Today’s rhinoplasty is now more predictable, more accurate, and more effective than at any other time in its history. With the right combination of surgical skill and favorable tissue, cosmetic rhinoplasty can produce a naturally beautiful nose that will flatter the face and last a lifetime. However, it is important to educate yourself and have realistic expectations before you undergo surgery. These are some things rhinoplasty patients wish they had known beforehand:

• There’s a big distinction between septoplasty and rhinoplasty. The term “nose job” conflates these two separate procedures. A deviated septum is a condition where the bone and cartilage that separate the nasal cavity is off-center or crooked. Septoplasty is an internal surgery that straightens the septum and helps alleviate any breathing issues stemming from blockage of the nasal passages.
• Rhinoplasty can performed when the nose has completed 90% of its growth, which can occur as early as age 15 or 16 in boys and 13 or 14 in girls however parental consent is required for patients under the age of 18. ⁽⁶⁾
• There are non-surgical options. Rhinoplasty surgery is the best way to make long-lasting changes to your nose. However, if you are only seeking subtle changes, there may be a non-surgical solution. Dermal fillers like Restylane, Juvederm and Radiesse can help with minor issues including small humps, bumps, or slight asymmetry. While non-surgical options are associated with minimal discomfort, results are temporary.
• Rhinoplasty (or nose reshaping) is among the most difficult of all cosmetic surgeries. Poor surgical technique can lead to permanent deformity, so it is important to choose your surgeon carefully.
• No rhinoplasty result is ever absolutely perfect. An accomplished surgeon who specializes in rhinoplasty can deliver exceptional results, but without experience, artistic skill and technical expertise, a good cosmetic outcome is all but impossible.

• One size does not fit all. Although you may desire a specific style, a nose that looks great on someone else may look awkward on you.
• Great surgical skills alone do not guarantee a good outcome. Good tissue and favorable healing responses are also necessary for a successful rhinoplasty. Weak cartilage, poor healing ability, and thin skin can negatively affect even the most skillful surgery.
• Young adults have the best prognosis. All other factors being equal, a young individual with a smooth, clear complexion, firm nasal cartilage, forgiving skin, and good overall health will have the best prognosis for a favorable rhinoplasty outcome.

• Final results may not be apparent for 12-15 months. In most cases, post-surgical swelling will distort the nose for several months after surgery. Even good results may look disappointing at first. It can take a year or longer to see your final results.

Rhinoplasty procedures can include the removal of bone, cartilage, or the addition of synthetic tissues, to increase or decrease the size of various elements of the nose. The visual effects may be subtle or dramatic, depending on your needs and desires. The exact techniques used for your procedure depends on the current shape and size of your nose and the desired results; no two rhinoplasty procedures are exactly the same. It helps to know some of the official terms used by plastic surgeons for rhinoplasty. Here’s a list of four of them: ⁽⁷⁾

• Open method: With the open method, the surgeon makes an incision in the columella (the bridge of tissue that separates the nostrils) in order to gain access to the underlying cartilage and tissue of the nose. Additional incisions made be made inside the nose.
• Closed method: The closed (or endonasal) method is a less invasive type of rhinoplasty that involves making an incision inside the nose and working entirely beneath the skin of the nose with limited visual access.
• Non-surgical: The term “non-surgical” typically implies the use of an injectable dermal filler to temporarily correct small imperfections.
• Nasal implants: Involves the use of silicone implants to help alter the shape and size of nose.

While rhinoplasty is performed in the same manner regardless of the patient’s ethnic background, the aesthetic goals of the patient may differ. Today, more and more people are seeking rhinoplasty that is tailored to their specific facial features. It is particularly popular among those of Asian and African descent. Many of these patients feel that the bridge of their nose is too flat, or that their nostrils are too wide. Some of these patients seek to ‘Westernize’ their facial features through surgery, while others simply want a more defined nose to bring balance to their face.

