Rhinoplasty Surgery Procedure: Step by Step

A beautiful nose with a lifted tip and a small bridge can improve everyone's look. Today, various surgical and non-surgical methods can enhance facial harmony and improve nasal function by eliminating deficiencies. Rhinoplasty is a surgical procedure that not only reshapes your nose but also corrects its structural defects. This article discusses a nose job's preparation, procedure, aftercare, etc., and provides tips about nose surgery. 

What Is Rhinoplasty Surgery?

A rhinoplasty or nose job surgery is one of the world's most common and popular cosmetic surgery procedures. It involves a surgical procedure on the nose that involves changing its shape or improving its function.

During nose surgery, certain nose parts (bone and cartilage) are changed to make them more compatible with other parts of the face. A rhinoplasty procedure is associated with maintaining proper respiratory function, meaning that not only does the patient not get into trouble breathing after the surgery, but also, if there is a breathing problem, it will improve.

Rhinoplasty Procedure

The rhinoplasty surgery procedure depends on several factors, such as the nose's shape, the nose, the nose's structure, the patient's expectations, and the surgeon's discretion.

Consultation

This is the initial meeting with the surgeon to discuss the patient's goals, medical history, and any concerns. The surgeon will assess the nose's structure and take photographs for planning.

Preoperative Preparations

Prior to the surgery, the patient may need to undergo certain tests and stop taking specific medications. Detailed instructions about eating, drinking, and smoking are given. The patient is also advised to arrange for transportation and postoperative care.

Anesthesia

The surgery begins with the administration of anesthesia. Depending on the complexity of the procedure and patient preference, either general anesthesia or local anesthesia with sedation is used to ensure the patient is comfortable and pain-free.

Incision Making

The surgeon makes incisions to access the bones and cartilage of the nose. There are two primary techniques:

• Closed Rhinoplasty: Incisions are made inside the nostrils, leaving no visible scars.
• Open Rhinoplasty: An incision is made across the columella (the narrow strip of tissue between the nostrils) for better visibility and access.

Reshaping the Nose Structure

The surgeon reshapes the nasal bones and cartilage to achieve the desired form. This may involve removing or adding bone or cartilage. If additional cartilage is needed, it may be taken from the septum, ear, or rib.

Correcting a Deviated Septum

If the patient has a deviated septum, the surgeon will straighten it and reduce the projections inside the nose to improve breathing.

Closing the Incisions

Once the underlying structure of the nose is reshaped, the surgeon redrapes the nasal skin and tissue and closes the incisions. Additional incisions may be made in the natural creases of the nostrils to alter their size or shape.

Recovery and Postoperative Care

After the surgery, the patient is monitored in a recovery room. They may have a splint and gauze dressing on their nose to support and protect the new structures during initial healing. Detailed postoperative care instructions are provided, including instructions on how to manage swelling and bruising, activities to avoid, and signs of complications to watch for.

Follow-Up Appointments

The patient will have several follow-up appointments to monitor healing and ensure that the results are as expected. The surgeon will remove any stitches and address any concerns or complications.

How Is Open and Closed Nose Surgery Performed?

In general, rhinoplasty is done in two ways: open and closed.

Open Rhinoplasty

In open rhinoplasty, done under general anesthesia, the surgeon makes an incision between the nostrils and lifts the nasal skin. By doing so, they have more access to the inner part of the nose and can shape its structure more precisely. Once the structure and shape of the nose are changed, the skin of the nose is returned to its place, and the incision is sutured. In most cases, the nose will be covered by a splint and gauze bandage to reduce bleeding and prevent nasal injury. Your healthcare provider will remove these bandages and splints a few days after the nose surgery.

Closed Rhinoplasty

In closed rhinoplasty, done under general or local anesthesia, the surgeon makes incisions inside the nostrils to separate the skin from the cartilage. After reshaping the nose by shaving the nasal bone, the incisions are sutured by absorbable stitches, and the patient is transferred to the recovery room. It is noteworthy that closed rhinoplasty takes less time, and its recovery period is shorter.

Read more: What are the Differences Between an Open and Closed Rhinoplasty?

