Rhinoplasty: The Ultimate Guide to a Nose Job

Medically reviewed by William Portuese, MDBoard Certified Facial Plastic SurgeonReviewed on May 8, 2023
Written byKaryn RepinskiUpdated on April 27, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by William Portuese, MDBoard Certified Facial Plastic SurgeonReviewed on May 8, 2023
Written byKaryn RepinskiUpdated on April 27, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Fast facts

90% Worth It rating based on 8,038 reviews

Up to 2 weeks of downtime

General anesthesia or local anesthesia with sedation


Rhinoplasty is a cosmetic surgery that changes the shape and appearance of the nose. The medical name for a nose job, rhinoplasty, comes from the Greek: rhinos means “nose” and plassein means “to shape.” 

This nose reshaping procedure is sometimes combined with septoplasty to correct a deviated septum, a condition where the dividing wall between the nasal passages is crooked. Septoplasty improves the function of the nose and makes breathing easier, while rhinoplasty is performed to improve the nose’s aesthetics, or to correct an injury (like a broken nose) or birth defect.

These two nose surgeries can be combined in a single operation called a septorhinoplasty, to improve nasal function and form. In this case, the septoplasty may be covered by insurance. 

For some patients, cosmetic rhinoplasty surgery also involves alarplasty, which narrows the base of the nostrils (the ala) and reduces nostril flare.

Nose job surgery is also frequently combined with a chin implant, to help create a more balanced profile.

RealSelf Tip: Rhinoplasty for people of Asian or African descent requires a specialized skill set. Surgeons who specialize in what many call "ethnic rhinoplasty" say that the challenge lies in reshaping and resizing the nose while retaining its distinct features and keeping it proportional to the face. 

It's worth seeking out a surgeon who has the expertise to meet your aesthetic goals, while being sensitive to your racial identity. Make sure that their rhinoplasty before and after photo gallery includes pictures of people who look like you and have the kind of result you're after.

See real RealSelf community members decide whether or not they want to have a nose job.

Interested in a rhinoplasty?

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This plastic surgery procedure can be completely customized to each patient’s anatomy and aesthetic goals. Whatever your personal reasons for nose surgery, it can create the best nose shape for your face by:

  • Reducing a prominent bump or hump
  • Narrowing the nasal tip to streamline a bulbous nose
  • Lifting a droopy tip or bringing down an upturned tip
  • Straightening a crooked bridge
  • Fixing asymmetry
  • Balancing your facial features by giving you a shorter or smaller nose

Most rhinoplasty surgeons offer 2D simulations, and some now offer 3D modeling so you can virtually “try on” changes to your nose during your initial consultation, says Dr. Sam Naficy, a board-certified facial plastic surgeon in Bellevue, Washington. In a recent survey, 63% of surgeons reported using computer imaging in rhinoplasty consultations.

It also helps to bring wish pics of your ideal result, so you can have a frank discussion about your goals, and will look natural and proportionate to your features.

Pros

  • Rhinoplasty surgery has a 90% Worth It Rating based on over 9,000 recent reviews on RealSelf, so it has a high satisfaction rate. 
  • If you’ve spent years feeling self-conscious about your nose, good results from this procedure can boost your self-confidence.
  • This nose reshaping surgery balances facial features. 
  • Rhinoplasty is an outpatient plastic surgery, so you’ll go home the same day.  
  • The procedure itself isn't painful at all (thanks to anesthesia), and postoperative recovery isn’t too painful, either, especially because painful packing is no longer used in the nose. “It’s more of a feeling of congestion like a head cold for a week or two,” says Dr. William Portuese, a board-certified facial plastic surgeon in Seattle.  

Cons

  • The procedure can be pricey, and health insurance will cover only the parts of the procedure done to correct a structural problem, such as nasal obstruction or valve collapse that compromises the airway. A purely cosmetic procedure won't be covered by insurance. 
  • This is a major surgery, and you can expect significant swelling and bruising for at least the first 14 days after the procedure.  
  • Some rhinoplasty patients experience nausea, vomiting, and a sore throat during the first few days of recovery.    
  • The hard cast that’s worn for the first week can be uncomfortable and make your nose feel congested.  
  • It can take up to a year for all the swelling to go down, so you can see your final results.
  • If your nose doesn’t heal properly—or if you end up with a botched nose job—you may need a revision rhinoplasty, a costly and complex reconstructive procedure.

Related: 8 Things to Know Before Getting Rhinoplasty

  • Average Cost:
  • $8,025
  • Range:
  • $3,229 - $20,000

Your nose job cost will include fees for your rhinoplasty surgeon, anesthesia, surgical supplies, and the facility where your procedure is performed. 

