Rhinoplasty Guide: Frequently Asked Questions

Reviewed for medical accuracy by Dr. M. Sean Freeman in January 2016

If you’re considering a rhinoplasty, 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?
Is It Right for Me?
How Much Does It Cost?
How Do I Choose a Surgeon?
What Happens During the Procedure?
What’s the Difference Between an Open and Closed Rhinoplasty?
What’s the Recovery Time?
What Results Can I Expect?
Does Getting a Rhinoplasty Hurt?
Do I Have to Get Surgery?
What Else Do I Need to Know?

What Is Rhinoplasty?

Rhinoplasty is any cosmetic surgery to the nose. Most commonly, the procedure reshapes and resizes the nose. In some instances, rhinoplasty 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 Rhinoplasty Right for Me?

“Rhinoplasty is an individual choice,” says Seattle facial plastic surgeon Dr. William Portuese. It all depends on how you feel about your nose and how you want it to look.

Also remember that your nose changes as you age. “The nose undergoes several changes as we age and develop,” explains New York facial plastic surgeon Dr. Vito C. Quatela. “Through the teenage years, we can see changes in the shape and structure of the nose.” Later in life, the tip may droop because of a loss of support. Ask your doctor if your aesthetic concerns may resolve without surgery, and if you proceed with the procedure, how your new nose may change over time. 

Rhinoplasty, like all major surgeries, also requires good overall health. Back to top

How Much Does Rhinoplasty Cost?

The price of a rhinoplasty depends on a number of factors, but doctors say you pay for experience. 

“Rhinoplasty is one of the most complicated operations in the field of cosmetic surgery,” says Dr. Portuese. “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.”

That type of experience, however, can impact the final price tag. See the latest pricing information for your area. Back to top

How Do I Choose a Surgeon for a Rhinoplasty?

“Rhinoplasty is not like shopping. Don’t look for bargains for your face,” advises Washington, D.C., facial plastic surgeon Dr. Shervin Naderi. Of course, he cautions, you don’t always get what you pay for. “Don’t throw money out the door by finding expensive surgeons who may not be as good as they think they are when it comes to nasal surgery.”

Look for a doctor with extensive hands-on 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 Charlotte facial plastic surgeon
Dr. M. Sean Freeman. Whether the doctor is a facial plastic surgeon or not, make sure he or she regularly performs rhinoplasties. 

Once you’ve narrowed down your list of potential doctors, make at least two appointments to see what kind of rapport you have.

“A good rhinoplasty should look like a nose that was intended for that face and not look operated,” says Dr. Freeman. “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 the Procedure?

In most rhinoplasties, you’ll be put under with general anesthesia (the preferred method, notes Dr. Freeman, as it allows the surgeon to protect the airway during surgery). Some doctors, however,perform rhinoplasties under local anesthesia that numbs only the treated area and doesn’t put you to sleep.

During the surgery, the surgeon makes incisions to better access the nose’s bones and cartilage. Learn more about the two most common surgical techniques by reading “What’s the Difference Between an Open and Closed Rhinoplasty?”

During a rhinoplasty, the doctor 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. Sometimes a doctor may use a silicone implant to achieve the desired look, but this is often discouraged because of an increased risk of infection.

Speak with your doctor to learn about your best options and make your specific surgical plan. 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 older, more 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 final results.

The pros and cons of the techniques continue to be debated among doctors, so be sure to ask yours what he or she prefers and why.
Back to top

What’s the Recovery Time?

Immediately following surgery, expect visible swelling and bruising (including, sometimes, black eyes). Many patients report feeling stuffed up and having to breathe through their mouths. (Pro tip: Stock up on lip balm to combat chapped lips.)

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

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, patients can typically breathe well, sleep much better, and blow their nose, says Dr. Freeman.

After 10 to 14 days, the swelling and bruising subside enough that many patients are able to return to work, school, and other non-strenuous activities. “Even this early on, the course their nose is on should already look better,” says Dr. Freeman. You’ll still need to take it easy, though. Most doctors recommend waiting at least a month before returning to vigorous activity and exercise. You’ll also want to avoid wearing glasses or sunglasses as the nasal bridge heals.

Keep your follow-up appointments, Dr. Freeman adds. “There are tricks the doctor should know to manage post-op swelling and give patients the best chance at healing uneventfully,” he 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?

Rhinoplasty 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's tip continues to soften and reduce in swelling.

"It takes years to see the final result especially in the tip area," cautions Los Angeles plastic surgeon 
Dr. Vladimir Grigoryants. "By the end of 12 months, the tips are still hard in most patients.... By year three, many patients report that their tips are much softer and look more refined." Expect more swelling if you have thicker skin, adds Dr. Grigoryants.

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


Photo courtesy of Charlotte plastic surgeon Dr. M. Sean Freeman


Photo courtesy of New York plastic surgeon Dr. Vito C. Quatela


Photo courtesy of Baltimore facial plastic surgeon Dr. Ira D. Papel

Does Getting a Rhinoplasty Hurt?

RealSelf doctors say it’s more annoying than painful. Most patients take prescribed pain medication for the first few days post-op before switching to non-narcotics. You may find the changes in your breathing and having to sleep upright (recommended to reduce swelling) more difficult than the pain.

Many patients say the most painful part is removing the nasal packing, the padding and, sometimes, sterile tampons inserted to the nasal chambers during surgery 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?

For the longest lasting results, yes, get a rhinoplasty. If you’re interested in only minor changes or want to test run a rhinoplasty 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?

Because the experience level of your surgeon is of the utmost importance, be sure to ask these questions during your rhinoplasty consultation:

  • 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, meanwhile, 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 crookedness.”

What Is Asian Rhinoplasty?

The terminology “Asian rhinoplasty” is a cosmetic nose surgery for a patient 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.“The importance of ‘ethnicity’ is that any change must be deliberate and match the patient’s aesthetic goals,” says New Hampshire plastic surgeon Dr. Mark B. Constantian. “You must find a surgeon who has enough control over his or her results to deliver the type of change you both have agreed on.”

What Is African-American Rhinoplasty?

Like Asian 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 after surgery, but plastic surgeons say this type of scarring is uncommon for rhinoplasty. “In more than 30 years of rhinoplasty,” says Beverly Hills facial plastic surgeon Dr. Toby Mayer, “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, North Carolina, 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. Learn more on his RealSelf profile.

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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