Rhinoplasty Surgery Guide: Procedure, Recovery, and Aftercare Tips

A Medical Guide to Rhinoplasty: Procedure and Comprehensive Care

Rhinoplasty, commonly called nose reshaping surgery, is one of the most frequently performed procedures in facial plastic surgery. While many people associate it primarily with cosmetic improvement, rhinoplasty (“코성형”) also addresses functional concerns such as nasal obstruction, trauma repair, or congenital deformities. Because the nose is both aesthetically central and functionally vital, understanding the surgical process and the surrounding care is crucial for safe and satisfying outcomes. This guide outlines the typical surgical procedure, preparation steps, and evidence-based aftercare recommendations.

Preoperative Considerations

Medical Evaluation

A thorough preoperative evaluation sets the foundation for a safe surgery. Patients typically undergo:

• A detailed medical history review, including prior nasal surgeries, allergies, bleeding tendencies, and chronic illnesses.
• Physical examination focusing on nasal anatomy, septum alignment, skin thickness, and airway patency.
• Imaging or endoscopy if breathing issues or internal abnormalities are suspected.

Patient Expectations

Psychological readiness is just as important as physical readiness. Surgeons often emphasize:

• Clear communication about desired changes.
• Realistic understanding of surgical limitations.
• Awareness that final results may take up to a year to stabilize.

Pre-Surgery Instructions

Patients are usually advised to:

• Avoid aspirin, ibuprofen, and herbal supplements like ginseng or garlic for at least 2 weeks, as they may increase bleeding.
• Stop smoking, since nicotine impairs wound healing.
• Arrange postoperative support, as swelling and nasal packing can temporarily limit daily activities.

The Surgical Procedure

Anesthesia

Most rhinoplasties are performed under general anesthesia, though selected minor cases may use local anesthesia with sedation. General anesthesia provides optimal comfort and airway control.

Surgical Approach

There are two primary approaches:

1. Closed Rhinoplasty: Incisions are hidden inside the nostrils. This technique leaves no external scars but offers limited visibility for complex corrections.
2. Open Rhinoplasty: A small incision is made across the columella (the strip between the nostrils). Although it leaves a fine scar, it gives surgeons direct access and greater precision.

Steps of Operations

• Exposure of Nasal Structures: The surgeon carefully lifts the soft tissues to reveal the cartilage and bone.
• Reshaping: The surgeon removes, adds, or repositions cartilage and bone depending on the case. Common techniques include dorsal hump reduction, tip refinement, septoplasty for a deviated septum, and grafting for reinforcement.
• Stabilization: The surgeon harvests cartilage grafts from the septum, ear, or rib to strengthen the nasal framework.
• Closure: The surgeon repositions the tissues and closes the incisions with sutures. Splints or packing support the new nasal shape and help control bleeding.

Most rhinoplasty procedures take 1.5 to 3 hours, depending on the complexity.

Immediate Postoperative Phase

Recovery Room

Patients are monitored closely until anesthesia wears off. Vital signs, oxygenation, and bleeding are checked. Most go home the same day, unless additional procedures or medical concerns require observation.

Common Early Symptoms

• Swelling and bruising around the nose and eyes.
• Nasal congestion due to internal swelling or splints.
• Mild to moderate discomfort, usually controlled with prescribed analgesics.

Postoperative Care and Management

Wound and Splint Care

• External splints typically remain in place for 5–7 days to stabilize the nasal framework.
• Internal packing, if used, is removed within 24–72 hours.
• Sutures across the columella (in open rhinoplasty) are removed within 5–7 days.

Activity Restrictions

• Avoid heavy lifting, vigorous exercise, and bending forward for at least 2 weeks.
• Sleep with the head elevated to reduce swelling.
• Avoid glasses resting on the nasal bridge until cleared by the surgeon.

Hygiene and Comfort

• Saline sprays help keep nasal passages moist and reduce crusting.
• Patients should avoid blowing their nose for at least 1–2 weeks.
• Cold compresses applied gently around, not directly on, the nose can ease swelling.

Nutrition and Lifestyle

• Hydration and a balanced diet rich in protein and vitamins (especially vitamin C and zinc) support tissue repair.
• Strict avoidance of smoking and alcohol during the healing phase prevents delayed recovery and complications.

Potential Risks and Complications

While rhinoplasty is safe in experienced hands, it carries risks like any surgery:

• Bleeding or infection.
• Septal perforation (rare but possible).
• Prolonged swelling or numbness.
• Dissatisfaction with cosmetic results.
• Breathing difficulties if nasal airway narrows unintentionally.

Early detection and surgeon follow-up are essential to manage these issues effectively.

Long-Term Recovery

• Swelling Timeline: Major swelling subsides within 2–3 weeks, but subtle refinement continues for 6–12 months.
• Follow-up Visits: Regular checkups allow the surgeon to monitor healing and address concerns promptly.
• Revision Surgery: About 10–15% of patients may seek revision for functional or aesthetic adjustments. Preventive steps include careful planning, realistic expectations, and strict adherence to aftercare.

Conclusion

Rhinoplasty is a delicate balance of artistry and surgical science. Success depends not only on technical skill but also on patient education and diligent postoperative care. By preparing thoroughly, following medical guidance closely, and maintaining realistic expectations, patients maximize both the functional and aesthetic benefits of this transformative procedure.