Fleshy and Bony Nose Rhinoplasty

A fleshy nose and a bony nose represent distinct anatomical variations that individuals may seek to address through rhinoplasty, a surgical procedure aimed at enhancing the aesthetic appearance and functionality of the nose. A fleshy nose rhinoplasty involves removing excess soft tissue, including cartilage and skin, which can contribute to a fuller or rounded nasal appearance. Rhinoplasty for a fleshy nose may involve:

• Sculpting and reshaping the nasal tip.
• Reducing the overall size.
• Refining the contours to achieve a more balanced and harmonious facial profile.

On the other hand, a bony nose often implies structural irregularities in the nasal bones, such as a prominent nasal bridge or deviations that can affect both appearance and breathing. Surgical intervention for a bony nose, known as septorhinoplasty, typically addresses bone-related issues, such as osteotomies to reshape the bones, correction of nasal deviations, and sometimes cartilage grafting to achieve the desired aesthetic and functional outcomes. In both cases, skilled surgeons tailor their approach to each individual's unique facial features and concerns to achieve optimal results in both form and function.

Rhinoplasty Surgery: How to Get Prepared?

Before undergoing rhinoplasty, you need to consider the following tips:

• Take the necessary lab tests and X-rays and provide the results to your surgeon a week before the surgery;
• Get a physical examination of your nose. Your surgeon probably examines your nostrils, nasal bone, and other facial features to choose the best rhinoplasty technique for you;
• Consult with your doctor about your expectations and desired results. Most surgeons use computer software to show your nose's appearance after the operation. You can discuss your preferences regarding the shape and size of your nose in the consulting session;
• Ask your surgeon to inform you about the potential risks and complications of a nose job;
• Mentally prepare yourself for nose surgery. You can use meditation and deep breathing techniques to reduce your stress; 
• Buy the things you will need after the surgery, such as a U-shaped pillow, ice packs, saline spray, tissue, and wet wipe, etc., in advance; 
• Avoid smoking and drinking alcohol from two weeks before the nose job;
• Do not take ibuprofen and blood thinners such as aspirin before the surgery;
• Avoid taking herbal supplements, vitamin E capsules, fish oil, and anti-inflammatory drugs before rhinoplasty as they increase the chance of bleeding;
• Provide a complete medical history, and if you have drug allergies, inform your surgeon before the surgery;
• Use more fluids and nutrients;
• Take a bath before the operation and do not eat or drink from 8 hours before the surgery;
• Wear front-closure clothes and avoid wearing tight and uncomfortable clothes;
• Avoid wearing makeup and jewelry on the day of the operation;
• Shave your beard and mustaches with a razor to prevent infection and
• Ask a family member or a friend to be your caregiver when you are in the hospital. 

Read more: Preparing for a Nose Job: Do's and Don'ts before Rhinoplasty

How Long Is a Rhinoplasty Surgery?

Generally, open rhinoplasty takes almost three hours, and closed rhinoplasty takes one to two hours. It also takes two to three hours to regain consciousness in the recovery room. Since this cosmetic nose surgery is mainly done under general anesthesia, your vital signs will be monitored in the post-anesthesia care unit (PACU) for a couple of hours. Then, you will be transferred to the general ward, where you should stay a night. The next day, the doctor will check your nose, and if everything is normal, you will be discharged.

What Should I Expect After Getting Rhinoplasty?

For a few days after rhinoplasty surgery, your nose is stuffed, and you cannot breathe through it; however, you should avoid inserting a cotton swab or finger inside your nose as it causes injury and more swelling. Also, while the tip of your nose is numb for a few days, the skin of other parts of the nose is itchy and painful. Remember that the nasal skin is sensitive to touch for a couple of days after the nose surgery, so scratching or hitting it will cause more pain. It probably takes a few months for your nasal skin to return entirely to normal after rhinoplasty.

When the splints are removed, your healthcare provider will teach you how to tape your nose. To achieve the best results, you should constantly tape your nose after rhinoplasty for the next few months. 

