Rhinoplasty (Nose Surgery

Definition

Rhinoplasty is a surgical procedure designed to correct both aesthetic and functional abnormalities of the nose. The operation may be performed to refine nasal shape, improve facial harmony, or restore airway function. Indications include congenital malformations, post-traumatic deformities, and age-related structural changes. By reshaping the nasal bones, cartilage, and soft tissues, rhinoplasty provides a symmetrical, proportionate, and functional nose in balance with the rest of the face.

Indications

Rhinoplasty is considered for patients presenting with:

Dorsal hump deformity (prominent nasal bridge)
Bulbous, drooping, or wide nasal tip
Nasal size disproportionate to facial proportions (too large or too small)
Functional obstruction due to septal deviation or valve collapse
Post-traumatic deformities such as crooked nose or asymmetry

Candidates should be in good general health, ideally non-smokers, and have realistic expectations regarding surgical outcomes.

Surgical Technique

Rhinoplasty is performed under general anesthesia and generally lasts 2–3 hours. The choice of surgical approach depends on the patient’s anatomy and the complexity of the deformity.

Techniques:

Open Rhinoplasty: A small transcolumellar incision is made between the nostrils, allowing full exposure of the nasal framework. This approach is preferred in complex or revision cases.
Closed Rhinoplasty: All incisions are confined to the inside of the nostrils, leaving no visible external scar. This method is less invasive and associated with faster recovery.

In both approaches, precise modification of the bony and cartilaginous structures is performed, while preserving or reconstructing the nasal airway to maintain function. Internal splints or soft packing may be placed temporarily, and an external nasal splint is applied for support during the early healing period.

Preoperative Considerations

Smoking cessation: Patients should stop smoking at least 2–4 weeks before surgery to optimize wound healing and reduce the risk of complications.
Discontinuation of anticoagulants: Blood-thinning medications such as aspirin should be discontinued under medical guidance.
Comprehensive evaluation: Assessment of nasal airway, septum, turbinates, and facial proportions is essential for planning. Photographic documentation and digital simulation may be used to align surgical goals with patient expectations.

Postoperative Course

Early phase: Swelling, bruising (particularly around the eyes), and mild discomfort are common during the first week. Splints and nasal packing are usually removed within 7–10 days.
Intermediate phase:Most edema resolves over 2–3 months, allowing significant improvement in nasal contour and breathing.
Final outcome: Subtle refinements continue for up to 12 months, when the nose achieves its definitive shape

During recovery, patients should avoid trauma, strenuous exercise, and sun exposure, while adhering strictly to the surgeon’s postoperative care instructions.

Risks and Complications

As with all surgical procedures, rhinoplasty carries potential risks, though complications are rare when performed by an experienced surgeon. Possible risks include:

Hematoma or bleeding
Infection
Septal perforation
Prolonged swelling or edema
Nasal asymmetry or contour irregularities
Temporary sensory disturbances of the nasal skin

Outcomes

Rhinoplasty delivers both aesthetic refinement and functional improvement. Patients benefit from a more balanced, symmetrical, and proportional nasal shape, alongside enhanced breathing and airway function. The results are long-lasting and contribute to improved quality of life and self-confidence.

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