There is always a risk that the results of your initial rhinoplasty procedure will not look exactly as expected. In this situation, your surgeon may recommend revision or secondary rhinoplasty. ⁽³⁾ This term refers to a rhinoplasty procedure performed on any patient who has previously undergone one or more nose procedures. The intention is to improve upon or modify the results of a previous operation. It can be a way of fixing a “botched” rhinoplasty or one that simply produced less than satisfactory aesthetic results. Some common reasons why you might consider secondary rhinoplasty include:

• Too much tissue was removed from the nostrils
• The bridge of your nose was not narrowed enough
• The tip was upturned more than you wanted it to be
• Difficulty breathing through the nose as a result of their first surgery

It is recommended that patients wait at least two years after the initial surgery before considering revision rhinoplasty. Although it may only take a couple of months for the nose to appear healed, it could actually take several years for the nasal tissue to settle into a more permanent position. Once the nose has settled, meet with a plastic surgeon to determine whether or not another procedure would be an appropriate option for you.

A few of the potential risks or complications that could occur as a result of rhinoplasty include: ⁽¹⁾

• An infection may develop, which can spread to other parts of the body or cause scarring
• Nose asymmetry
• Nasal blockages
• Excessive bleeding
• Breathing is difficult through the new nose
• The septum is damaged
• Nose numbness that is temporary or permanent

Recovering from rhinoplasty takes about two to three weeks. Most patients return to work after one week. During the first one to two months, it’s important to avoid strenuous activities, including sports that may cause trauma to the nose. This includes baseball, soccer, basketball, weightlifting, and other similar sports. A trauma to your nose during the recovery time can end up causing your new nose to deviate from its proper location.

Although initial results will be visible within a few weeks of your surgery, it will take a year or more before the nose is fully stabilized and all swelling has subsided. ⁽⁴⁾ Once the tissue has stabilized, the results of rhinoplasty are relatively permanent.

There are three basic fees that are associated with most rhinoplasty procedures. These include:

• Anesthesia fee
• Your surgeon’s fee
• Facility / hospital fee

On average, the surgeon’s fee for rhinoplasty is around $3,500. This amount does not include the facility or anesthesia fees, or additional expenses that may be required for patients undergoing rhinoplasty. The anesthesia costs are usually between $600 and $1,000, and the facility fee between $700 and $1,100. The total cost of rhinoplasty usually averages between $5,000 and $10,000. Other potential factors that may influence the cost include:

• The extent of your procedure
• Your location
• Revision rhinoplasty (performed on patients who have had a nose surgery in the past) tends to be more complicated, and therefore costlier, than an initial procedure

When you are given a quote for rhinoplasty, make sure that it is includes the total cost of the surgery and not just the surgeon’s fee. If cost is an issue for your rhinoplasty procedure, ask your surgeon whether they offer financing options. Many plastic surgeons are willing to offer flexible monthly payment plans. Ask your surgeon about financing options during your initial consultation.

Q: How long is it normal to have swelling after rhinoplasty? A: In most cases, swelling after rhinoplasty begins to subside in the first week after surgery, but minor swelling often persists for several months. Full resolution of all residual swelling may take up to a year. Q: I’m of African American ethnicity and my nose is very wide. Can rhinoplasty work for me? A: Yes. The goal of cosmetic rhinoplasty is to reshape the nose, and the techniques are effective no matter what your ethnicity is. Q: I’m afraid that my surgeon won’t understand what type of results I want. What should I do? A: You can search for photos from magazines, tear them out and bring them in with you. Before you undergo the surgery, make sure that you and your surgeon are on the same page as far as your goals and desired outcome. Q: How long do I have to wear the splint after surgery? A: Usually one week. Q: Is rhinoplasty covered by insurance? A: In most cases, rhinoplasty is considered a cosmetic procedure, meaning that the costs must be paid out-of-pocket by the patient. Insurance will only cover rhinoplasty for those who have structural defects (and breathing problems), birth defects, or damages due to a trauma.