Rhinoplasty Recovery

The duration of the rhinoplasty recovery period depends on the type and severity of the surgery. On average, the recovery time of open rhinoplasty is between four to six weeks, while the recovery period of closed rhinoplasty is much shorter. Although the bruising around your eyes and nose fades away 10 to 15 days after the operation, the swelling may last a year or more. Whether you undergo open or closed rhinoplasty, you can return to work ten days after the nose surgery.

Read more: Rhinoplasty Aftercare: All Recovery Tips You Need to Know

After Rhinoplasty: Step by Step

If you wonder what happens after rhinoplasty surgery and how you should care for your nose after the surgery, read the following passage.

• Right after the nose job 

After the nose job surgery, doctors will wrap up your nose, and two tampons are put inside your nasal cavity to prevent bleeding. Meanwhile, your caregiver must put a cold compress around your eyes and forehead to minimize the swelling and bruising around your nose. 

After the nose surgery, you can only drink water and juice. Early hydration after rhinoplasty flushes anesthesia from your blood flow and helps you regain consciousness sooner. Feeling nauseous and dizzy is also common after rhinoplasty surgery and can be controlled with the help of anti-nausea medications. 

• At home (or hotel)

If everything goes well, you will be discharged from the hospital 24 hours after the operation. Since your face is bandaged and your eyes are half-closed, you cannot drive, so you must ask someone to drive you home. At home, you should eat soft dishes and drink lukewarm fluids. Sleep supine and put a few pillows under your head to suit your convenience. 

• A couple of days after rhinoplasty surgery

Easy-to-chew dishes are suggested for one or two days after a nose job. Mincing and smashing food can also help you swallow your food more efficiently. Do not wash your face for a few days after the nose job because you may get your splint and bandages wet. You can shower and wash your face when the splints are removed and the bandages unwrapped. For some days after rhinoplasty, you may feel tightness and pressure in your nose, which is normal. When the internal splints and tampons after rhinoplasty are removed from your nostrils, you will feel less pressure on your nose and breathe through your nose again. 

• Weeks after the nose job

When the swelling and bruising have healed and the cast and sutures have been removed, your surgeon may prescribe repairing ointments to reduce suture marks under your nose. 

Taping the nose after nose surgery is of great importance because it prevents extra swelling and fixes the position of the tip of the nose. Usually, the patients have to tape their noses for up to 12 weeks. In the following weeks after rhinoplasty surgery, you need to visit your surgeon frequently to get the position of your nose, its shape, and its cavity checked. 

What to Eat After Nose Job? 

About four hours after the nose job surgery, you can have non-acidic beverages and soft dishes such as apple juice and soup. You can eat regular soft foods like mashed potatoes and scrambled eggs the day after the nose surgery.

For two weeks, avoid foods and fruits that require biting, chewing, and heavy jaw movement, such as apples, raw carrots, celery, chips, nuts, corn on the cob, etc. Also, it is recommended to avoid having milk, sour juices, spicy dishes, foods with too much sodium, and beverages with caffeine for a couple of days after the nose surgery, as they may cause digestive problems and increase nasal swelling.

Read more: Best Foods After Rhinoplasty

What Not to Do After Rhinoplasty?

After rhinoplasty, you should consider the following tips to minimize the side effects and speed up the healing process.

• Avoid strenuous activities and sports such as weight-lifting, swimming, mountain climbing, cycling, wrestling, etc.;
• Avoid taking a shower as long as there are splints on your nose;
• Avoid sexual intercourse;
• Avoid pushing, pulling, and lifting heavy objects;
• Avoid bending your head;
• Do not blow your nose;
• Avoid crowded places where there is the possibility of getting hit in the nose;
• Avoid smoking and drinking alcohol;
• Do not wear glasses and tight face masks until your doctor allows you to;
• Avoid sun exposure; 
• Do not sneeze or cough;
• Do not laugh or cry hard, and
• Don't drink through straws.

Rhinoplasty Result

The final result of surgery will be apparent when the swelling after rhinoplasty has subsided, i.e., almost a year after the operation. The good news is that the major swelling and discoloration will fade away three months after the nose surgery so that you can see the actual result of the surgery from the third month onwards. Keep your face relaxed, avoid sun exposure, and tape your nose as instructed to shorten this period. 

