Rhinoplasty, or cosmetic nasal surgery, is one of the most common cosmetic procedures performed today. The operation is usually carried out because a patient desires to improve his or her appearance. It is also frequently requested for repair of injuries, or correction of disfigurement from trauma. In addition, patients may also be influenced in their desire for surgery because of breathing obstruction, or other related functional problems. As this is a common procedure, and has been carried out for many years, technical refinements have allowed consistently good results, which are considerably better than they were 25 to 50 years ago. Nevertheless, patients must understand that the goal of this operation is improvement, and that perfection usually cannot be achieved. Patients who expect too much may be disappointed. Cosmetic nasal surgery is performed to bring the nose into harmony with the face, thereby improving overall appearance.

There is no standard operation for rhinoplasty. The plastic surgeon takes into account the patient's nasal features that need to be changed, carefully examining the nasal structure and the overlying skin covering. With this information, the surgeon and patient discuss the realistic modifications that can be made to obtain the desired result. Often there is an underlying deviation of the nasal septum, which causes difficulty in breathing. This can be corrected at the same time.

The surgery is usually performed through incisions inside the nose, and if any external incision is made, it is usually small and inconspicuous. The surgeon separates the skin of the nose from the underlying bone and cartilage, re-shapes the cartilage skeleton, then redrapes the framework with the skin. The skin, with its natural elasticity, usually re-shapes nicely over the new-formed framework. This surgery can be done under local anesthesia with intravenous sedation, or general anesthesia, usually in an outpatient surgical facility. The various procedures during the reshaping include removal of the hump on the bridge of the nose, narrowing the nose, refinement of the nasal tip, and correction of the deviated septum. Chin augmentation may or may not be suggested to further enhance the facial profile. The nose is usually splinted for support and to reduce swelling. A dressing may be placed inside the nose. This dressing is usually removed within the first day or two after the procedure.

Swelling and bruising around the nose and eyes is expected for two to four weeks. Although most of the swelling subsides by six weeks, some long-term swelling may take six months to one year to resolve. Complications related to this operation include bleeding, infection, diminished sense of smell, scarring and minor irregularities. These problems are rare and resolve in time. It is important to remember that healing after this operation continues for up to a year, as the skin shrinks and adjusts to the new framework. Occasionally, the final result may be different than what was anticipated by the patient and/or the surgeon. Minor irregularities can be corrected with a revision procedure after all healing is complete.

Following rhinoplasty, the nose has an improved esthetic appearance, in harmony with the other facial features. The improved appearance of the nose is long lasting. Most patients are highly satisfied with the results of their rhinoplasty.