Most surgeons offer payment plans or accept financing options like CareCredit.

See our complete guide to rhinoplasty costs

Interested in a rhinoplasty?

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As you're choosing your surgeon, look for nose job before and after pictures that show balanced facial features and the kind of results you want. The rhinoplasty photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

A nonsurgical nose job—also called a liquid rhinoplasty—temporarily reshapes the nose with hyaluronic acid–based injectable fillers, like Juvéderm Voluma or Restylane Lyft

The relatively quick treatment has no downtime. Results can last between eight months and two years, depending on the type of filler used and how your body metabolizes them.

This minimally invasive procedure can: 

  • camouflage bumps (especially along the bridge)
  • create more symmetry 
  • lift and build up the bridge

Injections to the nasal tip are also possible but considered more risky, notes Dr. Naficy.

Related: Doctors Weigh In on Surgical Rhinoplasty vs. Liquid Nose Jobs

However, the nonsurgical approach has limitations. “If you have a large nose, it’s not going to get any smaller with fillers,” says Dr. Andrew Miller, a facial plastic surgeon in Edison, New Jersey, "though changes in proportion can sometimes trick the eye and make the nose appear smaller."

It also can’t fix a crooked nasal bridge. 

The nose is one of the most dangerous areas on the face to inject. Since injecting filler into the nose carries serious risks, including blindness, it’s not an FDA-approved use.

Learn more about how nonsurgical rhinoplasty works and how much it costs.

Whether rhinoplasty surgery is right for you depends on a number of factors, including the cosmetic and structural issues you’re looking to change, your budget, and whether you can take up to two weeks off work for recovery.

Facial features need to reach maturity before any surgery for the nose, so girls should wait until they’re at least 15 and boys until they’re 16 years old. 

Beyond that, “there is no upper age limit for rhinoplasty as long as you are in good health,” says Dr. Naficy.

Certain safety risks may increase with age. If you're an older patient, you may need to provide a more detailed medical history and go through a more rigorous health screening. Still, it’s not unusual for patients beyond age 40 to combine a facelift with rhinoplasty, especially because the nasal tip can descend over time.

RealSelf Tip: A study published in a 2011 issue of Plastic and Reconstructive Surgery found that out of 226 patients seeking rhinoplasty, 33% showed moderate to severe symptoms of body dysmorphic disorder (BDD), a form of obsessive-compulsive disorder in which negative thoughts about a physical feature, like your nose, interferes with your quality of life. 

A follow-up study two years later showed a strong correlation between those pre-op symptoms and patient dissatisfaction with their results. If you find yourself obsessed with having a perfect nose and think you might have untreated BDD, keep in mind that you may still not like your nose, even after a successful surgery.

Rhinoplasty has an impressive 90% Worth It Rating from RealSelf members, meaning that a majority of the thousands of people who have recently reviewed their procedure think their results are worth the cost, discomfort, and recovery time. 

A good result from this facial plastic surgery can boost self-esteem and self-confidence, while decreasing anxiety. 

“My nose was a huge insecurity of mine,” says one RealSelf member. “I felt like my face wasn’t mine because my old nose threw everything off.” Of her new nose, she says “I’m truly obsessed with it in the best way possible.”

Unfortunately, some patients are obsessed with their new nose in a negative way, either because of the way it looks or functions, or both. In fact, 10% of nose job patients opt for revision rhinoplasty surgery, which can cost upwards of $12,000.

According to a 2019 study on patient satisfaction rates following rhinoplasty, “Patient selection is very crucial in rhinoplasty, as a significant percentage of patients may not be satisfied despite a good surgical result.” The researchers note elsewhere in the paper that “there may be unexpected responses from patients even after good surgical corrections because rhinoplasty has a huge psychological impact.”

Rhinoplasty is considered by many plastic surgeons to be the most difficult and complex of cosmetic surgery procedures, and it takes considerable training and experience to get predictable results.

During your consultation, ask what percentage of a surgeon’s practice is devoted to nasal surgery; 100 rhinoplasties a year is a good number. Make sure their patient reviews reflect happy patients and their before and after photos align with the kind of results you’re after.

The key to a successful result—a nose that matches the shape and size you desire, looks natural, and functions as well as (or better than) before surgery—is to work with a rhinoplasty surgeon who is board-certified and specializes in facial plastic and reconstructive surgery. 