Best Candidate for Rhinoplasty Surgery

Anyone applying for rhinoplasty may not be a good candidate for nose surgery. A good candidate for nose surgery should:

• Be physically healthy and don't have serious medical conditions or illnesses;
• Be mentally healthy. People with severe psychological problems such as depression are not ideal candidates;
• Be at least 18 years old;
• Have elastic skin with average thickness;
• Have a full-grown nose;
• Not be a smoker;
• Have a clear and realistic expectation of the surgery;
• Be able to take at least one week off from work.

Possible Side Effects of Rhinoplasty

Some of the common side effects of rhinoplasty include:

• Bleeding and infection: These are the most common complications of nose jobs, which can be eliminated by taking or avoiding some medications. For instance, your doctor probably asks you to cut off the inflammatory medications if you have frequent nosebleeds after a nose job. Also, if you have a nasal infection, you should use antibiotic pills or ointments to reduce it.
• Breathing problems: if the nose becomes too small during the surgery, the patient will have a breathing problem, especially when sleeping. To solve this problem, most surgeons offer to perform revision rhinoplasty.
• Scarring: in both open and closed rhinoplasty, scarring is possible. To minimize the scars and their complications (such as changing the contour of the nose), the doctor prescribes specific ointments.
• Swelling and bruising: These two are inevitable side effects of rhinoplasty surgery, which will subside over time. However, you can get rid of them sooner by putting ice compressions on them three times a day and elevating your head when sleeping.  

Read more: Infection in Nose After Rhinoplasty: Signs & Treatment

There are also other complications after nose surgery, such as:

• Hematoma or accumulation of blood under the skin;
• Allergy to anesthetics;
• Rupture of a small blood vessel on the skin;
• Nose Asymmetry and
• Mild pain for a few days after surgery.

Is Rhinoplasty Painful?

Generally speaking, rhinoplasty surgery is almost a painless procedure. Some patients who have undergone open rhinoplasty have reported mild pain in the nasal area and felt the pressure inside their nose for a week after the operation. Also, the bruising and swelling around the eyes may be sensitive to the touch for a few days. Fortunately, the pain after the nose job is moderate and can be controlled by medication. 

When Should I Call the Doctor After Rhinoplasty?

You should be aware of the warning signs during the rhinoplasty recovery period. In case you have any of the following symptoms, call your doctor ASAP:

• Fever;
• Severe pain that cannot be controlled by medication;
• Abnormal swelling;
• Yellow or green pus discharging from the incision site;
• Bad smell coming out of the incisions and
• Constant nosebleed.

It would help if you remembered that bruising and swelling are normal and inevitable complications of a nose job surgery, so they are not considered warning signs.

Cleaning Nose After Rhinoplasty

There may be blood discharges from your nasal cavity for two to four days after rhinoplasty. These discharges should be gently wiped with a towel or wet wipe. When cleaning your face, avoid inserting any object into your nose or holding pressure on the nostrils. Moreover, in order to prevent bleeding, avoid blowing your nose for up to a month after the nose job. 

Rhinoplasty surgeons usually ask patients to use dilute hydrogen peroxide, saline spray, or bulb syringes to clean their noses after the nose surgery. These products can be purchased from the drugstore and are easy to use. 

Read more: How to Clean the Nose After Rhinoplasty Properly?

Scarring After Nose Job

Scarring after a nose job depends on several factors, the most important of which is skin type. In people with bright and thin skin, the scars usually fade away within two months; however, in patients with dark skin tone, the scars remain a bit longer, and sometimes keloids (extra flesh) develop on the incision site. 

Usually, the scars of rhinoplasty surgery disappear after several months, but if your scars are permanent and visible, you can use one of the following treatments:

• Injecting cortisone steroid shots;
• Doing corrective surgery;
• Using silicone sheets or silicone ointments;
• Applying scar creams such as polysporin and bacitracin; and
• Applying creams that contain vitamins A, E, Aloe Vera, collagen, and Vitamin C.

Read more: Rhinoplasty Scar Healing: How to Get Rid of Nose Job Scar?

