Nose Surgery (Rhinoplasty)

What Is Rhinoplasty (Nose Surgery)?

Rhinoplasty is a surgical procedure that is performed to change the shape and/or the function of the nose. It may be done not only for aesthetic reasons, but also to correct breathing problems.

Nose surgery is commonly preferred to improve the overall appearance of the nose, create better harmony with the face, and increase a person’s self-confidence. It can also play an important role in correcting septal deviation, congenital abnormalities, or post-traumatic deformities.

Why Is Rhinoplasty Performed?

Rhinoplasty is generally performed for two main reasons:

Aesthetic Rhinoplasty: Focuses on changing the nose’s shape, size, or angles to achieve a more pleasing appearance.

Functional Rhinoplasty: Performed to improve breathing or correct structural problems inside the nose.

In some cases, both goals are addressed together through a combined rhinoplasty approach.

How Is Rhinoplasty Performed?

Rhinoplasty can be performed using either a closed or open technique, depending on the surgeon’s preference and the patient’s needs.

Closed Rhinoplasty: Incisions are made inside the nose, so there is no visible external scar.

Open Rhinoplasty: A small incision is made on the columella (the tissue between the nostrils).

The choice between open and closed rhinoplasty is determined by the surgeon based on the patient’s anatomy and the planned correction.

Both techniques allow the surgeon to modify the nasal structure to achieve aesthetic and functional improvements.

Why Do People Choose Rhinoplasty?

Rhinoplasty is a surgical procedure performed for both aesthetic and functional reasons. Some people choose it to improve the appearance of their nose, while others seek functional correction due to breathing difficulties.

In certain cases, combined rhinoplasty can address both aesthetic and functional concerns at the same time. For example, a patient with a prominent dorsal hump who also has difficulty breathing can have the shape refined while correcting septal deviation. In some situations, even if the patient does not have a cosmetic complaint, the position of the nasal deviation may still require aesthetic correction as part of the overall surgical plan.

Main Reasons for Rhinoplasty

Rhinoplasty is commonly performed for the following purposes:

Aesthetic Goals

Some individuals choose rhinoplasty because they are not satisfied with the shape or size of their nose. Since the nose is located at the center of the face, it can strongly affect facial balance and overall aesthetic perception.

With rhinoplasty, the following aesthetic concerns can be addressed:

•  A nose that is too large or too small – A nose that is disproportionate to facial features may be aesthetically bothersome. Rhinoplasty can balance facial proportions by reducing or augmenting the nose.
•  A prominent nasal hump – A hump on the nasal bridge can be noticeable in profile. During surgery, the hump can be reduced to create a smoother profile.
•  A droopy or overly upturned nasal tip – In some people, the tip points downward. Rhinoplasty can lift the tip or refine it for a more balanced look.
•  Large or asymmetric nostrils – Wide nostrils or asymmetry can be corrected for a more harmonious appearance.
•  Poor harmony between the nose and the face – Rhinoplasty aims to create a nose that fits the person’s facial structure more naturally.
•  Correction of post-traumatic deformities – Nasal fractures or deviations due to accidents, sports injuries, or falls can be corrected.

Functional Goals

Rhinoplasty is not only an aesthetic operation; it can also be performed to improve breathing. Structural issues inside the nose may lead to airflow limitation and negatively affect daily quality of life.

Main reasons for functional rhinoplasty include:

• Septal Deviation – A deviated septum can restrict airflow and may contribute to breathing problems and sleep-related issues. Rhinoplasty can be combined with septal correction to improve nasal breathing.
• Enlarged Turbinates (Turbinate Hypertrophy) – Enlarged turbinates can cause nasal obstruction. They may be reduced during surgery to improve airflow.
• Post-traumatic Breathing Problems – Fractures or deviation after trauma can narrow the nasal passages. Rhinoplasty can correct these deformities and improve breathing.
• Nasal Valve Insufficiency – Collapse or narrowing of the sidewalls can limit airflow during breathing. Rhinoplasty can repair the valve area to restore airflow.
• Congenital Nasal Abnormalities – Some people are born with structural nasal problems. Rhinoplasty may correct these and improve function.

