The rhinoplasty process

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About the rhinoplasty process

In these toggles, we’ve provided some general information about the procedure. For specific information about how we can help you, contact us for a consultation.

I choose the technique of your rhinoplasty depending on your suitability for either open or closed surgery. 

Your suitability for an open or closed approach depends upon what exactly is required to refine your nose. I will explain the appropriate technique once I have assessed your nose, and we have discussed your goals.

The open rhinoplasty technique

I make a small incision across the strip of skin between your nostrils. I combine this incision with further incisions on the inside of the nostrils. The skin of the nasal tip is then carefully lifted, and the cartilages and bones of the nose are surgically corrected. At the end of the procedure, I redrape the skin and close the incisions with fine sutures. The small scar on the skin between the nostrils typically heals well and is barely perceptible in most cases.

I use this approach when significant alteration at the nasal tip is required or when grafts are needed. 

The closed rhinoplasty technique

I do not need to make any external incisions with this technique. I access the skin and the structures of the nose through incisions on the inside of the nostrils. Once I have corrected the cartilaginous and bony structures of the nose, I close the incisions with sutures. 

I commonly utilise this approach when the area of concern is the bony part or upper 2/3rds of your nose.

Before surgery

Before the day of surgery, I will take a detailed history from you; this will include your past medical history, medications, allergies, smoking habits, previous surgery and more.  I will also ask you about your complaints related to nasal breathing and your wishes regarding the external shape of your nose. 

I will then perform a clinical examination that will include inspection of the inside of the nose with an endoscope. This examination tells me about the condition of the midline partition of the nose (the nasal septum) and the mucosa on the side of the nasal air passage (the turbinate).  

I will also discuss in detail, which changes to the outside shape of the nose are realistic and how I can achieve them. I will take photographs of your nose before surgery in different planes. 

If you have previously undergone rhinoplasty and the cartilage obtainable from your nose is not sufficient for shaping and reconstructing your nose, I may need to harvest cartilage from your ear or rib.

After surgery

You can typically get up and walk around the evening of the surgery or the following morning. You will have a splint on your nose and may experience some bleeding from the nostrils; this typically subsides on its own or with Otrivine nasal sprays.

You should expect moderate swelling and some bruising of the skin following surgery. The degree of swelling differs from patient to patient. A cold mask may be placed over your eyes and above the splint to decrease swelling and bruising. Most of the swelling and bruising will subside in 7-14 days, although sometimes swelling can persist for up to 2 months.

You should expect to see the final appearance of your nose at the end of 1st year.

Postoperative care instructions

  • The first night keep your head elevated; the higher, the better. Sleeping in a recliner can help. You will need to keep your head elevated 30 degrees for the first week after surgery.
  • Drink plenty of fluids. 
  • Use a cool-mist humidifier at your bedside to help moisturize membranes in your nose and mouth.
  • Avoid any travel requiring rapid elevation changes, i.e., airline or mountain travel for 2-3 weeks.
  • Nasal saline mist spray must be used every 2-3 hours after surgery and can make your nose more comfortable after surgery.  These sprays are over-the-counter medications, and you can purchase them in any pharmacy.
  • You will need to perform nasal irrigations twice a day, the day after surgery.  At first, they will feel strange if you haven’t done them before.  Soon, however, they will become quite soothing as they clean out the debris left behind in your sinuses after surgery.  You can expect some bloody discharge with the irrigations for the first few days after surgery.
  • You can make up the mixture using this recipe: Mix ¼ teaspoon of non-iodised salt with a ¼ teaspoon of baking soda in 250mL of room temperature tap water. Use a squeeze bottle to flush the solution gently through one nostril and allow it to come out through the other nostril or from your mouth. Alternately, the ‘Sinus Rinse’ system by NeilMed is available at many pharmacies with prepared packets of salt-baking soda mixture.

What to avoid after surgery

  • If you are a smoker, please do not smoke for at least four weeks after surgery.
  • Nose Blowing and Straining:  You should avoid straining, heavy lifting (> 20 lbs) and nose blowing for at least 14 days after surgery.  Straining or nose blowing soon after surgery may cause bleeding.
  • If you have to sneeze, keep your mouth open to prevent nasal irritation.

