Cosmetic and medical rhinoplasty: indications and contraindications

Many operations combine both goals. Correcting the shape without checking the airway can worsen breathing, and fixing the airway without considering appearance can change the look of the nose, so a good surgeon always assesses both.

• Nasal injury: after a fracture the nose may heal crooked or flattened, with both visible deformity and blocked breathing.
• Marked breathing problems: constant congestion on one or both sides, mouth breathing, snoring or poor sleep linked with the structure of the nose.
• Saddle nose: a collapsed bridge, often after injury or earlier surgery, which can affect both support and airflow.
• Nasal polyps: growths in the nasal passages that block breathing; their treatment is planned together with the specialist who assesses the nose.

Before a medical operation the surgeon examines the inside of the nose and usually orders imaging of the sinuses to understand exactly what narrows the airway.

The aim of modern cosmetic surgery is not a standard nose but one that suits your face. That is why honest expectations matter: surgery can make the nose more harmonious, but it cannot copy someone else's nose or change the rest of the face. At the consultation the surgeon explains what is realistic for your anatomy.

• skin damage in the area of the planned surgery.

Some contraindications are temporary: after an infection or inflammation clears up, surgery can be planned. The optimal age for primary rhinoplasty is usually 18 to 45, when the nose is fully formed and tissues heal well; with medical reasons, surgery can be done later if general health allows.

• Reconstructive rhinoseptoplasty: used after injuries or significant deformities; when the nose lacks its own cartilage for support, cartilage can be taken from a rib.
• Revision rhinoplasty: a repeat operation after an unsuccessful or partly successful first one, performed no earlier than a year after it.

An operation on the septum alone, without changing the outside of the nose, is a separate procedure. Here it is described only for context; the right option for you is chosen at the consultation.

Rhinoplasty is performed under general anaesthesia and usually takes 1.5 to 3 hours.

• First week: silicone splints in the nostrils and a nasal cast; breathing through the mouth in the first days, swelling and bruising.
• Day 7 to 14: the splints come out around day 7; the cast and stitches are removed by about day 14.
• First month: no sport, saunas, pools or sun, sleep on your back, no glasses resting on the nose.
• Up to 1–1.5 years: residual swelling, especially at the tip, slowly goes down, and the final shape settles.

Recovery after medical and cosmetic operations follows a similar course; after work on the septum, nasal congestion may last a little longer. Possible complications include bleeding, infection, irregularities or asymmetry, breathing problems and dissatisfaction with the result, which is more likely when expectations are unrealistic. Difficulty breathing, severe pain, high temperature or a change in the shape of the nose are reasons to contact the surgeon at once.

At the free consultation the surgeon examines your nose and facial proportions, listens to your goals, whether cosmetic, medical or both, creates a 3D model of the expected result and names the cost, which is fixed in the contract. The stay after surgery is one day. Check-ups are planned at 7 days, 3 and 6 months, and for a year after surgery consultations with your surgeon are free. A personal coordinator supports you from the first message to your final check-up. More details on the rhinoplasty page.