Revision Rhinoplasty

Revision rhinoplasty, also known as corrective rhinoplasty and secondary rhinoplasty, is a nose surgery performed to eliminate nasal deficiencies that were not completely corrected in the initial operation. In this surgery, the nostrils are symmetrized, the nose tip is repaired, and the nasal septum deviation is corrected. Respiratory disorders that have emerged after the first surgery are eliminated, and the dents on the nose are removed. If you are dissatisfied with the outcome of your previous nose job, you can perform a revision rhinoplasty at least a year after the first operation.

In some cases, the surgeon has to get a cartilage graft from the patient's ear or rib to correct and reshape the structure of the nasal tip. Therefore, the recovery period of corrective rhinoplasty is a bit longer. During this period, avoid going to crowded places and do the same things you did after your initial nose job.

Nonsurgical Rhinoplasty

Although traditional rhinoplasty has numerous advantages, many prefer to get a nose job without surgery to avoid anesthesia complications and have a shorter recovery period. Nonsurgical rhinoplasty, commonly known as liquid rhinoplasty, is a cosmetic procedure involving injecting hyaluronic acid gel into the nasal tissues to alter the nose's shape and size or eliminate the nasal deficiencies caused by the initial nose job. Although rhinoplasty without surgery has low risks and side effects, its results only last 8 to 12 months. 

Read more: What Does a Liquid Rhinoplasty Do?

What’s the Difference Between Rhinoplasty and Septoplasty?

Septoplasty, also known as nose bone surgery and septal reconstruction, is a surgical procedure in which nasal bone is reshaped, repositioned, and straightened. This operation suits those suffering from breathing issues due to a deviated (crooked) septum. Also, septoplasty improves the shape of the nose by removing extra cartilage from the side of the nose. Fortunately, nose bone surgery is considered a minor operation with a short recovery period. 

Why Do Rhinoplasty in Iran?

In recent years, rhinoplasty has been done at high rates in Iran, which has made the country a popular destination for rhinoplasty candidates worldwide. 

One of the main reasons for the large number of rhinoplasties in Iran is the nasal anatomy of Iranians, which is different from European countries. For this reason, Iranians are more likely than other countries to apply for nose surgery. 

In Tehran and several other cities, nose job operation is done by well-trained and skillful surgeons. Iran is a good destination for cosmetic nose surgery because of the high-quality clinics and hospitals, skilled and experienced surgeons, and affordable costs. Over the last few years, some famous foreign celebrities have traveled to Iran for rhinoplasty, which shows that Iran can be regarded as a global rhinoplasty hub.

Iran Rhinoplasty Cost 

You can benefit from all kinds of health services in Iran at a much more reasonable price than in other countries. Nose job surgery is also not very costly in Iran. Raadina Travel Co. offers affordable rhinoplasty packages whose prices vary due to several factors, such as the accommodation type and other services you receive.

To sum up, a nose job is one of the most popular plastic surgeries in the world, which can enhance your beauty to a significant extent; you will achieve the best possible result from nose surgery by carefully following the mentioned guidelines. The first and most crucial step in rhinoplasty is to choose an experienced and knowledgeable surgeon because it can directly affect the result of the operation.

Raadinahealth team, with years of experience in health tourism, can help you choose the best rhinoplasty surgeons in Iran and offer you the most appropriate package for a nose job.

nose job in Iran

FAQs on Rhinoplasty

1) Does rhinoplasty improve breathing?

Although rhinoplasty is a cosmetic surgery, it can improve breathing to a great extent. During the operation, the doctor eliminates the passage through which air flows widen, resulting in the patient's breathing problems.

2) Can I choose the shape of my nose?

In the consulting session before rhinoplasty, the doctor shows you what your nose will be like after the surgery. In this session, you can discuss your expectations from the operation with your surgeon.  

3) Does rhinoplasty last forever?

Yes, the results of rhinoplasty are lifelong.

4) Does rhinoplasty help with snoring?

If the cause of snoring is a defect in the structure of the nose, it can be corrected through rhinoplasty.

5) What is the best age to get a nose job?

The ideal age for getting a nose job is between 18 and 40 years old.