Surgeons should also be able to produce simulated images of what your final result would look like, says Dr. Gary Linkov, a facial plastic surgeon in New York City. “This is imperative to make sure you and your surgeon are on the same page when it comes to the look you’d like to achieve.”

Doing a few things before rhinoplasty surgery can reduce your post-surgery swelling, bruising, and healing time.

Your plastic surgeon might recommend that you:

  • Stop taking all blood thinners, including aspirin or ibuprofen, one to two weeks before surgery (pain relievers that contain acetaminophen, such as Tylenol, are a good alternative). A detailed list should be provided by your surgeon.
  • Stop smoking for four to six weeks before and after your procedure (find out why).
  • Avoid alcohol for at least 48 hours prior to and two weeks after surgery.

You’ll also need to pick up a few recovery supplies beforehand, for better healing and comfort. 

Your surgeon will probably give you a list of the essentials, but here’s what other RealSelf members have said are the must-haves after a nose job:

  • Antibiotic ointment (typically provided by the surgeon)
  • Nasal spray
  • Cotton swabs
  • Light ice packs
  • Baby wipes
  • The most comfortable neck pillow you can find, to make it easier to sleep upright
  • Cough drops
  • Biotene mouth spray

RealSelf Tip: Avoid applying antibiotic ointments that contain neomycin, which can cause severe skin reactions.

The type of rhinoplasty anesthesia you’ll have will depend on the complexity of your procedure and the personal preference of you and your surgeon.  

  • Local anesthesia with IV sedation (sometimes called twilight sedation) makes you deeply sedated and comfortable but still technically awake. “Patients may have some recollection of the procedure,” says Dr. Portuese.
  • General anesthesia puts you completely in a sleep-like state.

During your initial consultation, discuss the benefits and potential risks of each option with your provider.

Every surgeon has their own preferred surgical techniques, and there have been considerable advancements in the field in recent years, but here’s how a nose job works, generally speaking.

It typically takes 1–3 hours to perform rhinoplasty surgery, but more complicated procedures and revisions may take longer. Ideally, your surgeon will take their time to meticulously create the best result for your unique anatomy.

First, you’ll be given anesthesia to keep you comfortable during the procedure. 

Before making any incisions, your surgeon may draw guidelines on the nose with a pen, indicating the areas they will modify. 

There are two primary nose surgery approaches: open and closed. 

  • With a closed rhinoplasty, two small incisions are made inside each nostril, leaving no visible scar.  “The two internal incisions allow full access to all of the structures inside the nose. Closed rhinoplasty is less invasive, heals faster, and avoids an external scar,” explains Dr. Portuese.
  • In an open rhinoplasty procedure, small incisions are made on the columella (the tissue at the base of the nose, between the nostrils) and inside each nostril. This allows your surgeon to fully access the underlying framework. 

Some people are very concerned about the scar from an open rhinoplasty approach, but “the incision is usually well-hidden and only seen if you lift your head back,” says Boston plastic surgeon Dr. Brooke R. Seckel. He notes that an open rhinoplasty allows the surgeon “to see and more accurately modify the nasal structures.” 

The specifics of your surgery will depend on your anatomy, desired result, and surgeon's technique, but it may involve:

  • removing portions of nasal tip cartilage and using sutures to narrow a large or bulbous nasal tip
  • removing a small wedge of tissue at the base of each nostril (a procedure called an alarplasty) to reduce nostril flare and streamline the nostrils
  • removing a strip of nasal bone and cartilage (an osteotomy) before bringing the remaining bones and cartilage together to remove a dorsal hump and narrow the nasal bridge
  • using a cartilage graft taken from the septum, ear, or ribs to rebuild the tip or create a straighter bridge (some plastic surgeons use a synthetic material, like silicone, but studies have shown that there may be more complications with this approach) 

Once the nose has been reshaped, your surgeon closes the incisions with dissolvable stitches.

Your nose will be secured with a cast or splint, which you'll wear for the first week of recovery. Your surgeon will remove it at your follow-up appointment.

Some surgeons also fill the nostril cavities with cotton or gauze nasal packing post-op, to absorb blood and help secure the new nose structure. However, current clinical guidelines advise against painful packing. This practice is also becoming less common with modern nose surgery techniques, which have reduced post-op bleeding. However, if you do come home with nasal packing, your surgeon will prescribe antibiotics, and you may need to be seen in a few days to remove the packing.

RealSelf Tip: Many rhinoplasty surgeons are now adopting preservation rhinoplasty techniques, which are less aggressive and aim to preserve as much tissue as possible rather than removing/reducing significant bone and cartilage to reshape the nose. Preservation rhinoplasty can be done open or closed, but it’s commonly performed as a closed procedure.

