Nose correction and rhinoplasty for a harmonious nose shape and improved breathing through plastic surgery on the nose

A nose job is also known as rhinoplasty. It is one of the most technically demanding procedures in aesthetic and plastic surgery. It is therefore recommended to choose a specialist in nose surgery.

Nose jobs can be performed for aesthetic or medical reasons. Even in cases of aesthetic correction, the nose’s function must be preserved. The right specialist for this is usually an ENT doctor trained in plastic surgery.

Most patients opt for rhinoplasty to achieve a nose that is attractive and harmoniously proportioned to their face. People who are dissatisfied with the shape and size of their nose often suffer for years from psychological problems and low self-esteem.

Surgical rhinoplasty can then provide both significant psychological relief and a boost to self-esteem.

Rhinoplasty can be used, for example, to remove a nasal hump © New Africa | AdobeStock

For rhinoplasty, a

• an otolaryngologist (especially if there are issues with nasal breathing) or
• a specialist in plastic and aesthetic surgery

. This specialist should have extensive experience specifically in nasal surgery, which ideally encompasses not only aesthetic nasal procedures but also functional corrections.

During rhinoplasty, the shape and size of the nose are refined and altered through precise surgical techniques. The goal is for the nose to blend harmoniously into the face. Not every patient’s vision is technically feasible, and not every suggestion is considered aesthetically sound by the surgeon. The new nose should complement the patient’s facial structure and blend in harmoniously.

In general, rhinoplasty makes it possible to

• reduce the size of the nose,
• enlarge it, or
• narrow it,
• reduce a nasal hump and oversized nostrils,
• straighten a crooked nose,
• correct a saddle nose,
• reshape the nostrils, and
• to alter the angle between the nose and the upper lip.

In most cases, patients wish to

• to have their nose made smaller or shorter,
• to raise or reshape the tip of the nose,
• a refinement of the nostrils, or
• a narrowing of the bony structure.

Straightening the nasal septum is also often performed during rhinoplasty. This is frequently due to a deviated septum that impedes nasal breathing. Pronounced crooked or saddle noses may also require cartilage or bone grafts.

The best conditions for rhinoplasty are

• a sound bony and cartilaginous nasal framework and
• a normal nasal mucosa.

During the preliminary consultations, it is important to

• obstructions to nasal breathing (e.g., deviated nasal septum, nasal polyps),
• previous injuries to the nose, or
• allergic reactions affecting the nasal mucosa and sinuses

and to plan the rhinoplasty procedure accordingly. This requires a thorough examination by an ENT specialist. Rhinoplasty should ideally be performed only after the patient has reached full growth. Rhinoplasty can be problematic in very elderly patients.

The type of anesthesia used for rhinoplasty depends on the extent of the procedure. Minor procedures on the tip of the nose can be performed under local anesthesia combined with twilight sedation. More extensive rhinoplasty procedures should be performed under general anesthesia.

The surgery takes about 1–2 hours.

The procedure for a rhinoplasty depends on

• the individual’s anatomy,
• the structure of the bony and cartilaginous framework of the nose,
• the condition of the skin, and
• the patient’s age

. 

During the procedure, the surgeon first exposes the bony and cartilaginous framework of the nose using special instruments. To do this, he detaches the skin and mucous membranes using invisible incisions inside the nose. The surgeon then reshapes the nose according to the patient’s preferences or the anatomical conditions. Generally, a distinction can be made between open rhinoplasty and closed rhinoplasty.

In most cases, the endonasal approach is used, in which the incisions are made inside the nose and are therefore invisible from the outside. However, for various reasons—primarily the severely limited field of view—open rhinoplasty may also be necessary for some procedures. In this case, the surgeon makes a small incision through the external nasal bridge.

Illustration of a rhinoplasty with cartilage reshaping © lenka | AdobeStock

Several preoperative examinations are necessary before rhinoplasty. The doctor assesses

• breathing function and
• the condition of the nasal mucous membranes, as well as
• whether any allergies are present.

Some patients have very sensitive nasal mucosa. They should use moisturizing nasal ointments or oily nasal drops for 2 to 3 weeks before the rhinoplasty procedure.

It is also necessary to treat any chronic inflammation

• of the nose,
• the throat, or
• the ears

well in advance of the rhinoplasty.

The patient should also avoid

• take sleeping pills and pain relievers that inhibit blood clotting, such as aspirin, as well as
• the consumption of alcohol

.

During the first 24 hours after rhinoplasty, the patient should avoid any physical exertion.

• Sports,
• direct sunlight,
• saunas,
• tanning beds, and
• hot baths

must be avoided for 6 weeks to 3 months.

