Rhinoplasty is one of the most popular procedures in plastic surgery. A surgical nose job can make a real and lasting change to one’s appearance, from increasing facial symmetry to rejuvenating the face.
Rhinoplasty is ideal for men and women who are bothered by the appearance of the nose. It can be a wide nose they would like to see thinner, a bulbous nose they would like to see smaller, or a crooked nose that needs to be straightened for aesthetic or functional issues. The droopy tip or a crooked nose are also indications for a rhinoplasty to better balance the face, and also improve breathing and nasal function.
What is a rhinoplasty?
Rhinoplasty is a common cosmetic surgery procedure, often referred to as a nose job. A rhinoplasty or a nose job treats aesthetic (the looks) and functional (the breathing) problems of the nose. It also improves facial proportions and overall facial balance.
Rhinoplasty surgery is done on an outpatient basis, has quick healing times and long-lasting results.
Am I a good candidate for rhinoplasty?
You are a good candidate for surgical rhinoplasty if you would like to permanently change the look of your nose, improve the overall balance of your face, or if you are experiencing chronic breathing problems related to a deviated septum and nasal obstruction.
When we meet for a rhinoplasty consultation, we do a full facial and nasal and can even do some simulations to see what your nose might look like after surgery.
How is a rhinoplasty surgery performed?
The procedure is performed with either an open or a closed approach. In an open approach, we proceed with a much fuller exposure of the nose and the septum and we can treat more difficult deformities. We start with a little incision near the columella, the skin area between the two nostrils, and another small cut inside of the nose. This allows us to go in, reshape and modify all areas of the bone structure and cartilage. The open incision heals really well and is virtually imperceptible.
The other method of a rhinoplasty we perform is known as a closed approach. Here, there will be no columella incisions made, but only incisions inside the nose. We reserve a closed rhinoplasty for patients with isolated problems of the nasal tip and small problems of the dorsum. I perform both approaches depending on the problem of the patient.
A rhinoplasty can also be performed at the same time with other procedures of the face such as a facelift, eyelid surgery, or facial contouring. A rhinoplasty also rejuvenates the face by lifting the nasal tip and reshaping the nose, bringing more balance to the face.
Will a rhinoplasty help me breathe better?
If there are chronic breathing issues, we can make the nose breathe better by addressing the septal deviation or the inferior turbinate, and at the same time make the nose look better. The turbinates are bone and tissue structures on either side of the nose which aid in cleansing and moistening the air we breathe. When these structures become swollen and inflamed, as with chronic allergies, it can interfere with the flow of air and make breathing uncomfortable. Large inferior turbinates can be corrected during a functional rhinoplasty, or as part of a cosmetic rhinoplasty.
Rhinoplasty versus septoplasty.
A cosmetic rhinoplasty is performed to improve the aesthetics of the nose and to improve facial balance. A septoplasty can be part of an aesthetic rhinoplasty if there are certain breathing problems. A septoplasty can also be done in isolation, without changing the nasal aesthetics, specifically to correct a deviated septum.
Do I need to be sedated during rhinoplasty to the face?
All rhinoplasties are done under general anesthesia to secure the airway, patient comfort and safety during the procedure.
Does rhinoplasty hurt?
Patients may feel pressure from swelling after a rhinoplasty, and some mild pain after the surgery, which is treated with pain killers and NSAIDS.
How long does a rhinoplasty last? Is a nose job permanent?
Yes, a rhinoplasty is a permanent change. The results will last as long as no other injury happens to the nose or face. However, as we age and the nose skin gets thinner, there may be small changes to the nasal shape. There is an average of minor revisions after rhinoplasty of about 10%. That is usually carried out after a year of the initial procedure if needed. Most patients enjoy beautiful result for years with no need for revision.
Is there a non-surgical option for a nose job?
