Rhinoplasty Guide: Frequently Asked Questions

If you’re considering a rhinoplasty, also known as a nose job, you probably have a lot of questions. We’ve drawn on the expertise of our doctors and the RealSelf community to give you answers to the most commonly asked questions. 

In This Overview:

What is rhinoplasty, aka a nose job?
Is a nose job right for me?
How much does it cost?
How do I choose a surgeon?
What happens during a nose job?
What’s the difference between an open and closed rhinoplasty?
What’s the recovery time?
What results can I expect?
Does getting a nose job hurt?
Do I have to get surgery?
What else do I need to know?

What is rhinoplasty, AKA a nose job?

Rhinoplasty is any cosmetic surgery to the nose. Most commonly, the procedure reshapes and resizes the nose. In some cases, a nose job may also correct breathing problems. 

The procedure often alters nose size in relation to the rest of the face, the width of the bridge, the appearance of humps or depressions, the position of the nasal tip, the size of the nostrils, and asymmetry. Back to top

Is a nose job right for me?

Choosing to have a nose job depends on how you feel about your nose and how you want it to look. It's also important to note that your nose will change as you age. 

"Through the teenage years, we can see changes in the shape and structure of the nose," says Dr. Vito C. Quatela, a Rochester, N.Y., facial plastic surgeon in a nose Q&A. "As we get older, a loss of support causes the nasal tip to droop. Reabsorption of the mid-facial bone and tissues causes the nose to appear more projected as well."

Ask your doctor if your aesthetic concerns may be resolved without surgery, and if you proceed with a nose job, how your new nose may change over time. Rhinoplasty, like all major surgeries, requires good overall health. Back to top

How much does it cost?

The price of a nose job depends on several factors, but doctors say you pay for experience. 

“Rhinoplasty is one of the most complicated operations in the field of cosmetic surgery,” says Dr. William Portuese, a Seattle facial plastic surgeon. “The experience of the surgeon will usually determine how good the outcome will be. It is in a patient’s best interest to find a surgeon who has performed thousands of rhinoplasties.”

The level of experience, however, impacts price. See updated pricing for your area. Back to top

How do I choose a surgeon?

"It's the most prominent part of your face. Find a great surgeon no matter where or how much," says Dr. Shervin Naderi, a Washington, D.C., facial plastic surgeon in a rhinoplasty Q&A

For a nose job, it's vital to look for a doctor with extensive experience. “Ideally, patients should find a facial plastic specialist who performs an average two or more rhinoplasties every week and has done so for decades,” says Dr. M. Sean Freeman, a Charlotte, N.C., facial plastic surgeon.

Once you narrow down your list of potential doctors, make at least two appointments for consultations.

“A good rhinoplasty should look like a nose that was intended for that face,” Dr. Freeman adds. “The best compliment I get is when my patients tell me that people who don’t know they had their nose done say they look so much better, but they can’t put their finger on exactly why.” Back to top

What happens during a nose job?

In most rhinoplasty surgeries, you’ll be put under with general anesthesia, which is the preferred method, according to Dr. Freeman, as it allows the surgeon to protect the airway during surgery. However, some doctors perform nose jobs under local anesthesia, which numbs only the treated area.

During the procedure, the plastic surgeon will make incisions to access the bones and cartilage. The doctor then adds or removes bone and cartilage to change the form, and sometimes the function, of the nose. Depending on your needs, the doctor may add a cartilage graft to remodel the tip, and use fillers or fat grafts to add volume. At times, a doctor may use a silicone implant, but this is often discouraged because of an increased risk of infection.

Speak with your doctor to develop the best surgical plan for you. Back to top

What’s the difference between an open and closed rhinoplasty?

In a “closed” rhinoplasty, all incisions are placed inside the nose. In an “open” rhinoplasty, the doctor cuts immediately underneath the nose in an area called the columella.

Of the two, closed rhinoplasty is the more established and common technique. Some doctors say closed rhinoplasties heal faster than open rhinoplasties, while others say open rhinoplasties provide more control during the operation and more consistent results.

Dr. Paul Nassif, a facial plastic surgeon in Beverly Hills and star of E!'s "Botched," explains the difference between an open and closed rhinoplasty below:

*Treatment results may vary

View popular Revision Rhinoplasty videos

The pros and cons of the techniques continue to be debated among doctors, so be sure to ask your surgeon which one they prefer and why. Back to top

What’s the recovery time?

Immediately following surgery, expect visible swelling and bruising, which may include black eyes. Many people report feeling congested and have to breathe through their mouths. 

“I tell all my patients that the first week after a rhinoplasty will not be fun,” Dr. Freeman says. “The most common complaint is difficulty breathing through the nose, since surgery causes swelling inside the nose as well as outside.” 

