Rhinoplasty

Rhinoplasty is an aesthetic and/or functional surgery procedure aimed at modifying the shape and/or function of the nose. It is suited to individuals wishing to correct a dorsal hump, refine the tip, reduce nasal width, correct a deviated nasal septum, or improve nasal breathing. The surgical goal is to achieve a natural, harmonious result while respecting the balance of the face and the personality of each patient. The information presented here is intended for general guidance only and does not replace an individual medical consultation.

The Different Rhinoplasty Techniques

Rhinoplasty encompasses several surgical approaches that adapt the procedure to the specific needs of each patient. The choice of technique depends on nasal anatomy, the type of correction desired, and the balance sought between aesthetics and respiratory function.

Open rhinoplasty and closed rhinoplasty

• Open rhinoplasty: a small incision is made at the columella (between the nostrils) to directly access the internal structures of the nose. This technique offers excellent visibility and great precision, particularly for reshaping the tip, correcting a deformity, or performing a graft.
• Closed (endonasal) rhinoplasty: all incisions are made inside the nostrils, with no visible external scar. It is preferred for lighter corrections when direct access is not necessary.

The choice between open and closed rhinoplasty is made during the consultation, based on nasal morphology, the complexity of the procedure, and the patient's aesthetic and functional goals.

Reduction, profiloplasty, and reconstructive rhinoplasty

• Reduction rhinoplasty: aims to reduce the size or width of the nose, or smooth a dorsal hump.
• Profiloplasty rhinoplasty: aims to harmonise the facial profile by adjusting the tip and nasal bridge, often in relation to other facial structures (chin, lips).
• Reconstructive or functional rhinoplasty: restores the shape and function of the nose after trauma, a congenital malformation, or nasal breathing impairment, sometimes combined with septoplasty.

Secondary rhinoplasty

Secondary (or revision) rhinoplasty is performed after a previous nasal operation. It requires particular expertise due to the scars and anatomical modifications already present. It allows refinement of the aesthetic result or improvement of respiratory function when necessary.

Pre-operative Consultation

The initial consultation with the surgeon includes:

• Medical history: past medical history, surgical history, smoking, medications, motivations, and patient expectations.
• Clinical examination: external and endonasal examination, assessment of skin, cartilage, and facial morphology.
• Medical photography: taken for analysis and follow-up.
• Discussion of the project: explanation of possibilities, limitations, and appropriate techniques (open/closed rhinoplasty, need for septoplasty, possible grafts).
• Simulation: a digital simulation may be offered to visualise possible modifications, without guaranteeing the final result.
• Information on risks and alternatives.
• Provision of a detailed quote and information document.
• Reflection period: in accordance with regulations, a mandatory 15-day period must be observed between the provision of written information and the procedure.

Additional tests (blood panel, nasal X-ray or CT scan in cases of functional problems) may be requested. Smoking cessation is strongly advised before surgery to optimise healing.

Procedure

• Anaesthesia: generally general anaesthesia. For limited procedures, local anaesthesia combined with sedation may be possible.
• Duration: variable, generally between 1 and 3 hours depending on complexity.
• Hospitalisation: often day surgery (same-day discharge) or one night depending on the procedure and medical conditions.
• General steps: incision according to the chosen technique (open or closed), modification of cartilage and/or bone (resection, reshaping, grafts if necessary), possible correction of the nasal septum to restore breathing, closure of incisions.
• Traceability: detailed operative report in the medical record; specification of implants or grafts used if applicable.
• Safety: adherence to anaesthetic and surgical protocols to minimise risks, scheduled post-operative monitoring.

Post-operative Recovery

• Dressing and splint: an external splint (plaster or shell) is often placed and removed after approximately 7 days.
• Pain and discomfort: moderate, controlled by medication. Bruising and swelling around the eyes are common, decreasing in 10–15 days.
• Care: local hygiene, analgesics, antibiotic prophylaxis if indicated. Avoid blowing the nose in the first few days.
• Resumption of activities: return to work generally in 7–14 days depending on swelling and the nature of the work. Resumption of sport and intensive activities often deferred 4 to 6 weeks (or longer in cases of osteotomies).
• Follow-up: regular appointments scheduled (1 week, 1 month, 3 months, 6 months, 1 year) to evaluate healing and result evolution.

Results and Limitations

• Evolution: results stabilise progressively; residual swelling, particularly at the tip, may take several months to resolve. An appearance close to definitive is often observable between 6 and 12 months, with final refinement potentially taking up to 12–18 months.
• Individual variability: the result depends on skin quality, cartilage structure, age, and history. The goal is a natural, harmonious result, without any formal guarantee of outcome.
• Durability: the achieved shape is in principle lasting, but natural ageing and any trauma may alter appearance over time. A touch-up can sometimes be considered if necessary.

Risks and Complications

Possible complications include, non-exhaustively:

• General risks: anaesthetic reaction, infection, bleeding, haematoma;
• Local risks: prolonged swelling, bruising, visible scar (rare), altered skin sensitivity, asymmetries, insufficient improvement or need for revision, residual aesthetic defects;
• Functional risks: persistent or new nasal obstruction, septal perforation (rare), olfactory disturbances;
• Rare complications: thrombosis, embolism.

These complications are rare but must be explained and will be detailed during the consultation. Any complication is managed with appropriate follow-up.

Alternatives and Non-surgical Options

• Medical rhinoplasty (hyaluronic acid injections): can soften a dorsal hump or improve the profile without surgery; results are temporary and limited (does not correct breathing problems or bone reduction).
• Functional treatments: medical management of allergies, nasal devices, or isolated septoplasty if the problem is primarily respiratory.
• No procedure: accepting the current appearance of the nose remains an option.

FAQ (Frequently Asked Questions)

At what age can rhinoplasty be considered? As a general rule, it is advisable to wait until nasal growth is complete: around 16–18 years for girls and 17–18 years for boys, but the decision is personalised based on the patient's development and motivation.

Is the result immediately visible? An improvement is visible quickly, but the definitive result requires progressive resolution of swelling; complete stabilisation often occurs between 6 and 12 months, sometimes up to 18 months for the tip.

Are there visible scars? With the closed technique, scars are internal. With the open technique, a small scar is present at the columella; it is generally discreet but depends on individual healing.

Can breathing also be corrected during a rhinoplasty? Yes. Correction of the nasal septum (septoplasty) can be performed simultaneously to improve breathing.