Differences Between Aesthetic and Functional Rhinoplasty

Types of Rhinoplasty and Techniques

Rhinoplasty can be performed using the following techniques:

Open Rhinoplasty

Open rhinoplasty is performed through a small incision on the columella (the tissue between the nostrils). This approach provides the surgeon with a clearer view and more direct access to the nasal framework.

Advantages of Open Rhinoplasty:

•  Full access to the nasal bones and cartilage.
•  Complex deformities can be corrected more effectively.
•  More controlled shaping is possible.

Disadvantages of Open Rhinoplasty:

•  A minimal scar may remain (usually fades over time).
•  Recovery may be longer compared to closed rhinoplasty.
•  Often preferred for nasal fractures, severe deviations, and cases requiring major structural changes.

Closed Rhinoplasty

Closed rhinoplasty is performed with all incisions inside the nose. It is sometimes presented as less invasive, and it can offer similar levels of detail in appropriate cases, with typically faster early recovery.

Advantages of Closed Rhinoplasty:

•  No visible external scar.
•  Faster recovery period.
•  Less swelling and bruising.

Disadvantages of Closed Rhinoplasty:

•  The surgeon’s visibility and access are more limited than in open rhinoplasty.
•  May not be suitable for all complex cases.
•  Commonly preferred for minor shape corrections, tip refinement, and mild deviations.

Ultrasonic Rhinoplasty (Piezo Rhinoplasty)

Ultrasonic rhinoplasty is a modern technique that has gained popularity in recent years. While traditional rhinoplasty may use mechanical instruments, ultrasonic rhinoplasty uses Piezo technology to shape bone more precisely.

Advantages of Ultrasonic Rhinoplasty:

•  Highly precise bone work.
•  Less trauma to surrounding tissues.
•  Reduced bruising and swelling.
•  Faster recovery.

Disadvantages of Ultrasonic Rhinoplasty:

•  May take longer than traditional methods.
•  Not every surgeon uses this technique.
•  May be more costly due to equipment and technique.
•  Especially suitable for patients who need significant bone reshaping.

Revision Rhinoplasty

Revision rhinoplasty is a second (or third) procedure performed for patients who have previously undergone rhinoplasty but did not achieve the desired result.

Main Reasons for Revision Rhinoplasty:

•  The nasal shape after the first surgery is not as desired.
•  Breathing problems persist or worsen.
•  Asymmetry or collapse in the nasal structure.
•  Irregular healing of cartilage or bone.

Challenges of Revision Rhinoplasty:

•  Structural changes and scar tissue may be present after the first surgery.
•  There may be insufficient cartilage, requiring additional grafts.
•  Recovery can be longer than after primary surgery.
•  It must be carefully planned and performed by an experienced surgeon.

Comparison of Rhinoplasty Techniques

Who Is a Good Candidate for Rhinoplasty?

Rhinoplasty can be performed for both aesthetic and functional reasons. However, not everyone is an ideal candidate. Age, overall health, expectations, and psychological readiness should be considered to ensure safe surgery and satisfying outcomes.

In this section, we will discuss ideal candidates, who may not be suitable, and key factors to consider before surgery.

People with Breathing Problems

Rhinoplasty may be performed not only for cosmetic reasons, but also to improve breathing. Functional rhinoplasty may correct:

•  Septal deviation (crooked septum) to improve airflow.
•  Nasal valve insufficiency to support easier breathing.

Example: Someone who frequently has to breathe through the mouth during sleep may benefit from functional rhinoplasty to open the nasal airway.

People with Nasal Trauma

Individuals who have developed deformity after injury, accidents, sports trauma, or falls can improve both appearance and breathing through rhinoplasty.

Example: A person who broke their nose during sports may require surgery to restore both form and function.

People Who Have Completed Nasal Development

The ideal age for rhinoplasty is generally 18 and older, as nasal bone and cartilage should be fully developed. Surgery at a younger age may require additional procedures later.

Example: A 20-year-old with stable facial development may be a suitable candidate.

People with Realistic Expectations

Candidates should have realistic expectations about results. Rhinoplasty does not turn someone into a completely different person; it aims to create a nose that looks natural and harmonious with the face. It is important to discuss potential outcomes thoroughly with the surgeon.

Example: A patient seeking cosmetic improvement should understand that the goal is natural facial harmony, not a “perfect” or identical nose.

