How rhinoplasty is performed: from consultation to cast removal

The whole path usually looks like this:

Photos of the face are often used to build a 3D model of the future nose. It helps you and the surgeon agree on the goal and see what is realistic for your anatomy. A forecast is a planning tool, not a promise: the final result depends on healing and on how the skin settles.

At the consultation the surgeon also checks for reasons to postpone or avoid surgery, such as an active infection, poorly controlled chronic disease, bleeding problems, skin damage in the area or inflammation of the ear, nose or throat. Surgery is usually planned for adults, and the optimal age is often given as 18 to 45, although older patients can be operated on if their health allows.

• a physician’s report confirming there are no contraindications, and specialists’ reports if you have chronic conditions.

About a week before surgery you stop smoking and alcohol, limit salty and spicy food, avoid peels and other procedures that damage the facial skin, and agree with your doctor which medicines affecting clotting should be paused. On the day of surgery you do not eat or drink for at least six hours beforehand.

• Closed rhinoplasty. All incisions are inside the nostrils, so there is no external scar. It suits moderate changes, for example removing a small hump.
• Open rhinoplasty. A small incision across the skin between the nostrils lets the surgeon lift the skin and see the framework directly. It is often chosen for complex tip work, grafts and revision cases.
• Tip rhinoplasty. Work limited to the lower part of the nose, such as refining a bulbous or asymmetric tip.
• Rhinoseptoplasty. The septum is straightened in the same operation as the reshaping, to improve both breathing and appearance.
• Revision rhinoplasty. A repeat operation to correct an earlier result, usually no earlier than a year after the first surgery. Cartilage grafts, sometimes from a rib, may be needed to rebuild support.

Rhinoplasty is performed under general anaesthesia and usually takes from about 1.5 to 3 hours, depending on its complexity. The surgeon reshapes the bone and cartilage according to the plan, straightens the septum if needed, and closes the incisions. Soft splints are placed inside the nostrils and a light external cast is fitted over the nose to protect the new shape.

You wake up in the recovery area with the nose blocked, so you breathe through your mouth. Mild pain, a feeling of pressure and some swelling are expected and are managed by the medical team.

• Days 1–7. Breathing is through the mouth while the splints are in. Swelling and bruising reach their peak in the first days. Avoid bending over, touching the nose and wearing glasses.
• Around day 7. The inner splints are removed and breathing through the nose starts to return.
• Up to day 14. The external cast is worn for up to two weeks and removed together with the stitches.
• After the cast. The nose still looks swollen. For a month, avoid sport, saunas, pools, hot baths and the sun, and sleep on your back with the head raised.

The first improvement shows after two to three weeks, but the final shape is judged after 12 to 18 months.

This is general information: City Medical Centre does not offer non-surgical nose correction. If your goal can be reached without surgery, or if surgery is not right for you, the surgeon will tell you so at the consultation.

The first consultation is free and can be held online. Send photos of your nose from several angles, and the surgeon will assess your anatomy, prepare a personal plan with a 3D forecast and name the cost, which is fixed in the contract. Consultation and preparation can be organised in one trip. After surgery, check-ups are planned at 7 days, 3 and 6 months, and for a year consultations with your surgeon are free. A personal coordinator stays with you from the first message to the end of recovery, and photos and questions can be sent by Telegram. More details are on the rhinoplasty page.