Rhinoplasty (nose job)

What is Rhinoplasty (nose job)? 

Rhinoplasty is the medical term for the procedure commonly known as a nose job, a surgical procedure where the shape of the nose is altered. Surgery to improve the nose has been in practice for thousands of years but this was typically done as a reconstructive procedure for broken or otherwise damaged noses. The first purely cosmetic rhinoplasty is attributed to a German plastic surgeon named Jacques Joseph who published a report on fixing a patient’s hump nose in 1904.

Rhinoplasty has remained a popular procedure since the mid-1900s and consistently places in the top 10 most performed aesthetic surgeries.

How does it work? 

Whether you want your nose reduced in size, increased or just reshaped, the surgeon first needs to cut through the skin of the nose in either an ‘open’ or ‘closed’ rhinoplasty. In closed rhinoplasties, the surgeon makes cuts inside the nostril which will hide any scars following the surgery. Depending on the scope of the corrections however, it might not be possible to do a closed rhinoplasty. In this case the surgeon will make a cut in the skin between your nostrils and pull the tip of your nose back, revealing the cartilage beneath. Open rhinoplasty has the benefit of a better view of the cartilage being worked on and can give better control of the cuts being made.

Once the opening cuts have been made, the following steps depend on what the patient wants done to their nose. If the patient wants reshaping and not a change in overall size, then cartilage can be moved around and the bone broken and re-set in a different shape to give the desired nose shape. Reduction in size can involve the cutting and removal of cartilage and/or the chiselling away of bone. Nose size can also be increased by grafting on extra cartilage from the ears and bone from the hips, although artificial grafts can also be used.

Other corrections like narrowing the tip of the nose or changing the way the tip points can be done with stitches to the cartilage.


What is it like?

The surgical procedure is typically done under general anaesthetic so the patient will be unconscious throughout. The surgery will last around 2 hours. Once the desired changes to bone and cartilage structure have been made, the cuts used to access them will be stitched up. For an open rhinoplasty this will leave a small scar between your nostrils but once healed they aren’t usually very noticeable.

When the anaesthesia wears off you will have gauze packed into both nostrils and a splint on your nose. The gauze will prevent breathing through your nose but is removed when leaving the hospital. You can typically leave either the same day of the surgery or the day after. The splint will have to remain in place for at least a week.

There may be a follow up assessment session where the splint is removed and healing and shape are checked. A second, corrective rhinoplasty may be required if the first did not work as desired and this happens in as many as 15% of nose jobs.


What is the recovery time?

For at least a week following the procedure you will be required to wear a splint over your nose. It is typically recommended to take this week off work as well.

Swimming should be avoided for three weeks following the surgery, and strenuous activity and contact sports should be avoided for at least a month.

You may also be advised to avoid heavy sneezing and blowing your nose as well as wearing glasses.

All the recovery period times can vary and you should follow the advice of your doctor.


What are the risks and side effects?

As a surgical procedure, rhinoplasty comes with some serious possible risks and side effects. There’s a small chance that following surgery you could develop permanent breathing problems, have and altered or lost sense of smell, develop an infection or blood clot or experience excessive bleeding during or after surgery.

Less severe side effects include considerable bruising and swelling around the nose as well as black eyes, pain and tenderness around the nose and nosebleeds.

Some people can also experience allergic reactions to anaesthesia.


How much does it cost?

Rhinoplasty can cost between £4,500 and £7,000.


So is it worth it?

Rhinoplasty is a serious, expensive and permanent procedure so it’s important to weigh up you options before undergoing surgery. Thousands of people in the UK each year undergo this procedure and a study found that overall satisfaction with the results was 83.6% of patients, though men alone had a much lower satisfaction of 56.1% [3].

In terms of alternatives, injected fillers are becoming a popular method of non-surgical nose reshaping. While these offer an attractive prospect of nose correction with a tenth of the cost and none of the surgery they aren’t appropriate in all cases as they can only add size to the nose. They’re also a temporary measure and will wear off in a year or so.

Ultimately, rhinoplasty is the only option for permanent corrections to nose shape. The cost may be high but it should be a one-time thing compared to yearly filler top ups. There are some severe risks involved and the recovery period can last months but if you’re truly unhappy with your nose then rhinoplasty may well be worth it.