including enough fiber and fluid in your diet can help ease constipation (a common side effect of pain medication).
Recovery
Give yourself a full week off from school or work after your nose surgery to recover. The external splint is removed in one week. If packing is used it is usually removed in one or occasionally two days after surgery.
Most daily activities can be resumed within two weeks, but intense physical activity and contact sports should be avoided for six weeks or until your surgeon says it's safe. Hold off on sexual activity during the initial recovery phase because raising your heart rate may increase bleeding if coagulated blood vessels become reopened.
Healing
You should expect swelling and bruising during the first week of having nose surgery. Pain is typically minimal after surgery, but following your healthcare provider's recommendations for icing your nose, resting, and taking pain medications as prescribed will help.
If you experience signs of infection, such as a fever or excessive swelling, contact your healthcare provider right away. Pay attention to your healthcare provider's advice on what's normal to expect regarding nosebleeds after surgery so you can get help if bleeding becomes excessive.
Coping With Recovery
You'll have a good idea of your results within a month after nose surgery, but the final look won't become apparent until you've had a full year to recover. You may be tempted to assess the effects of your nose surgery right away, but try to reserve judgment until the swelling has fully subsided.
Patience is imperative when recovering from surgery. Give yourself plenty of time to rest, but also try to fill your day with enjoyable activities to keep your mind occupied.
Reading, watching movies, catching up with supportive friends over the phone, and going for walks outdoors once you feel up to it can boost your mood and help you maintain a positive outlook while dealing with discomfort as you heal.
Possible Future Surgeries
Once your nose has healed and your surgeon can evaluate your final results, it's possible that you'll require a rhinoplasty revision.
While the need to have a second surgery can be frustrating, it doesn't necessarily mean that you won't be able to achieve the results you had originally hoped for. Nose surgery is a highly complex procedure and may require a few adjustments to get it right.
If you're thrilled with the results of your rhinoplasty, you may be tempted to opt for another cosmetic procedure. Plastic surgery can be addicting, especially if you've had a good experience. A reputable surgeon should be able to advise you against having too much work done.
If you're on the fence about whether you're be overdoing it with cosmetic surgery, consider seeing a mental health professional to help you explore the motivation behind your desire for surgery. Weigh the risks and benefits of each procedure to keep yourself from doing more harm than good.
A Word From Verywell
Nose surgery can vastly improve your self-image and quality of life, regardless of whether it's a medical necessity, aesthetics, or a mixture of both. Take time to shop around for a surgeon who is experienced in the procedure and will listen to your preferences.
Your nose can significantly impact the way you see yourself, so finding the right healthcare provider to guide you through the rhinoplasty process is essential.
Once you've changed your look, it's up to you if you'd like to share your experience or keep it private. There's no reason to feel pressured to explain yourself to others. Let your confidence speak for itself as you enjoy the benefits of a stellar nose job.