Who May Not Be Suitable for Rhinoplasty?

Not everyone is an appropriate candidate. There are situations where surgery may be risky or not recommended.

People with Serious Health Conditions

Chronic conditions such as heart disease, diabetes, bleeding disorders, or immune system problems may increase surgical risk. Patients taking blood thinners may also not be suitable.

Recommendation: Always consult your physician to determine whether you are medically fit for surgery.

People Who Are Not Psychologically Ready

Individuals with body dysmorphic disorder (BDD) may experience dissatisfaction after surgery and may seek repeated procedures. Psychological readiness and healthy expectations matter.

Smokers

Smoking can impair blood circulation and negatively affect healing. It can increase the risk of infection and bleeding.

Recommendation: Stopping smoking at least 2–3 weeks before surgery can support healthier recovery.

People Who Are Impatient for Results

Final rhinoplasty results take time. Although swelling improves significantly over months, full refinement may take 6 months to 1 year. People expecting immediate final results may feel disappointed early on.

Recommendation: Accepting the healing timeline and allowing time for swelling to resolve is important.

Pre-Operative Preparation for Rhinoplasty

Rhinoplasty is a serious surgical procedure performed for both aesthetic and functional reasons. To achieve a successful surgery and a smoother recovery, certain preparations are necessary. This process includes choosing the right surgeon, undergoing an examination, completing pre-operative tests, and making certain lifestyle adjustments.

In this section, you will find detailed information about what to consider before rhinoplasty, how to prepare for surgery, and which habits to avoid beforehand.

Choosing the Right Surgeon

The success of rhinoplasty depends greatly on the surgeon’s expertise and experience. Before surgery, it is important to research carefully and choose the most appropriate specialist for your needs.

Key Points When Choosing a Surgeon:

•  The surgeon should be experienced in rhinoplasty (often an ENT specialist with rhinoplasty focus).
•  Review before-and-after photos of previous rhinoplasty cases.
•  Check patient reviews and references.
•  Ensure the hospital/clinic conditions are suitable for surgery.
•  You should feel comfortable communicating and sharing expectations openly.

Pre-Operative Evaluation and Examination

Before rhinoplasty, you will need a consultation with your surgeon. During this appointment, your nasal anatomy will be evaluated, the most suitable plan will be determined, and the surgical approach will be outlined.

What Happens During the Evaluation:

•  Internal nasal structure and the bone-cartilage framework are examined.
•  Breathing issues such as septal deviation or turbinate enlargement are checked.
•  Patient goals and expectations are discussed, and potential techniques are explained.
•  Computer simulations may be used to demonstrate possible outcomes.
•  General health is assessed, and blood tests or imaging may be requested if needed.

Recommendation: Make sure you and your surgeon align on the planned outcome. If you have questions, do not hesitate to ask.

Pre-Operative Tests and Health Checks

Some tests may be required before surgery to evaluate overall health and ensure the procedure can be performed safely.

Possible Tests:

•  Blood tests (CBC, clotting tests, etc.)
•  Endoscopic nasal examination
•  Breathing function tests (if required)
•  If general anesthesia is planned: ECG and chest X-ray

Recommendation: Inform your surgeon about any serious medical history, chronic conditions, allergies, or regular medications.

Habits to Avoid Before Surgery

To support safer surgery and optimal healing, some habits should be avoided before rhinoplasty.

Smoking and Alcohol

Smoking can significantly slow healing. Nicotine reduces blood circulation, delays wound healing, and increases infection risk. Alcohol can thin the blood and increase bleeding risk during surgery.

Recommendation: Stop smoking and avoid alcohol for at least 2–3 weeks before surgery.

Preparing for the Day of Surgery

To have a more comfortable and stress-free surgery day, some practical preparations are recommended.

Important Points for Surgery Day:

•  Do not eat or drink in the morning if general anesthesia is planned (follow fasting instructions).
•  Wear comfortable clothing, preferably a button-up or zip-up top.
•  Do not apply makeup, perfume, or creams.
•  Bring someone to accompany you.
•  Follow all final instructions from your surgeon.

Recommendation: Bringing a book, headphones, or calming music may help you feel more relaxed while waiting.

How Is Rhinoplasty Surgery Performed?