Recent studies comparing preservation rhinoplasty to traditional methods have not found one approach to be superior. In a 2022 retrospective study, the authors acknowledged the “theoretical functional and aesthetic benefits of SPR [structural preservation] techniques,” but concluded that “the patient reported benefits may be minimal.”

The preservation rhinoplasty technique, used in both primary and revision surgery, involves preserving as much of the original nasal structure as possible, while correcting cosmetic or functional issues. It can be performed as an open or closed procedure, but it’s most commonly done as closed.

“Preservation rhinoplasty is not a novel concept,” says Dr. Joseph Shvidler, a board-certified facial plastic surgeon in Seattle. “The technique has been recently revisited and refined by a group of talented surgeons. Many preservation techniques focus on preserving natural dorsal lines, while some  preserve a natural looking tip.”

According to Dr. Shvidler, preservation rhinoplasty has several benefits:

  • Preserving the original nasal structure can offer a more natural, proportional result.
  • The technique can be less invasive than traditional rhinoplasty procedures, which leads to less swelling, bruising, and recovery time. 
  • It avoids the risks associated with extensive tissue removal and manipulation, which makes it a safer option.

However, he also cautions that it has drawbacks.

  • Patients who will need significant structural changes to the nose to achieve their desired result may not be good candidates.
  • The procedure requires that the surgeon be more precise and meticulous in their approach, which can take longer. 
  • Because the surgeon is working with existing tissue, preservation rhinoplasty may not offer the same level of control over the final result as traditional rhinoplasty. In some cases, the tissue “may not respond to surgical changes and tissues may revert to their original shape,” says Dr. Shvidler.
  • While it preserves the upper bridge, the technique “requires extensive cuts in the nasal bones and the septum, completely disarticulating and dropping or pushing down the nasal bridge,” Dr. Shvidler explains. This can lead to unwanted “step-off irregularities.”

Recent studies comparing preservation rhinoplasty to traditional methods have not found one approach to be superior. 

In a 2022 retrospective study, the authors acknowledged the “theoretical functional and aesthetic benefits of SPR [structural preservation] techniques,” but concluded that “the patient reported benefits may be minimal.” The most important factor in your outcome will be the skill and experience level of your surgeon.

Rhinoplasty is a very safe procedure, when it’s performed by an experienced surgeon.

However, all surgical procedures come with risks and side effects. During your consultation, your surgeon should walk you through these nose job side effects and potential complications.

  • The most common side effects after a nose job are swelling, bruising, and minor bleeding.
  • More rarely, some patients can experience serious nose bleeds (called epistaxis), which require immediate medical attention.
  • Infection is also possible, if extensive cartilage grafting is needed or if the incision isn’t kept clean while it heals.
  • A more serious potential complication of rhinoplasty is nasal obstruction, though this issue isn't life-threatening. 
  • Septal perforation, a tear in both sides of the nasal septum lining, can also occur. 

Related: The 6 Biggest Rhinoplasty Risks, According to Plastic Surgeons

Rhinoplasty surgery doesn’t hurt, thanks to the anesthesia. 

You will feel some discomfort and pain around the nose during the first 1–3 days of rhinoplasty recovery, but it’s usually far less than people expect and they’re often pleasantly surprised, says Dr. Oakley Smith, a facial plastic surgeon in Toronto, Ontario. 

“Use pain medication for as long as needed,” advises Dr. Smith, who says that most patients don’t need prescription pain medication. He recommends extra-strength Tylenol. “Remember it’s easier to stay on top of pain than to play catch-up. As the pain diminishes, break the pill in half or even a quarter.”

The initial recovery after rhinoplasty surgery can take up to 2 weeks for the visible bruising and swelling to dissipate, but most patients are back to work in 10-14 days, according to Dr. Portuese.

The entire healing process takes a full year.

During your immediate nose job recovery, expect swelling, bruising, and a clogged-nose feeling—but not necessarily pain. Once the cast is removed at the one-week mark, that stuffy feeling will start to dissipate.

