Rhinoplasty (Aesthetic / Functional Nose Surgery)
Surgical reshaping of nasal bone, cartilage, and soft tissue for facial harmony and, when indicated, airway function
About This Treatment
Rhinoplasty surgically reshapes the nasal bones, upper and lower lateral cartilages, septum, tip framework, and soft-tissue envelope. It may address aesthetic goals such as a hump, tip shape, alar width, deviation, or asymmetry, and may also reconstruct the septum or nasal valves to improve breathing. Open and closed approaches can incorporate structural reconstruction, dorsal preservation, osteotomies, and cartilage grafts according to anatomy and goals.
This entry covers surgery and is distinct from the existing nonsurgical nose-thread or filler concepts. ISAPS estimated 1,083,631 procedures worldwide in 2024, making it a high-volume core operation, but year-over-year volume declined and it should not be described as globally accelerating. Current interest emphasizes natural proportions and tissue preservation, yet evidence does not show preservation techniques to be universally superior to structural methods.
Mechanism of Action
Osteotomy or rasping adjusts the bony vault and dorsum, while sutures, selective resection, and cartilage grafting rebuild tip, columellar, and alar support. Functional work may include septoplasty, spreader grafts, and nasal-valve support to preserve or improve airflow. Dorsal-preservation methods retain the osseocartilaginous dorsal continuity where appropriate and lower it with push-down or let-down maneuvers. Skin-envelope contraction, scarring, and long-term cartilage behavior also shape the outcome.
Indications
Expected Results
Major contour change is visible when the splint is removed after about 1-2 weeks, but edema—especially at the tip—can persist for months, and final assessment usually takes 12-18 months. A 2025 meta-analysis of dorsal preservation versus reduction (10 studies, 1,339 patients) found fewer dorsal irregularities but more residual or recurrent hump with preservation, with no significant difference in functional outcomes, overall aesthetic outcomes, or revision surgery. Patient-reported outcomes generally improve after surgery, but substantial heterogeneity in measures, techniques, and populations prevents guarantees of an individual result or perfect symmetry.
Clinical Evidence
Risks & Side Effects
Substantial swelling, bruising, pain, epistaxis, infection, scarring, sensory or smell change, asymmetry, contour irregularity, tip stiffness, graft warping or resorption, and dissatisfaction may occur. Persistent or worsened obstruction, nasal-valve collapse, septal perforation, skin injury or necrosis, anesthesia complications, rare visual injury, and revision surgery are possible. Smoking, prior surgery, very thick or thin skin, scar tendency, and body-dysmorphic concerns require careful preoperative assessment.
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