Rhinoplasty is a surgical procedure performed to change the shape and function of the nose. The techniques used, the type of anesthesia, and the details of the surgical plan play a major role in outcomes.

In this section, we explain how rhinoplasty is performed, the anesthesia options, and what patients can expect during the procedure.

Pre-Operative Steps

On the day of surgery, patients typically arrive at the hospital in the morning and the following steps take place:

Final medical assessment: The surgeon confirms your health status and reviews final instructions.

Preparation of the surgical area: The nose is cleaned and sterilized with a special solution.

Anesthesia preparation: Anesthesia is administered so the patient does not feel pain.

Recommendation: Wear comfortable clothes and avoid jewelry, contact lenses, or makeup on surgery day.

Anesthesia Options

Rhinoplasty can be performed under general anesthesia or local anesthesia with sedation.

Rhinoplasty Surgical Process

The exact procedure and duration depend on the technique and the patient’s needs. Surgery typically lasts 1–3 hours, and revision cases may take longer. Because the focus is outcome-driven, the operating time may vary depending on the steps needed to achieve the planned result.

The rhinoplasty process generally includes these steps:

Making the Incisions

In closed rhinoplasty, incisions are made inside the nose. In open rhinoplasty, a small incision is made on the columella.

Reshaping the Nasal Structure

The nasal bones may be shaped with instruments such as a bur or Piezo device. Tip cartilages can be refined, nostrils can be adjusted, symmetry can be improved, and if septal deviation is present, it can be corrected to open the airway. If turbinates are enlarged, their size may be reduced.

Recommendation: If additional support is needed, cartilage grafts may be taken from the ear or rib.

Closing the Incisions and Placing Nasal Splints/Packing

Incisions are typically closed with dissolvable sutures. Nasal packing may be placed, and an external splint or cast is applied to protect the new shape.

Recommendation: Modern silicone splints can allow easier breathing and may be more comfortable than traditional packing.

The First Hours After Surgery

After waking from anesthesia, patients often feel nasal congestion. Resting with the head elevated is recommended. Mild bleeding or oozing may occur during the first few days and is usually normal. Pain is generally controlled with prescribed medication, and patients are often discharged the same day or the next day.

Recommendation: Sleeping with the head elevated on the first night can help reduce swelling and bleeding.

Duration and Recovery

The duration depends on the scope of the procedure and typically ranges from 1 to 3 hours.

Key Points After Rhinoplasty

Swelling and bruising are common in the first days and gradually improve. Some patients may have little to no bruising, while others may bruise more; bruising often fades by day 7. Nasal splints or packing are typically removed within 5–7 days. Heavy exercise and bending should be avoided in the first 2 weeks. Sun protection is important, and the nose should be protected from impacts.

Recommendation: Cold compresses during the first 3 days may help reduce swelling.

Recovery After Rhinoplasty

Recovery after rhinoplasty is one of the most important factors that determines both the quality of healing and the final nasal shape. Swelling, bruising, nasal congestion, and mild discomfort are normal. With proper care and by following medical instructions, healing may proceed more smoothly and the risk of complications can be reduced.

This section explains the stages of recovery, what to watch for, and how long it typically takes to see the final result.

First 24 Hours: Waking Up From Anesthesia and Early Symptoms

The first 24 hours are when the body’s initial response to surgery is most noticeable. Patients are usually monitored for a period and discharged the same day or the next day.

What Happens in the First 24 Hours?

Nasal congestion is common. Swelling and bruising around the eyes may begin. Mild bleeding or oozing can occur (this is usually normal). Dizziness or mild nausea may be felt due to anesthesia. Speaking and eating may feel slightly uncomfortable.

Recommendation: Sleep with your head elevated the first night. Using 2–3 pillows to keep your head above heart level can help reduce swelling and bleeding risk.

First Week: Removal of Splints/Packing and Early Changes

The first week is a critical healing phase when splints and/or packing help protect the new nasal shape.

Key Points During the First Week

Packing is often removed within 5–7 days. The cast/splint is usually removed around day 7. Swelling and bruising are at their peak but begin decreasing after day 10. Bruising under the eyes often fades within 7–10 days. Nasal congestion may continue, but breathing gradually improves.

