What is Rhinoplasty?

Rhinoplasty is surgery to improve the function (reconstructive surgery) or change the look (cosmetic surgery) of your nose. This surgery may also be done to correct birth defects and injuries.

The surgery can sometimes be done through incisions made inside the nose. This will keep the scars from being noticed.

Other times, incisions may be needed at the base of the nose, mainly if the procedure is done to make large nostrils narrower. This may leave small scars, but they usually cannot be noticed.

When cosmetic surgery is done only to change the shape of the nose, a person’s age plays a part in when to do the surgery.

Most often, the nasal bone needs to have stopped growing before the surgery can be done. This happens around age 14–15 years for girls, and a little later for boys.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Swelling and bruising.
• Bleeding.
• Blocked nasal breathing (airway obstruction).
• Numbness.
• Loss of smell.
• Changes in skin color.
• Infection.
• Heavy scars (keloid formation).
• Failure to correct the problem.
• An abnormal shape.
• Allergic reactions to medicine.

Other problems can occur, but they are rare:

• A hole in the septum.
• Skin necrosis or skin death (more likely in smokers).
• Toxic shock syndrome.
• Falling out (extrusion) of implants.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Wear clean, loose-fitting clothing.
• Avoid wearing makeup, jewelry, and hair accessories.
• Stop smoking if you smoke. Stopping will help you heal better after surgery.
• Ask your health care provider how your surgical site will be marked or identified.
• To reduce your risk of infection:
  • You may be given antibiotic medicine to help prevent infection.
  • You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the nose area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• To reconstruct or reshape your nose, the surgeon:
  • Will make incisions inside the nostrils or on the skin between the nostrils. The surgeon will then reshape the bone and the tissue that helps to form your nose (cartilage).
  • Might use a piece of your cartilage or bone to strengthen or improve the build of your nose, or to improve breathing or help your nose look better. The surgeon may use cartilage from the wall that divides the nostrils inside your nose (septum). Or, cartilage may be taken from your ear or rib.
  • May use man-made (synthetic) implants to rebuild your nose if the normal structure is very damaged or weak. This is rare.
  • May reshape the septum or remove part of the cartilage or bone of the septum. This is called septoplasty. It may be done to improve nasal breathing. The cartilage that is removed may be used to make your nose and its framework look better.
• To finish the surgery, the surgeon:
  • Will close incisions with stitches (sutures) that will dissolve safely into your body. These will not need to be removed.
  • May place a nasal splint in your nostrils. An aluminum splint may be put over your nose to protect it.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Your nose and face will likely be swollen.
• You may have a headache and pain in your face. You will be given pain medicines to control this.
• A splint will be used to support the new shape of your nose after surgery. You may also have splints placed inside the nostrils. This will keep the septum in place.
• Do not drive for 24 hours if you were given a sedative.

Rhinoplasty, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

• Swelling of your nose and face. Swelling and bruising around your eyes may get worse for the first 2–3 days. This is normal. It usually goes away in a couple of weeks.
• Headaches and pain in your face. You will be given pain medicine to control this.
• Minor bleeding from your nose the first couple of days after surgery.
• Stuffy nose (nasal congestion). Your health care provider may suggest an over-the-counter medicine (decongestant) for this.
• Discharge from your nose for 1–2 days after surgery.

Follow these instructions at home:

Nose care

• Do not blow your nose or pick at your nose until healing is complete.
• Only remove bandages (dressings) when your health care provider says it is okay.
• Leave the nasal splint in place. It will be removed 5–7 days after the surgery.
• Keep your nose dry when taking a bath or a shower as told by your health care provider.
• Keep your head raised (elevated) on a couple of pillows. Sleep with your head elevated.
• If directed, apply ice to your face to help keep swelling down:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• If you wear glasses, tape them to your forehead until your nose is completely healed.

Activity

• Protect your nose until healing is complete.
• Avoid activities that require a lot of energy (are strenuous) for as long as told by your health care provider.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says that it is safe.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
• Do not drive or use heavy machinery while taking prescription pain medicine.

General instructions

• Protect your nose from the sun for 2 months. Use sunscreen and wear a broad-brimmed hat when you are out in the sun.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.
• Be patient with the healing process. Day by day, your nose will look better. In a couple of weeks, makeup can be used to cover up the signs of the surgery. Healing takes time, and you may not see the final results for up to a year.

Contact a health care provider if:

• You have a fever.
• You have pus-like discharge from your nose.

Get help right away if:

• You have more pain or swelling than expected in your face or around your eyes after the first 2–3 days.
• You have more bleeding from your nose.
• Your headache or facial pain does not get better after you take pain medicine.
• You have chest pain or shortness of breath.