While pain may be a factor, also don’t expect to sleep well or look particularly presentable. “Since patients should not blow their noses, all the nose discharge comes out from the front,” Dr. Freeman adds.

Five to seven days post-op, depending on your doctor’s preference and your healing progress, your cast and/or nasal packing is removed. At this point, you can expect to typically breathe and sleep better, and blow your nose.

After 10 to 14 days, swelling and bruising should subside enough for you to return to work and/or school, and other non-strenuous activities. Most doctors recommend waiting at least a month before returning to vigorous activity and exercise. Also avoid wearing glasses or sunglasses as the nasal bridge heals.

It's crucial to keep your follow-up appointments. “There are tricks the doctor should know to manage post-op swelling and give patients the best chance at healing uneventfully,” Dr. Freeman says. “It does take about a year to completely heal, but during that time the nose should look better every month.” Back to top

What results can I expect?

Nose job results are likely to change over time. It takes several months and sometimes up to a year for swelling to completely subside. This is why many doctors advise waiting at least a year post-op before deciding to do a revision rhinoplasty. Some suggest waiting even longer as the nose tip continues to soften and reduce in swelling.

"One year is not enough to see the final result. It takes years to see the final outcome," says Dr. Vladimir Grigoryants, a Los Angeles plastic surgeon in a rhinoplasty Q&A about swelling. "By 12 months, about 20% of swelling may still be present in the tip...Even after three years, many patients, especially those with thick tip skin, report that the tip continued to improve." 

To get an idea of the types of results you can expect, here are three of our most viewed rhinoplasty before-and-after photos. Back to top


Photos courtesy of Dr. M. Sean Freeman


Photos courtesy of Dr. Vito C. Quatela


Photos courtesy of Dr. Ira D. Papel

Does getting a nose job hurt?

RealSelf doctors say that a nose job is more annoying than painful. Many people take prescription pain medication for the first few days before switching to OTC pain meds. You may find that changes in your breathing and having to sleep upright, which is recommended to reduce swelling, is more difficult than the pain.

Many patients say the most painful part of a nose job is removing the nasal packing or the padding used to control bleeding. However, not all doctors use or even recommend nasal packing, so be sure to ask your surgeon his or her preferred treatment method. Back to top

Do I have to get surgery?

If you seek long-lasting results, then surgery is the answer. If you’re interested in minor changes or want a test-run before committing to surgery, try a non-surgical nose job. This procedure uses injectable fillers like Radiesse and Juvederm to alter the nose’s appearance. It may also correct breathing issues.

Non-surgical nose job results typically last at least six months, with most lasting no longer than 18 months. This option is often much less expensive than a rhinoplasty. Back to top

What else do I need to know?

Your surgeon's experience level is of the utmost importance, but be sure to ask these questions during your consult:

  • What percentage of your practice is devoted to rhinoplasty?
  • When did you perform your last rhinoplasty?
  • How many do you perform in a typical month?
  • What is your policy on revision?

You may also have these questions:

How is a septoplasty different?

A rhinoplasty is any cosmetic surgery to the nose. A septoplasty addresses a specific nasal problem: a deviated, or crooked, septum. (The septum is the bone and cartilage barrier that separates the left and right sides of your nose.) The two procedures are often combined, as it’s rare that a septoplasty alone will correct external issues.

What is Asian rhinoplasty?

Asian rhinoplasty is cosmetic nose surgery for a person of Asian heritage, which specifically addresses facial features common among Asian populations. Changes made during Asian rhinoplasty may include adding more height to the nose, narrowing the nose, and creating a sharper tip.

What is African-American rhinoplasty?

African-American rhinoplasty addresses common characteristics of African-Americans. The procedure may include narrowing the nasal bridge, redefining the tip, and narrowing the nostrils with an alarplasty

African-American rhinoplasty patients may be concerned about the appearance of keloids (overgrowth of scar tissue) after surgery, but doctors say this type of scarring is uncommon for rhinoplasty. 

“In more than 30 years of rhinoplasty,” says Dr. Toby Mayer, a Beverly Hills facial plastic surgeon, in an African-American rhinoplasty Q&A. “I have never had a patient with a keloid from rhinoplasty even when they have them elsewhere.” Back to top

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The RealSelf Guide to Rhinoplasty has been medically reviewed for accuracy by Dr. M. Sean Freeman. A facial plastic surgeon in Charlotte, N.C., since 1988, Dr. Freeman is one of the few double board-certified, fellowship-trained surgeons in the Southeast who specialize in facial aesthetic surgery. He’s certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology.

Disclaimer: This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional. Your reliance on any information or content provided in the guide is solely at your own risk. You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. RealSelf does not endorse or recommend any specific content, procedure, product, opinion, healthcare professional or any other material or information in this guide or anywhere on this website.

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