Recommendation: Avoid forceful movements when cleaning the nose and use any moisturizing sprays as recommended by your surgeon.

First Month: Decreasing Swelling and Early Refinement

Noticeable changes occur during the first 3–4 weeks. However, the nose has not reached its final shape yet, and swelling may still be present.

Key Points During the First Month

Avoid heavy exercise. Protect the nose from contact. Avoid prolonged sun exposure (it can increase swelling and cause skin discoloration). Avoid wearing glasses to prevent pressure on the nasal bridge. Tip stiffness and mild numbness may continue (this is usually normal).

Recommendation: Reduce salt intake to help swelling resolve more quickly.

Months 3–6: Most Swelling Resolves and the Nose Refines

Most swelling has typically resolved, and the contours become more defined. However, tip swelling may still persist, and final refinement may not be complete.

Key Points Between 3–6 Months

The skin may remain sensitive, so protect the nose from impacts. Tip swelling may still be present, and patience is important for full refinement.

Recommendation: If you still have concerns, consult your surgeon to evaluate whether any further correction might be needed later.

After 1 Year: The Final Result

Final rhinoplasty results are typically seen between 6 months and 1 year. During this time, the nose continues to settle and refine.

What to Expect After 1 Year

Swelling is largely resolved. The nasal tip becomes softer and more natural. Breathing function is improved. The nose looks more harmonious with facial features.

Recommendation: Full healing is a gradual process. Individual recovery timelines vary, so following your surgeon’s guidance is essential.

Recommended vs. Avoided Behaviors After Rhinoplasty

Recommended:

Drink plenty of water to support recovery. Sleep with your head elevated. Use nasal sprays as instructed. Eat soft, nourishing foods. Avoid smoking and alcohol.

To Avoid:

Touching or rubbing the nose. Wearing glasses (for at least 2 weeks). Heavy sports in the first month. Prolonged sun exposure. Hot baths, sauna, or extreme heat environments.

Recommendation: Do not skip follow-up appointments and attend all scheduled check-ups.

Rhinoplasty-Specific Risks

Because rhinoplasty changes both the aesthetic and functional structure of the nose, it may involve specific complications:

A- Shape-Related Issues

Asymmetry: Mild irregularities or asymmetry can occur.

Tip Droop: If structural support weakens, the nasal tip may drop over time.

Unsatisfactory Aesthetic Outcome: Expectations may not be fully met, and revision surgery may be needed.

B- Breathing Issues

Nasal Obstruction: Swelling, edema, or internal adhesions can temporarily narrow the airway.

Septal Perforation: A hole in the septum may develop and cause breathing problems.

Temporary Side Effects

Temporary effects that often improve over time include:

Swelling and Bruising: Especially around the eyes; usually improves within weeks.

Sensitivity and Numbness: May occur around the nose and gradually resolve over months.

Dryness and Crusting Inside the Nose: May be relieved with proper moisturization.

Long-Term Complications

Skin Changes: Thinning, discoloration, or visible small vessels may appear in some cases.

Need for Revision: A second procedure may be required if aesthetic goals are not met or functional issues persist.

How to Reduce Risks

Choose an Experienced Surgeon: Expertise can reduce risks and improve outcomes.

Follow Medical Instructions: Strictly adhering to pre- and post-operative guidance supports healing.

Avoid Smoking and Alcohol: These can negatively affect healing.

Be Patient: Final results may take 6 months to 1 year.

Making an informed decision and understanding these risks is important when considering rhinoplasty.

What to Pay Attention to After Rhinoplasty

Post-operative care is critical to reduce complications and support the nose in achieving its best final shape.

First 24–48 Hours

Keep the Head Elevated: Helps reduce swelling and bruising.

Use Cold Compresses: Intermittent cold compresses around the eyes may help during the first 48 hours.

Avoid Straining Movements: Avoid bending, heavy lifting, and sudden movements.

Stay Hydrated: Drinking water supports healing.

Rules for the First Week

Protect the Nose from Impact: Sleep on your back to avoid pressure.

Avoid Forcing the Nose: Do not blow the nose forcefully.

Protect from Sun: Use sunglasses/hat as advised to reduce risk of discoloration and prolonged bruising.

Avoid Very Salty and Spicy Foods: These may increase swelling.

