What is a rhinoplasty or ‘nose job’?

Cosmetic surgeon Mr Ken Stewart explains how a rhinoplasty operation works, and discusses other important information about the procedure.

Rhinoplasty is a cosmetic surgical procedure to change the shape of the nose. Most commonly this is through reducing the size of the nose, removing a hump or refining the tip.

What can the operation involve?

There are two types of rhinoplasty: reduction and augmentation. In a reduction rhinoplasty, cartilage and bone are removed or rearranged through cuts inside your nostrils to make the nose smaller. An augmentation rhinoplasty may involve enhancing certain features with bone or cartilage grafts.

You can also have a septorhinoplasty, an operation that combines a change in nasal chaps with surgery on the septum to improve the airflow.

Who is suitable for a rhinoplasty?

Anyone who is dissatisfied with their nasal appearance can have a rhinoplasty and has realistic expectations of what they can expect from the procedure.

Typically patients will have developed enlarged noses in their late teens and will be self-conscious about their appearance. But it is very important to have realistic expectations about what surgery can achieve.

Post-traumatic nasal deformity, for instance following damage caused in impact sports such as boxing or rugby, is another common reason for surgery.

What would a ‘nose job’ involve?

Surgery typically involves a general anaesthetic lasting two hours and an overnight stay in hospital. Many surgeons avoid packs (dressings placed in each side of your nose to keep things in place and prevent bleeding) as they are uncomfortable but they may be necessary overnight if you are having septal surgery.

Any splints and sutures are typically removed after one week. You may have some bruising around the eyes for ten to 14 days.

What can be changed about the shape of a nose?

Many features can be changed. Typically in a reduction rhinoplasty, the nasal projection can be reduced along with the hump, the tip can be refined and made less angular or flared, the nose can be made narrower and the angles between forehead and nose and between nose and lip can be improved.

These days surgeons avoid removing too much of the original nose, which could cause problems such as the 'ski jump nose'.

In augmentation rhinoplasty, grafts can be used to enhance features such as nasal profile, tip projection and nostril contour.

How long would it take to recover?

Modern anaesthetics are very short-acting, and post-operative sickness is rare. I woke up from my own nasal surgery feeling great.

During the first few days of your recovery you will be able to potter around the house. The bruising typically takes two weeks to settle. It will take several months for the swelling to settle and for your skin to adapt to the new nasal shape.

How quickly could I return to work?

This is dependent on your job; if you are a self-employed accountant that can work from home then you can return to your figures and computer screen after a few days.

If you have a physical job such as construction then three weeks of recovery would be the minimum.

If you are a self-conscious teacher and you don't want any trace of the surgery to be apparent in school, then I would recommend that your surgery is scheduled for the start of your summer break.

What results can I expect?

Your surgeon will try to fully understand what you are looking for from a rhinoplasty. He or she will also spend time explaining what is possible and what is not possible through surgery – you need to fully understand the limitations of surgery and the risk of complications. Most patients are ultimately satisfied with the results of surgery but realistic expectations are crucial.

What are the risks?

Temporary issues such as bruising are common. A small proportion of patients may seek revision surgery if, for example, there is a small irregularity that forms during the healing process.

It's difficult to overemphasise the importance of pre-operative consultations. Be sure to ask many questions; ask to see typical examples of photographs of your surgeon’s previous work. Be sure your surgeon understands what you are looking for and consider coming to see them several times prior to the day of surgery.


Mr Ken Stewart is a consultant plastic surgeon at Spire Edinburgh Hospitals, and was named in Tatler's annual Beauty and Cosmetic Guide as one of the UK's best facial cosmetic surgeons for 2015.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.

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Mr Ken Stewart

Mr Ken Stewart, cosmetic surgeon at Spire Edinburgh Hospitals

Mr Ken Stewart is a consultant plastic surgeon at Spire Edinburgh Hospitals in Scotland, and was named in Tatler's annual Beauty and Cosmetic Guide as one of the UK's best facial cosmetic surgeons for 2015.

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