Case 1 – Before and After Rhinoplasty

This young patient was concerned about the hump of his nose and their asymmetrical nostrils. He had difficulty breathing since his teenage years. He had a closed rhinoplasty to address these problems. The postoperative pictures were taken at three weeks from the date of surgery

Case 2 – Before and After Rhinoplasty

This patient was distressed with the large bulbous tip of her nose, the uneven profile and “masculine” angulation of her nose. She felt it was “too” big for her face.

She had an open rhinoplasty to correct the defects. These pictures were taken at three weeks following the surgery when she had significant swelling. This settled down over the next month to give a further refined nasal tip and profile.

What is the most appropriate age for a cosmetic rhinoplasty?

Studies suggest that a minimum age of 17 years is preferred to perform rhinoplasty as the bony structures of the face near completion and will not change much after this age. 

Infrequently it may be justified to perform the surgery at an earlier time. If this is the case, I will talk to you about the possible need for a second operation in future years.

Will I be asleep during surgery? Do I need to stay in the hospital?

I perform the surgery while you are asleep under general anaesthesia. The operation is usually performed as an outpatient day-case procedure unless done later during the day, in which case you may need to stay overnight.

Will I have an outside cast, inside foil splints and inside packing after nose surgery (rhinoplasty)?

At the end of the procedure, I will typically place small strips of adhesive tape over your nose and put a cast on these strips. You should leave the cast in place for at least 7 to 12 days after the surgery.  I do not usually place packing in the nostrils.

Will sutures be removed after nose surgery (rhinoplasty)?

If you undergo an open rhinoplasty, I place sutures on the skin between your nostrils. I will remove these 5-10 days after surgery and close the incisions inside the nose with absorbable material that don’t need to be removed. 

How long will I need to take off work and sport following surgery of the nose (rhinoplasty)?

Generally speaking the swelling and bruising around your eyes and nose may last up to 2-3 weeks. Most patients take two weeks off work after nose surgery.  

You should refrain from exercise before removal of the cast and splints. Once I have removed these, you may resume light sport with less intensity. However, please avoid strenuous physical activity for at least six weeks. You should avoid contact sports for at least one year.

Can I wear glasses after nose surgery (rhinoplasty)?

After the cast on your nose has been removed, I would ask you to refrain from using glasses for four weeks. You may need to obtain contact lenses for this duration.

Can I sunbathe after nose surgery (rhinoplasty)?

It is advisable to minimize sun exposure during the first year after rhinoplasty surgery, especially in the noon hours. Applying sunscreen and wearing a sun hat is urged. 

May I visit the sauna or steam bath after nose surgery (rhinoplasty)? 

I recommend avoiding these activities for about three months after surgery to allow the swelling to decrease more quickly.

Is nose surgery (Rhinoplasty) painful, and do I need pain medication?

After surgery, pain is mild to moderate for 1 to 3 days and is usually well managed with Paracetamol, Brufen or Codeine. You should not experience any severe pain, and if you do, you should visit your doctor as soon as possible.

Who benefits from a nose job / rhinoplasty?

For anyone who feels self-conscious about their nose
You feel like your insides don’t match your outsides

You know you are beautiful on the inside yet when you catch sight of yourself in the mirror, you don’t feel it reflects who you are. You want these two states to match up more closely.

You feel like your nose could use some adjustment to bring out your best.

Maybe it’s an unusual hook in your nose, or maybe it bends slightly to the right. Maybe you feel your nose is too big or too small for your face. Or, it might be that you feel the overall shape of your nose just doesn’t suit your face shape. We get it. You don’t feel like your nose helps you look your best.

You would like to change the shape of your nose but want a very natural looking end result

You’ve been thinking about changing the shape of your nose but you’ve seen some people that wound up with obvious looking changes and you really don’t want that. For you, the whole point of getting your nose treated is to finally not have to think about it anymore. You want a natural look that fits in so well with your face that everyone who meets you from now on will feel like you were born with your new nose.

Send us your selfie and you’ll get an idea of what you might look like

We’ll reply within 48 hours to give you a sense of what you can expect from rhinoplasty

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How it works

Three simple steps towards a more confident you

1. Chat about your concerns

One of the most challenging things you’ll do is take the first step. We’re here to help and guide you through the maze of options so that you can take it one step at a time.