Second Week and Beyond

Avoid Heavy Exercise: Avoid strenuous activity for at least 2 weeks.

Limit Glasses Use: Avoid pressure on the nasal bridge for several weeks.

Avoid Smoking and Alcohol: These may slow recovery.

Maintain Balanced Nutrition: Vitamins and minerals support healing.

Splint and Bandage Use

Splints and bandages are usually kept for 7–10 days.

Avoid getting the nose wet for the period recommended by your surgeon.

Even after removal, the nose remains sensitive and should be protected.

Common Complaints and Practical Suggestions

Follow-Up Visits

Attend all follow-up appointments scheduled by your surgeon.

If unexpected symptoms occur (severe pain, heavy bleeding, signs of infection), contact your doctor promptly.

Benefits of Rhinoplasty

Rhinoplasty offers a range of benefits not only in appearance, but also in function and self-confidence. After surgery, improvements may be seen physically, psychologically, and in everyday comfort.

Below are the main advantages of rhinoplasty in detail.

Aesthetic Benefits

Rhinoplasty can correct various aesthetic concerns to create a more balanced and proportional facial appearance.

a- A More Balanced Face

Because the nose is central to facial aesthetics, even subtle changes can significantly impact harmony.

Concerns such as a droopy tip, a prominent hump, or wide nostrils can be corrected to improve facial balance.

b- Profile Improvement

A dorsal hump or excessive projection can be refined for a smoother profile.

Better balance can be achieved with the forehead and chin.

c- Refining the Tip and Nostrils

A wide or overly upturned tip can be adjusted to look more natural.

Nostrils can be reduced if they are overly wide.

Functional Benefits

Rhinoplasty is not only cosmetic; it can improve nasal function and breathing.

a- Improved Breathing

Nasal obstruction can be reduced and airflow can be improved.

Deviations can be corrected to restore healthier airflow.

b- Better Sleep Quality

Snoring and sleep-related breathing problems may improve if nasal obstruction is corrected.

Easier breathing can support deeper, higher-quality sleep.

c- Improved Daily and Athletic Performance

Better breathing can improve endurance and comfort during physical activity.

Breathing during sports may feel easier.

Long-Lasting Results

When performed properly, rhinoplasty can offer long-lasting improvement.

With appropriate surgical techniques, the result can be permanent.

Patients may benefit from improved breathing and a more harmonious appearance long-term.

Frequently Asked Questions (FAQ) About Rhinoplasty

We have compiled the most common questions and answers about rhinoplasty. This section aims to clarify concerns about the surgical process, recovery, and outcomes. 

1) Is Rhinoplasty a Painful Surgery?
No. Since general anesthesia is used during rhinoplasty, you do not feel any pain during the procedure. After surgery, you may feel mild pressure or a sense of tightness, but this can usually be controlled with the painkillers prescribed by your doctor. Many patients report that postoperative pain is much milder than they expected.

3) When Does the Nose Fully Settle Into Its Final Shape?
Some swelling is normal during the first few months after rhinoplasty. In most cases, the nose settles significantly by around 6 months, but the final result typically becomes fully apparent within 1 year. Tip swelling, in particular, may take longer to resolve.

4) Will I Have Difficulty Breathing After Rhinoplasty?
During the first few weeks, breathing can feel difficult due to internal swelling (edema) inside the nose. This is usually temporary. If the internal nasal airway was corrected during surgery, breathing often becomes more comfortable once healing is complete.

5) Is Rhinoplasty Permanent?
Yes, rhinoplasty is considered a permanent procedure. However, the natural aging process, skin characteristics, and external factors (such as trauma or a direct impact to the nose) can cause minor changes over time. If the surgery is performed with proper technique and postoperative instructions are followed, results are typically maintained for many years.

6) What Is the Best Age for Rhinoplasty?
Bone development must be complete before rhinoplasty. Women are generally suitable after ages 16–17, and men after ages 17–18. Rhinoplasty can also be performed in older individuals, but recovery may take longer because skin elasticity decreases with age.

7) Can I Exercise After Rhinoplasty?
Strenuous exercise should be avoided for the first 2 weeks. Light walking can be recommended, but sports with a risk of nasal impact (such as boxing, basketball, or football/soccer) should be postponed for at least 2–3 months.