Find answers to common questions about rhinoplasty procedures, recovery, and results
Rhinoplasty, commonly known as a "nose job," is a surgical procedure that reshapes or reconstructs the nose. It can be performed for cosmetic reasons to improve appearance, for functional reasons to improve breathing, or for both purposes simultaneously.
Good candidates for rhinoplasty include physically healthy individuals with fully developed facial growth (typically 16+ years for females and 17-18+ years for males), non-smokers (or those willing to quit), and those with realistic expectations about what the procedure can achieve. It's also important to be pursuing rhinoplasty for yourself, not to fulfill someone else's desires or to fit an idealized image.
Cosmetic rhinoplasty focuses on improving the appearance of the nose, addressing concerns like bumps, size, shape, or asymmetry. Functional rhinoplasty aims to improve nasal breathing by correcting structural issues like a deviated septum, nasal valve collapse, or turbinate hypertrophy. Many rhinoplasties are actually a combination of both cosmetic and functional improvements.
Most surgeons recommend waiting until facial growth is complete before undergoing rhinoplasty. This typically means at least 16 years of age for females and 17-18 years for males. However, exceptions may be made in cases of significant functional issues or severe deformities that affect breathing or quality of life.
There is no specific upper age limit for rhinoplasty. The procedure can be performed on older adults as long as they are in good health and have realistic expectations. However, older patients may have reduced skin elasticity, which can affect results, and may have a longer recovery period.
In closed (endonasal) rhinoplasty, all incisions are made inside the nose, leaving no visible external scars. In open rhinoplasty, a small incision is made on the columella (the tissue between the nostrils) in addition to internal incisions, allowing the surgeon to fully visualize the nasal structures. Open rhinoplasty provides better access for complex cases but leaves a small external scar, while closed rhinoplasty has no visible scarring but offers more limited access.
A typical primary rhinoplasty takes between 1.5 to 3 hours to complete, depending on the complexity of the case and the techniques used. Revision rhinoplasty (a second or subsequent procedure) often takes longer, sometimes 3-4 hours or more, due to the increased complexity and the potential need for grafting.
Most rhinoplasties are performed under general anesthesia, where the patient is completely asleep. However, some surgeons may perform less complex procedures under local anesthesia with sedation (twilight anesthesia), where the nose is numbed but the patient remains conscious though relaxed. The choice depends on the complexity of the procedure, surgeon preference, and patient factors.
Non-surgical rhinoplasty, also known as "liquid rhinoplasty," involves using injectable fillers (typically hyaluronic acid-based) to temporarily alter the shape of the nose without surgery. It can camouflage bumps, improve symmetry, or enhance tip projection, but cannot reduce the size of the nose or correct functional issues. Results typically last 6-18 months depending on the filler used.
Grafts used in rhinoplasty are typically autologous (from the patient's own body), with the most common sources being septal cartilage (from the nasal septum), ear cartilage (conchal cartilage), and rib cartilage. These grafts can be used to add structure, support, or volume to various parts of the nose. Synthetic implants are sometimes used but carry a higher risk of complications like infection or extrusion.
Most patients describe rhinoplasty recovery as uncomfortable rather than painful. The most significant discomfort typically occurs in the first 24-48 hours and is usually well-controlled with prescribed pain medication. Many patients transition to over-the-counter pain relievers after a few days. Congestion and pressure sensations are common and may persist longer than pain.
External nasal splints are typically worn for 5-7 days after surgery to protect the nose and help maintain its new shape during initial healing. Internal splints or packing, if used, are usually removed within 1-5 days. Some surgeons may also recommend nighttime taping of the nose for several weeks after the external splint is removed.
Most patients can return to desk work or school within 7-10 days after surgery, once the external splint is removed. However, if your job involves physical exertion, heavy lifting, or exposure to potential nasal trauma, you may need to take 2-3 weeks off or request modified duties. It's important to discuss your specific work requirements with your surgeon.
