Rhinoplasty

Rhinoplasty is performed under general anaesthesia and typically takes two to three hours depending on complexity. In the open approach, a small incision is made across the columella (the strip of tissue between the nostrils), allowing full exposure of the cartilaginous and bony nasal framework. The closed approach uses incisions entirely within the nostrils, leaving no external scar but providing more limited visualisation. The surgeon modifies bone, cartilage, and soft tissue according to the pre-operative plan, which may include hump reduction, tip refinement, base narrowing, or correction of septal deviation.

Ideal candidates are adults who have completed nasal growth (typically eighteen years or older), are in good general health, are non-smokers or have ceased smoking well in advance, and have realistic expectations regarding outcomes. Patients with very thick nasal skin have reduced definition from cartilage work and should be counselled accordingly. Functional concerns such as septal deviation and turbinate hypertrophy may be addressed concurrently with aesthetic rhinoplasty.

A nasal splint is worn for approximately seven to ten days post-operatively. Significant bruising and periorbital oedema typically peaks at two to three days and resolves over two to three weeks. Patients are generally advised to remain near the surgical facility for a minimum of seven to ten days before travelling. The nose continues to refine over twelve to eighteen months as residual oedema subsides, particularly in the nasal tip. Final results cannot be fully assessed until this period has elapsed, and minor asymmetries apparent at one month may improve substantially. Revision rates in published series range from five to fifteen per cent.

Rhinoplasty pricing varies substantially with the complexity of the case and the seniority of the operating surgeon. Quoted fees generally include the surgeon's fee, anaesthesia, and operating facility costs. Patients should confirm whether the quote covers only primary rhinoplasty or also includes concurrent septoplasty if functional correction is required, as the latter may attract a supplementary fee. Cartilage grafting using costal (rib) cartilage adds both surgical complexity and cost compared to tip work using existing nasal cartilage.

Additional costs that may not be included in the headline price are pre-operative blood tests and medical clearance, the anaesthetist's separate fee (common in some countries), post-operative medications (antibiotics, antiemetics, analgesics), nasal splint and dressings, the initial consultation and 3D imaging or morphing software session, and follow-up appointments. Revision rhinoplasty — should it be required — is invariably more expensive than the primary procedure and is rarely covered by any guarantee offered by the original surgeon.

The first week is the most demanding phase. Swelling, bruising around the eyes, and nasal congestion are at their peak in the first two to three days, then gradually subside. The nasal splint is worn continuously and removed at the surgeon's follow-up appointment at seven days; internal dissolvable sutures require no intervention, while any external columellar sutures are removed at the same visit. Most patients feel presentable and comfortable returning to light sedentary work by ten to fourteen days, though visible residual bruising may persist to three weeks.

Swelling diminishes progressively but unevenly. The majority resolves by six to eight weeks, at which point the overall shape is apparent, but the nasal tip — the last area to fully resolve — continues refining for twelve to eighteen months. Strenuous exercise and contact sports should be avoided for four to six weeks. Patients should protect the nose from sun exposure during the first year to prevent pigmentation changes in the skin. A follow-up appointment at three months provides an interim review, with final result assessment at twelve to eighteen months.

Rhinoplasty requires patients to remain near the surgical facility for a minimum of seven to ten days post-operatively. The splint removal appointment, which typically takes place at seven to ten days, is a mandatory follow-up and should not be missed. Patients flying home before splint removal risk incomplete wound assessment and may have difficulty finding a local practitioner willing to manage another surgeon's fresh rhinoplasty case. Long-haul flights during the acute post-operative period also carry risks of increased swelling and discomfort.

The twelve to eighteen month window for final results means that any concerns about the outcome will arise long after the patient has returned home. Revision rhinoplasty, if needed, would ideally be performed by the original surgeon to maintain continuity, but returning abroad for revision adds significant cost and logistical complexity. Patients should request comprehensive operative notes, photographs, and details of any grafts or implants used before leaving the clinic. It is advisable to identify a rhinoplasty-experienced ENT or plastic surgeon in the home country who can manage any post-operative concerns and conduct the long-term follow-up appointments.