Here’s what to do (and avoid) during rhinoplasty recovery to help reduce swelling: 

  • Sleep on your back with your head elevated on pillows, to help the swelling go down and avoid bumping your nose. Usually, it’s OK to resume your normal sleeping position (including sleeping on your side) after two weeks, but check with your provider first. 
  • Ice your nose with cool compresses, light ice packs, or frozen peas almost continuously for the first 48 hours. After that, icing can actually inhibit healing, so don't overdo it.
  • Apply topical arnica gel or cream and take bromelain supplements, if your provider recommends them.
  • For the first day or two, stick to a diet of low-sodium broth or a light homemade soup; applesauce; mashed potatoes; or other soft, bland foods. Stay away from spicy or salty foods for a week; they can increase swelling and bruising. 
  • Tape your nose at night, if your provider recommends it. Taping may simply involve placing a single strip of tape over the area just above the tip of the nose, or you may be instructed to tape under the columella (the bridge of tissue that separates the nostrils at the bottom of your nose) and gently squeeze the tape around the sidewalls of the nose, to reduce swelling and help elevate the tip.  

These rhinoplasty recovery tips can also help you heal more quickly, with the best possible results:

  • Don't wear glasses for the first month or two—or ask your surgeon to give you your cast after it’s removed, so you can wear glasses over the top of the cast to disperse the weight. “After the nose splint is removed, about a week after surgery, I instruct my patients to tape their glasses to their forehead or prop them on their cheeks,” says Dr. Rady Rahban, a plastic surgeon in Beverly Hills, California.
  • Refrain from taking ibuprofen (Advil, Motrin) or naproxen (Aleve) for one week after surgery. These medications can increase your risk of bleeding.  
  • Resist the urge to blow your nose for at least a week (and blow very gently after that), to avoid disrupting the healing process and compromising your result. 
  • Try to avoid sneezing. If you have to do it, doctors on RealSelf advise sneezing with your mouth open. 
  • Keep your cast dry. A wet cast can cause skin irritation and itching, so cover your cast with plastic wrap taped to your forehead once you’re allowed to shower or cleanse your face. 
  • Avoid strenuous activities for the first few weeks. Every provider has their own protocol, but many doctors on RealSelf say you can resume physical activity (including workouts and sex) after 3–4 weeks. 
  • Steer clear of sports where you might get hit in the nose for at least three months.

Related: 8 Things Not to Do After a Nose Job

Swelling after rhinoplasty can affect the appearance of the nose for months. When your splint first comes off you’ll be excited to show off your new nose to the world, but these early results probably won’t look like what you were expecting. 

After a few days, the swelling actually gets worse. Don’t panic—this is normal.

The nasal splint provides compression for the soft tissues, and removing it causes the nose to swell. 

Seattle-based facial plastic surgeon Dr. William Portuese says, “The amount of swelling after a rhinoplasty procedure depends upon the type of rhinoplasty performed [open versus closed], the thickness of the skin, the amount of alteration required to the nasal tip, and the patient’s variability with the healing process itself.” He also notes, “Some patients require taping and steroid shots in the tip of the nose to reduce swelling in that area for the first several months after the procedure.”

Doctors on RealSelf say you should expect this timeline for swelling after rhinoplasty.

  • Two weeks after nasal surgery, you’ll look normal enough to be “restaurant-ready.” Swelling and bruising should have diminished enough to return to work or run errands without anyone noticing anything is off.  
  • Three months afterward, you’ll have a good idea of the new shape and size of the nose. Most swelling in the upper third will have resolved.  
  • Six months after surgery, approximately 90% of swelling will be gone, with the remainder in the tip.  
  • One to three years post-op, all swelling will have resolved and you'll see the final shape. 

It can take a year or more for nasal tip swelling to resolve, especially if significant work was done. “The tip takes the longest time to heal and mold to the new framework because it is the thickest skin of the nose,” says Beverly Hills, California, facial plastic surgeon Dr. Deepak Raj Dugar

If you think you still have a bulbous tip after rhinoplasty or want a smaller nose, wait at least a year for it to heal completely before considering a revision.

Surgical rhinoplasty results are permanent. You will see some subtle changes to your nose as you age, but the shape and size will probably remain largely consistent.

If you’re not happy with your results or have breathing difficulties once you’ve healed, you may be a candidate for revision surgery. In many cases, scar tissue is the main culprit. 

“The force of a scar is very strong,” says Dr. Miller. “It can pull a nose one way or another—push it in, pull it out, turn it.” When this happens, a surgeon has to go back in and tweak the work.

According to Dr. Naficy, “older rhinoplasty techniques left the structure of the nose somewhat weaker, potentially allowing the forces of healing and scar tissue to change the nose over time. But newer techniques provide more structural stability to the nose, which may mean that the nose is a bit stiffer early only, but does a much better job retaining its shape and resisting the healing forces of scar tissue.”

Interested in a rhinoplasty?

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Updated April 27, 2023

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