Rhinoplasty

What is rhinoplasty?

Rhinoplasty—commonly known as a nose job—is plastic surgery to reshape the nose. This is one of the most common procedures in plastic surgery.

What can rhinoplasty do?

Rhinoplasty performed for cosmetic purposes can:

• Reduce or increase the size of your nose
• Change the shape of the tip or the bridge
• Narrow the span of the nostrils
• Change the angle between your nose and your upper lip

Rhinoplasty is considered reconstructive surgery when it is performed to:

• Correct a birth defect or injury
• Help relieve some breathing problems

Sometimes nasal surgery also helps relieve snoring.

Do most rhinoplasty patients want the size of their nose reduced?

Yes. That procedure, called a reduction rhinoplasty, is for patients who have a hump or think that their nose is too long—it hangs down and they want it picked up.

In other cases, patients want a short nose made longer, which is a much more difficult operation.

Is there a standard for the angle of the nose tip?

Yes. The bottom of a man’s nose typically makes about a 90-degree angle with his face. For a woman, it’s more like 110 degrees. So the tip of a woman’s nose is usually turned upward just a little bit.

Does nose-reshaping surgery always involve fracturing the nose?

Not always. If a patient just needs some changes in the tip or maybe the angle at the bottom of the nose, there is no need to break the nose. This, of course, makes recovery much quicker.

When does rhinoplasty involve fracturing the nose?

A rhinoplasty involves fracturing the nose when there is a hump or other structure that needs to be reduced in size.

Why does the nose need to be fractured?

The two nasal bones on the sides of your nose come together like a teepee or a pyramid. Up the middle, there’s a strut called the septum—so the structure of the nose is like a triangle with a line in the middle.

I have to close that space between the nasal bones. If I just took off the hump, you’d see a big, flat spot with a divot in the middle of the nose. So, to prevent that, we use specially designed instruments to fracture the nasal bone precisely where we need to, then push it into position. This is what causes most of the bruising and swelling after rhinoplasty.

Now imagine a patient has a big hump on her nose and I need to remove the top of that hump. If I simply take off the hump, she’d be left with what we call an ‘open-roof deformity’—the hump would be gone, but there would be a space between the two nasal bones. Then the septum would be sticking up between them.

Where is rhinoplasty performed?

I perform rhinoplasty on an outpatient basis at Mount Sinai Hospital.

How long does nose-reshaping surgery take?

A rhinoplasty procedure takes only about 90 minutes.

What kind of anesthesia is used for rhinoplasty?

Rhinoplasty is done using a general anesthetic, which enables you to sleep during the entire procedure. It can also be done under sedation.

How long does recovery from rhinoplasty take?

You should be able to go back to work or school about 10 days after nose surgery.

How long does it take to see the final results of a rhinoplasty?

Healing is a slow and gradual process. You may notice some subtle swelling for months after surgery, especially in the tip. It really takes about a year before we really know what the final results will look like, although you’ll have a very good idea in six months.

Is rhinoplasty covered by insurance?

In some cases, the work on the septum and some of the sinus work is covered by insurance. The rhinoplasty itself is rarely covered unless there was an accident or fracture.

See financing and insurance for more information.

What results can you expect from rhinoplasty?

Your nose will be in much better proportion to your face; most patients find that having nose surgery gives their spirits a lift as well. If you have had reconstructive rhinoplasty, you will typically notice that your breathing or snoring difficulties have been greatly relieved.