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2. Get a consultation to understand your options

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3. Reveal your real self

Discover the feeling of regaining the confidence you hadn’t realised you’d lost. Every day you’ll notice the little things that come when you feel completely comfortable in your own skin.

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A rhinoplasty can help you escape the self-consciousness you feel and reveal a new you

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Hear what our patients have to say

Our reputation rests on the experience of our patients
“Mr. Supriya operated on my daughter Mia earlier this year carrying out a septoplasty and surgery to both turbinates. I am a nurse myself and have worked for many years in the operating theatre and cosmetic industry so I am used to dealing with surgeons. Mr Supriya is an amazing person, not only a very competent surgeon but a very kind caring man who put himself out completely to help and accommodate Mia for her surgery. For the first time in 12 years Mia can breath properly so to say we are grateful is an understatement.”
S.A., Septoplasty
“I was there for my medical examination. From setting up appointments, registration, consultation and check up process, all staff and Mrinal himself were exceptional. I would highly recommend the clinic and I am very happy with the results of my treatment.”
M. R., Deep Plane Facelift
“I have received only what I can describe as world class treatment from Mr Supriya. His care & professionalism has been a comfort for me from day one.”
A. C., Rhinoplasty
“Dr Supriya was very friendly, professional, and put me at ease straight away. He spent time talking to me about specifically what I wanted and gave me his honest advice. Consultations were always very positive, and I didn’t feel nervous for my surgery.”
K. T., Facelift
“The result from my surgery was fantastic – it was exactly what I wanted. I had an open septorhinoplasty, and as soon as I came out of surgery I could breath much better than before. To my surprise, I didn’t experience any noticeable facial bruising or swelling at any point in my recovery.”
G. E., Septorhinoplasty
“The results were so natural-looking that no one at work could tell I had anything done! I am delighted with my experience overall, and would certainly recommend Dr Supriya to anyone interested in cosmetic surgery, particularly rhinoplasty.”
G. v.H., Rhinoplasty
“My experience has been amazing from the first consultation till the surgery and even after the surgery. The support and care given by Steve (Patient Coordinator) and my surgeon Dr Mrinal Supriya has been amazing and comforting. I am very pleased with the results so far and I couldn’t be happier.”
C. T., Septorhinoplasty

Even more information about the rhinoplasty process

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Read more about rhinoplasty

I’m an expert in this area and have all of the answers to any questions you might have. However, If you’d like to continue learning about rhinoplasty, open up the toggles below to read more.
For an official overview of the treatment and to find out why patients have rhinoplasty, click here.
The NHS has provided useful information on rhinoplasty, including the cost and where to go to have the procedure. Click here for more information.
For an overview of the rhinoplasty procedure, and to find out what rhinoplasty could do for you, please read this useful article here. 

About the expert

Mr Mrinal Supriya | Facial Cosmetic Surgeon

FRCS (OTOL-HNS), MRCS Ed, DO-HNS, MS in ENT, MBBS

Mr Mrinal Supriya is a Consultant ENT Head and Neck Surgeon with a special interest in facial cosmetic surgery. He is among 30 cosmetic surgeons who are members of the Royal College of Surgeons’ voluntary registration scheme – a professional body that works to advance surgical practice and patient care.

Mr Surpriya has previously worked in top hospitals around the world including the UK, Australia and the USA. He has also spent time with Dr Andrew Jacono who has been named one of the top plastic surgeons in the USA.

In the UK, Mr Supriya has worked as an ENT Consultant at Northampton General Hospital & St. George’s University Hospital, London as well as Ninewells University Hospital, Dundee.

Mr. Supriya’s clinical interests are minimal-access facial cosmetic procedures with a further expertise in Deep Plane Facelift and Rhinoplasty. By focusing his cosmetic practice solely to the face, Mr Supriya has developed super-specialised skills and achieved extremely reliable results with high patient satisfaction.

Mr. Supriya is able to provide comprehensive expertise that can only come from super specialisation: eyelid rejuvenation, nose job, endoscopic brow, face and neck lift, lip rejuvenation, cheek rejuvenation, ear surgery, chin surgery, buccal fat pad resection and skin treatments.

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