What is a Rhinoplasty?

A Rhinoplasty is an operation designed to change the appearance and function of the external nose. It may be performed purely for cosmetic reasons or to improve the function of the nose or both. Every nose is different and accordingly the operation will be designed for the specific problems present in each individual.

The nasal skeleton is defined as those structures that support the external nose. It consists of an upper bony component, the nasal septum and the upper and lower lateral cartilages that support the lateral walls of the nose. A rhinoplasty addresses problems in some or all of these areas.

The Operation

Rhinoplasty is performed in hospital under general anaesthesia in most cases. It is often performed in conjunction with Septoplasty and Turbinate Surgery.

Access to the nasal skeleton is via either an internal or external approach. The internal approach is via incisions inside the nose whereas an external approach is via a small incision on the skin between the nostrils. In both cases the soft tissues over the nasal skeleton are elevated to allow visualisation. The external approach allows better access in more difficult cases.

Issues that can be dealt with by rhinoplasty include;

  • Nasal hump
  • A crooked nose
  • A bulbous tip
  • An asymmetric nose
  • Under or over projection of the nose
  • Nasal obstruction due to lateral wall collapse

At the end of the operation any incisions are closed and a supportive external splint is applied.

After surgery

The first night

An overnight stay in hospital is normal after the surgery. It is not uncommon have a small amount of bleeding on the first night. Pain is not normally a major feature.

Discharge from hospital

Around 7 AM the following morning the nursing staff will remove the packs. It is not uncommon to have a slight bleed at this point. I will usually be in around 730 AM to make sure all is well. Providing there are no concerns with bleeding, pain or nausea then discharge would normally occur mid-morning.


Following nasal surgery it is best to avoid food and drinks are too hot as they may increase bleeding. A cool to warm normal diet is satisfactory.


Because the nose is such a vascular structure excessive physical activity May provoke bleeding. I therefore suggest that strenuous physical activity is avoided for two weeks.

Pain relief

Pain is not normally excessive following nasal surgery. 

Surgery on the nose does however result in the release of natural compounds called inflammatory mediators. These are the same compounds that are released in viral infections and it is not at all unusual to have symptoms similar to a virus, such as lethargy and headache. Paracetamol is normally sufficient however panadeine forte is also prescribed in case it is required.

Nurofen should not be used.

Other medications

Salt-water nasal sprays or douches are also provided and help clear some of the mucus and congealed blood. These can be used as much or as little as desired as they are essentially for comfort.

Nose blowing

It is best to avoid nose blowing from the first few days as excessive or vigorous nose blowing may precipitate bleeding. Thereafter the nose may be blown gently, both nostrils open at the same time.

Nasal obstruction

It is normal to have some nasal obstruction for several days to a week following Rhinoplasty . This is due to swelling and congestion in a confined space. Sleeping with the head elevated may help to some degree.


It is normal to have bloody mucous discharge from the nose or an occasional small fresh bleed for a few days after the operation. If bleeding is heavy or prolonged you should contact me.

Bruising and swelling

These occur invariably after rhinoplasty varying from minor to quite marked. In particular bruising around the eyes is typical. Most of the swelling and bruising resolves within a week or two but some residual darkness under the eyes can persist for some time.

Postoperative instructions

You will be given instructions for care upon discharge. These are also available to download here. At discharge you will also be given a post-operative appointment and my mobile phone number.