By Alison Cassidy - Own work, CC BY-SA 3.0, Link

Immediately after rhinoplasty, the operated area should be cooled. Swelling and bruising should be minimized as much as possible and will subside within a few days. The nose will remain sensitive to pressure for several weeks.

In the first few days after rhinoplasty, regular nasal suctioning can provide relief for the patient. It is no longer necessary to heavily bandage the face. In the early stages, there will be frequent follow-up appointments (e.g., removal of the nasal packing, replacement of the nasal cast). It can take up to a year for the nose to heal completely.

Serious complications are extremely rare. However, obstructed nasal breathing or a dry nose cannot be entirely ruled out as a result of the procedure. In very rare cases, a follow-up surgery may be necessary several months after rhinoplasty.

Like any surgical procedure, rhinoplasty does carry certain risks. However, when performed correctly, rhinoplasty generally does not pose a significant risk to the patient’s health. Serious complications following rhinoplasty, such as

• injuries to the tear duct,
• purulent wound infections,
• embolisms, and
• thrombosis

.

Reduced tactile sensitivity in the nose

A possible complication is changes in the sensitivity of the nose to touch. It is possible that the nose and the surrounding skin areas of the cheeks and upper lip may experience reduced sensitivity to touch in the first few weeks after rhinoplasty.

Cartilage damage may occur as a result of scarring and impaired blood flow to the inner nasal mucosa. This can occur particularly after extensive rhinoplasty, especially in the nasal septum. This very rare complication can impair both the shape and function of the nose.

Changes in shape are among the most common complications of rhinoplasty. They result from uneven scarring of the bone and cartilage structure of the nose. Sometimes these irregularities and changes in shape do not resolve, or resolve only very slowly, in the weeks following rhinoplasty. In such cases, a minor revision procedure may be necessary.

To prevent complications from rhinoplasty, the surgeon must be informed of any existing medical conditions or allergies the patient may have, such as allergies to medications or skincare products. Coagulation disorders must also be ruled out. If the patient is prone to noticeable bruising or prolonged bleeding following minor injuries, this could be an indication of such a disorder.

Rhinoplasty can permanently alter and refine the size and shape of the nose according to the patient’s wishes. For example, a nasal hump and oversized nostrils can be effectively reduced through rhinoplasty. A wide nose can be narrowed, and a crooked nose can be straightened.

If the patient has a pronounced crooked nose or a saddle nose, cartilage or bone grafts may sometimes be necessary to achieve the desired result. Problems with the shaping of the nose or with subsequent nasal breathing function should be prevented. Therefore, any previous injuries or surgeries on the nose must be taken into account when planning rhinoplasty.

The outcome of rhinoplasty can be affected by

• coarse-pored, fatty skin, which can prevent the formation of a refined nasal tip, or
• very thin skin, which makes the contours of the bony and cartilaginous framework stand out more clearly,

. However, modern plastic surgery techniques generally allow for the desired outcome of rhinoplasty to be achieved.

What is rhinoplasty?

Rhinoplasty is a surgical procedure to alter the shape or function of the nose. Rhinoplasty is one of the most common procedures in plastic surgery and can be performed for both aesthetic and functional reasons. It can correct the tip of the nose, the bridge of the nose, the nostrils, or the nasal septum.

When is nose surgery recommended?

Nose surgery may be considered if the shape of the nose is perceived as bothersome or if it impairs nasal breathing. Common reasons include a humped nose, a crooked nose, a wide nose, or functional problems inside the nose. In some cases, rhinoplasty is performed for medical reasons.

How is rhinoplasty performed?

Rhinoplasty is usually performed under general anesthesia. Depending on the findings, cartilage and bone are reshaped, the bridge of the nose is straightened, or the nose is narrowed. During surgical rhinoplasty, small incisions or an incision along the nasal bridge may be necessary. The bone and cartilage structure is specifically adjusted to achieve the desired shape of the nose.

What are the risks associated with rhinoplasty?

Like any surgical procedure, rhinoplasty carries a certain degree of risk. Possible complications include swelling, mild bruising, postoperative bleeding, or infection. An experienced surgeon and careful postoperative care help minimize risks and achieve optimal results.

How much does rhinoplasty cost, and does health insurance cover the costs?

The cost of rhinoplasty depends on the extent of the surgery and the method chosen. If the rhinoplasty is performed solely for cosmetic reasons, health insurance generally does not cover the costs. If there are functional or medically relevant limitations, partial coverage may be possible. Questions regarding rhinoplasty should therefore be discussed in detail during the initial consultation.