People who decide to undergo nose enhancement or corrective surgery, for which the collective term is rhinoplasty, do so for a variety of reasons. In many cases the change is for aesthetic purposes, to whittle down a nose that is too prominent or hooked, or to give additional definition and sharpness to a nose that is flat or bulbous. Sometimes, people will fracture or injure their noses in some way, or suffer from a genetic defect that inhibited the proper formation of the nose. In either case, breathing may be impaired unless corrective surgery is performed.

A rhinoplasty may involve increasing or decreasing nose size, adjusting the tip and the bridge, fixing of the angle of the nose as it slopes downward, or altering the shape and size of the nostrils, or a combination of any or all of these processes. The type of incision used by the surgeon to access the inner tissue that composes the nose determines whether it is an open or closed rhinoplasty.

An open rhinoplasty begins with an incision across the thin strip of flesh and cartilage that divides the nostrils, otherwise known as the columella. The incision along this area allows the surgeon to lift the skin off the nose tip and reshape the nose cartilage with substantial precision. This technique is favored because of the unmatched access that the surgeon has from this vantage point. However, an open rhinoplasty is prone to scarring and will leave a small, barely noticeable scar beneath the nose, even after the healing process is complete.

A closed rhinoplasty is favored by patients who are concerned about external scarring, since the incisions are all made on the inside of the nose and will not be visible afterwards. This technique provides less freedom on the part of the surgeon when manipulating the cartilage, but if extensive work is not required, then the results will approximate those of an open rhinoplasty.

Regardless of the type of incision to be used, the rhinoplasty itself involves adjusting, removing and reshaping the nose cartilage and bone to achieve the look desired by the patient. In certain instances, augmentation of the nose will require the insertion of additional cartilage, taken directly from the septum, which is the partition in the middle of your nose, or from other parts of your body. Occasionally, cartilage from the ear or rib will be utilized. In some cases, the nose bones will be broken and reshaped, such as when correcting a deviated septum to improve breathing.

The rhinoplasty procedure will take about two hours, and will be performed under either general or local anesthetic, depending on the complexity of the surgery required. Afterwards, skin and soft tissue are draped over the reshaped nose bone and cartilage, and sutured closed. Splints and internal tubes will be used to support the nose and reinforce it over a period of about one week while it heals and adjusts to its new internal structure. There will be some swelling that subsides within a few weeks, but the new nasal contour will become fully defined after a much longer period, sometimes taking up to a year. Bruising around the eyes and cheeks is also common, and most apparent for up to three days after the surgery. It should fade, along with any other discoloration, within a week.

Strenuous physical activity should generally be avoided during the first few weeks, with patients able to resume normal exercise after three weeks of recovery. It must also be noted that the nose will be more vulnerable to sunlight during this period, and conscientious use of sunblock is highly recommended.