Rhino means nose and plasty means to shape, mold, or form. Rhinoplasty was the fifth most common procedure one by plastic surgeons in 2012, according to the latest statistics released by the American Society for Aesthetic Plastic Surgery (ASAPS). Many plastic surgeons feel rhinoplasty is the most artistic and difficult cosmetic surgical procedure. I agree, because the surgeon makes three-dimensional changes which instantly alter other areas of the nose.

Accurate preoperative analysis is 50 percent of the outcome. I encourage my patients to bring in photographs of how they envision the results. Only a limited number of experts specialize in rhinoplasty, so do your homework.

Rhinoplasty is done on a same-day basis. I prefer to use general anesthesia because there tends to be bleeding in the back of the throat, and this may be a problem with a semi-conscious patient. Ultimately, however, I tend to let the patient decide what anesthesia they would like. There are various techniques, depending on the anticipated outcome.

Because rhinoplasty is a complicated procedure and the nose swells during the operation, there is a chance you may need to have some post-surgery touch- ups. About 15 percent of rhinoplasty operations require touch-up procedures.

At the conclusion of the procedure a long-acting numbing agent is used to ensure the patient leaves the surgery center pain-free. A splint is usually placed on the nose for one week. The nose will be noticeably swollen for several days, and shouldn’t be blown. Half of rhinoplasty patients have some bruising. It may take up to a year or even long before all minor traces of swelling disappear, but the nose will definitely look better by the time the splint comes off after surgery.

The biggest limitation with rhinoplasty is thick skin, because this is difficult to shrink and conform to the underlying framework of the procedure. A surgeon can only do so much with a large nose if the skin won’t contract. Risks include infection, postoperative nose bleeds, numbness, swelling, possible collapse of the nose, external scarring, fullness, residual deformity, and holes inside the septal area of the nose.