The most common alternative to a surgical nose job are injections of fillers to reshape the nose, also known as a liquid rhinoplasty. A liquid rhinoplasty can achieve beautiful changes to the nasal shape, which are temporary and can last for about a year. This is a very common procedure performed for mild to moderate aesthetic nasal improvement and nasal shaping, and it can be repeated as needed.
If there are breathing problems, surgery by a skilled plastic surgeon is the only appropriate method to correct those issues. Products, such as nasal sprays, may help momentarily, but without a reduction of the enlarged inferior turbinates, or the treatment of an obstructing deviated septum or collapsed internal or external nasal valve, they may have any real breathing improvement.
Will there be a visible rhinoplasty scar after surgery?
No, the rhinoplasty incisions are very small and done in hidden areas in the nose. The open incision heals very well and is virtually imperceptible.
Will there be swelling after rhinoplasty surgery?
Yes, there will be some bruising and swelling after the surgery for about a week to 10 days.
What is the rhinoplasty surgery recovery time?
Recovery time depends upon which technique is used, and whether you have to have a septoplasty or structuring of the nose. The procedure itself lasts from 2-4 hours on average. The downtime is about 1-2 weeks after surgery. Some patients have more swelling or bruising than others, so it may take about 3 weeks for the most visible signs of surgery to be gone. We recommend 1-2 weeks off of work.
How much does rhinoplasty cost?
There are several factors which make up the cost of a rhinoplasty. It varies depending on the goals of the patient, the complexity of the procedure, and if the surgery includes both aesthetic and functional improvements.
How can I get started to learn more?
If you think you might be a good candidate for a rhinoplasty, we can meet at my office for an examination and even do some simulations to see what your nose might look like after surgery. I can show you several before and after photos of my patients, and we can talk more about the results you are looking for. Rhinoplasty is a wonderful and life changing surgery and I look forward to seeing you soon.
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Dr. Gabriele Miotto, Atlanta plastic surgeon known for her beautiful, natural results and high patient satisfaction.
Surgery and Recovery Information
After the rhinoplasty procedure
After the procedure, there will be some bruising and swelling. Swelling can be minimal or more intense depending on how many procedures need to be done to make the results the most beautiful and natural possible. Frequently combined procedures with a rhinoplasty are fat grafting to the face, liposuction, facelift, breast augmentation. There are many options for us to achieve the comprehensive aesthetic results.
Return to normal daily activities between 1-2 weeks. Expect at least 8 weeks for committing to major social events as residual swelling can remain for some patients after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising.
General preoperative recommendations for rhinoplasty procedures:
What to avoid before:
- DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
- Discontinue Vitamin E 10 days before surgery.
- Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
- Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
- Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.
What to take before surgery:
- Dr Miotto recommends some supplements before and after the procedures to speed up recovery during the office consultation.
General postoperative recommendations after rhinoplasty procedures:
- You need a responsible adult to take you home, we will not allow you to drive or be home alone immediately after surgery.
- You will be unable to drive if you are taking narcotics.
- It is recommended to elevate the head with two to three pillows after all facial procedures.
- Do not submerge the face and nasal cast for a week after the procedure (until the cast is removed)
- Rinse the nose with nasal saline 3-4 times a day to keep the area clean
- We require that you have a responsible adult stay with you for twenty-four hours after your surgery for general help, as you may find your balance and judgement impaired.
- Please refrain from intense physical activity that will increase your heart rate or blood pressure for 2 weeks after surgery.
- You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
- Do not scrub the surgical sites, however you can allow soapy water to run over them.
Returning to Work:
- Recovery time will vary; usually the swelling and bruising are visible for 1-2 weeks after surgery.
- Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
- Eat a few bites of food before taking pain medications as these can cause nausea.
- A diet low in sodium will help minimize swelling and water retention.
- Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.
- Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
- It can take months for the very final results of your surgery be apparent. After 8-12 weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing (including the appearance of scarring) to continue to improve for up to six to twelve months.
- It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.
GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, nose, breast and liposuction.
Call 404-850-5851 for your consultation.