Rhinoplasty (nose surgery)

Rhinoplasty can be performed in a hospital or outpatient surgical suite. During the procedure, the surgeon may administer general anesthesia or local anesthesia combined with a mild sedative. The surgery is usually completed within one to two hours but may occasionally take longer. Rhinoplasty candidates should be over the age of 15 so that growth of the nasal bone is nearly complete.

To perform the procedure, the surgeon makes a small incision, usually inside the nose. This is known as closed rhinoplasty. The nose can then be altered with minimal scarring. In some cases, the columella-the small bridge of tissue between the nostrils-may need to be cut. This is called open rhinoplasty. Open rhinoplasty offers the surgeon better access to the internal structures of the nose but requires slightly more recovery time. Closed rhinoplasty leaves the columella intact.

During rhinoplasty, the surgeon makes incisions to access the bones and cartilage that support the nose. The incisions are usually made inside the nose so that they are invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added (either from another part of the body or using a synthetic filler). After the surgeon has rearranged and reshaped the bone and cartilage, the skin and tissue is redraped over the structure of the nose. A splint is placed outside the nose to support the new shape of the nose as it heals. Nasal packing may be used inside the nose to provide additional support.

Rhinoplasty may be done using general or local anesthesia. It is often done as an outpatient procedure but sometimes requires a one-night stay in the hospital or surgery center.

The results of rhinoplasty may be minor or significant, depending on what kind of correction you want. It is important that you and your plastic surgeon agree on the goals of the surgery; if your expectations are realistic and your plastic surgeon shares them, he or she will probably be able to give you the results you want.

The results of rhinoplasty are permanent, although subsequent injury or other factors can alter the nose's appearance. Cosmetic surgery should only be done on a fully developed nose; complete development has usually occurred by age 15 or 16 in females and by age 17 or 18 in males. If surgery is done before this time, continued development of the nose can alter the surgical results and possibly cause complications.