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Rhinoplasty, or surgery to reshape the nose, is one of the commonest of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of the nose, change the shape of the tip or the bridge, narrow the width of the nostrils, or change the angle between the nose and the upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. Rhinoplasty can improve the appearance, but it won't necessarily change the patient's looks to match the imaginary ideal. The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes, to correct birth defects or breathing Problems. Age is also a consideration. It is better not to operate on teenagers until after they've completed their growth spurt -- around 14 or 15 for girls, a bit later for boys. It's important to consider teenagers’ social and emotional adjustment too, and to make sure it's what they, and not their parents, want. When rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. However, there is always a possibility of complications, including infection, nosebleed, or a reaction to the anesthesia. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible. In about one case out of ten, a second procedure may be required, for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons. The corrective surgery is usually minor. At the initial consultation, the patient is asked to describe what kind of nose is desired. The surgeon then will examine the nose in particular and the face in general and discuss the possibilities with the patient. The factors that decide the outcome of the surgery include the structure of nasal bones and cartilage, the shape of the face, the thickness of skin, age, and expectations. The patient is given specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing the face.

Where the surgery will be performed
Rhinoplasty may be performed as an outpatient surgery, or as an inpatient in a hospital. Complex procedures may require a short inpatient stay

The surgery
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery, the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on the problem and the surgeon 'preferred technique. Finally, the skin is red raped over the new framework. Many plastic surgeons perform rhinoplasty from within the nose, making their incision inside the nostrils. Others prefer an "open" procedure, especially in more complicated cases; they make a small incision across the columella, the vertical strip of tissue separating the nostrils.

The surgery
When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in the nostrils to stabilize the septum, the dividing wall between the air passages.

After surgery -- particularly during the first twenty-four hours -- the face will feel puffy, nose may ache, and there may be a dull headache. The swelling and bruising around the eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling -- unnoticeable to anyone but you and your surgeon -- will remain for several months.) A little bleeding is common during the first few days following surgery, and there may be some stuffiness for several weeks. If the nose is packed, it will be removed after a few days. By the end of one week, all dressings, splints, and stitches should be removed. In the days following surgery, when face is bruised and swollen, many patients feel depressed for a while -- it's quite normal and understandable. Day by day, the nose will begin to look better. Still, healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year.
If you are realistic in your expectations then you will be satisfied with the results.