Rhinoplasty: what the operation can and cannot change

Rhinoplasty is surgery to change the shape of the nose, the way it works, or both. It has a reputation as a straightforward cosmetic procedure. It is not: the nose is a structure of bone, cartilage and skin in which every change affects the parts around it, and the same operation performed on two people can heal quite differently. This page sets out how the operation is planned, what it can realistically achieve, and what the recovery asks of you.

Two different problems, often in the same nose

A rhinoplasty may be functional, aesthetic, or a combination of the two.

• Functional surgery addresses breathing: a deviated septum, collapsed nasal valves, enlarged turbinates, or deformity after an injury. The purpose is airflow, not appearance.
• Aesthetic surgery changes the shape of the bridge, the tip, the nostrils or the proportions of the nose in relation to the rest of the face.

Because the septum both supports the shape of the nose and divides the airway, a change made for one reason almost always affects the other. This is why a proper assessment examines the inside of the nose as carefully as the outside, even when your concern is purely about appearance.

The assessment

A consultation should cover your breathing, any previous nasal injury or surgery, allergies, sleep quality, medication and smoking, alongside what you want changed. The examination includes an internal look at the septum and the nasal valves. Photographs are taken from standard angles for planning — these are clinical records, kept confidentially.

An honest consultation includes the word "no". If what you are asking for would weaken the structure of the nose, look wrong on your face, or cannot be delivered by surgery, you should be told that at this stage rather than discovering it afterwards.

Open and closed techniques

In the closed technique all incisions are inside the nostrils. In the open technique a small additional incision is made across the columella, the strip of skin between the nostrils, which allows the surgeon to see and reshape the framework directly; it leaves a fine scar that usually becomes difficult to see. Neither approach is universally better. The choice depends on what has to be changed, and on whether this is a first operation or a revision.

The operation usually takes two to four hours under general anaesthesia, with one night in hospital.

What rhinoplasty can and cannot change

It can reduce a dorsal hump, narrow or straighten the bridge, refine or rotate the tip, adjust nostril width, correct asymmetry after trauma, and improve nasal breathing.

It cannot give you someone else's nose. Skin thickness sets a hard limit on how much definition is achievable — thick skin will not drape over a finely sculpted framework, and thin skin shows every small irregularity. Facial asymmetry does not disappear, because almost every face is asymmetrical to begin with. And a nose that has been over-reduced in pursuit of a smaller shape can collapse and obstruct breathing years later, which is one of the commonest reasons for revision surgery worldwide.

Recovery

• Week 1. An external splint, and sometimes internal silicone splints, are worn for about seven days. Bruising around the eyes is usual and peaks on days two to three. You sleep with your head elevated and avoid blowing your nose.
• Week 2–3. Visible bruising has largely settled. Most people return to office work after about ten days, and the nose still feels blocked as internal swelling resolves.
• Week 4–6. Light exercise resumes. Contact sports, and anything that risks a blow to the nose, wait for at least six to eight weeks. Glasses may need to be supported off the bridge.
• Month 3–12. Swelling continues to subside slowly, particularly at the tip, and tip numbness gradually resolves. The definitive shape is judged at around one year — longer in thick skin and after revision surgery.

Risks

• Bleeding in the first days, and infection, both uncommon
• Difficulty breathing through the nose, which can be temporary or, less often, persistent
• Asymmetry, irregularity of the bridge, or a shape that does not meet expectations
• Reduced or altered sense of smell, usually temporary
• Numbness of the nasal tip and upper lip, usually temporary
• A visible scar on the columella after open rhinoplasty, and poor scarring in people prone to it
• Septal perforation, rarely
• The need for revision surgery. Revision is not rare anywhere in the world, and it is not by itself evidence of a poorly performed first operation — healing is not fully predictable. Any revision is normally deferred for at least a year.

Risks are higher if you smoke, have a bleeding disorder, or have had previous nasal surgery.

Why we do not publish before-and-after photographs

Turkish health legislation does not permit hospitals to advertise treatment, and before-and-after galleries are advertising. There is a clinical reason as well: another person's result tells you very little about your own, because their skin, cartilage and bone structure are not yours. Photographs relevant to your case are reviewed with you in the consultation instead.

For the same reason you will not find prices, patient testimonials or campaign offers on this site. Surgery is not a purchase to be hurried, and any provider pressing you towards a quick decision is telling you something useful about themselves.

Questions worth asking your surgeon

• Is my breathing part of the problem, and will this operation affect it?
• Which parts of what I have asked for are realistic for my skin and structure — and which are not?
• Will the technique be open or closed, and why?
• What is your approach if I am unhappy with the result at one year?
• If I travel from abroad: how long must I stay, when can I fly, and how will you follow me up afterwards?

Rhinoplasty at Medinova is performed within our Plastic, Reconstructive and Aesthetic Surgery department by Surgeon Dr. Deniz Güneş.