Light walking can be resumed within a few days after surgery. Light cardio exercise (like stationary biking) can typically be resumed after 2 weeks. More strenuous activities, including running and weight lifting, should be avoided for 3-4 weeks. Contact sports should be avoided for at least 6 weeks, and when resumed, proper nose protection is recommended for several months.
Swelling after rhinoplasty resolves in stages. Most visible swelling improves within 2-4 weeks. By 3-6 months, about 80-90% of swelling has typically resolved. However, subtle swelling, particularly in the nasal tip, can persist for 12-18 months, especially in patients with thicker skin. Complete resolution of all swelling can take up to 2-3 years in some cases.
The cost of rhinoplasty varies widely depending on geographic location, surgeon experience, complexity of the procedure, and facility fees. In the United States, the average cost ranges from $5,000 to $15,000. This typically includes the surgeon's fee, anesthesia fees, facility fees, and basic pre- and post-operative care. Additional costs may include medications, special garments, and follow-up visits beyond the standard care package.
Insurance typically does not cover rhinoplasty when performed for purely cosmetic reasons. However, if the procedure is being done to correct a functional problem that affects breathing (such as a deviated septum or nasal valve collapse), insurance may cover the functional portion of the surgery. Documentation of medical necessity, including evidence of breathing difficulties and failed conservative treatments, is usually required for insurance coverage.
Septoplasty is a surgical procedure to correct a deviated nasal septum (the wall between the nasal passages). Unlike cosmetic rhinoplasty, septoplasty is considered a functional procedure and is often covered by insurance when medically necessary to improve breathing. When septoplasty is performed alongside cosmetic rhinoplasty (a procedure called septorhinoplasty), insurance may cover the septoplasty portion while the patient pays for the cosmetic aspects.
Many plastic surgery practices offer financing options through third-party companies specializing in medical financing, such as CareCredit, Alphaeon Credit, or Prosper Healthcare Lending. These typically offer payment plans ranging from 6 to 60 months, sometimes with promotional interest-free periods. Some surgeons also offer in-house payment plans. It's important to carefully review interest rates and terms before committing to any financing option.
Beyond the basic surgical package, additional costs may include prescription medications, specialized nasal care products, time off work, travel expenses if seeing a surgeon outside your area, and potential costs for revision procedures if needed. It's also important to consider the cost of pre-operative medical clearance if required, which may include lab work or specialist consultations that might not be fully covered by insurance.
While you'll see a significant change once the splint is removed (typically 5-7 days after surgery), this is not your final result. Most patients look "socially presentable" within 2-3 weeks. By 3-6 months, about 80-90% of swelling has resolved, giving a good indication of the final result. However, the truly final result isn't apparent until 12-18 months after surgery, as subtle refinements continue as the last of the swelling resolves.
Rhinoplasty results are generally considered permanent, as the bone and cartilage modifications create lasting structural changes. However, your nose continues to age along with the rest of your face, which may lead to gradual changes over decades. Factors that can affect long-term results include aging, trauma, sun exposure, and smoking. The nasal tip may gradually drop slightly with age, particularly in patients with thicker skin.
The revision rate for rhinoplasty ranges from 5-15%, depending on the complexity of the case and the surgeon's experience. Revision rates tend to be higher for complex cases, ethnic rhinoplasty, and cases with significant functional components. Most revisions are minor refinements rather than complete redos. It's generally recommended to wait at least 12 months after the initial surgery before considering revision to allow for complete healing.
Minor changes in voice resonance are possible after rhinoplasty, particularly if there are significant changes to the nasal airway. However, these changes are usually subtle and often unnoticeable to others. Professional singers and voice actors should discuss this concern specifically with their surgeon, as they may be more sensitive to even minor changes in resonance.
When choosing a rhinoplasty surgeon, consider their board certification (look for certification in Facial Plastic Surgery, Plastic Surgery, or Otolaryngology), specific training and experience with rhinoplasty, before-and-after photos of previous patients, patient reviews, and your personal comfort level during consultation. It's advisable to consult with multiple surgeons before making a decision. The ideal surgeon should have extensive experience with cases similar to yours and should communicate clearly about realistic expectations.