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The invasiveness and permanency of a surgical procedure are often big considerations for those interested in going under the knife – you’ll likely have some downtime and there’s no going back. The market is ripe with non-surgical treatment options ([we recently broke down some of the most exciting advancements](https://aedit.com/aedition/best-new-nonsurgical-aesthetic-procedures)), but few cosmetic surgeries have a non-surgical counterpart that can offer similar results, sans operation. One of those unicorn pairings, however, is the ever-popular [surgical rhinoplasty](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty) and its less invasive sister, the so-called [liquid rhinoplasty](https://aedit.com/procedure/liquid-rhinoplasty). 

You may already know that both procedures can enhance the [shape of the nose](https://aedit.com/concern/nose-shape) and address aesthetic concerns, but, as it turns out, their commonalities don’t stop there. In fact, a liquid rhinoplasty “is a great alternative to surgical rhinoplasty for those interested in improving the side view of their nose,” says [Usha Rajagopal, MD](https://aedit.com/provider/usha-rajagopal-md-1330), a board certified plastic and reconstructive surgeon and founder of [San Francisco Plastic Surgery & Laser Center](https://www.sfcosmeticsurgery.com/). As she explains, it can even “improve some function concerns, however, it’s mostly for those who want to contour the [profile view](https://aedit.com/concern/nose-angle).” This is especially true, she says, “if they have a hump or a nasal bump.” 

<a href="https://youtube.com/shorts/UwL56Kc7LrQ?feature=share" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://youtube.com/shorts/UwL56Kc7LrQ?feature=share</a>

Since you’ve undoubtedly seen transformative [before and afters](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) of liquid rhinoplasty on social media, it’s time to get to the bottom of what the procedure can and cannot do. Read on for the top five things you should know about the non-surgical nose enhancement solution.

## **1. It’s a Quick – But Temporary – Fix** 
The most obvious differences between a surgical rhinoplasty and a liquid rhinoplasty: [recovery and results](https://aedit.com/procedure/rhinoplasty-nose-job/recovery). “This is not a permanent procedure and not a substitute for a [surgical rhinoplasty](https://aedit.com/procedure/open-rhinoplasty),” Dr. Rajagopal says. But, unlike a traditional rhinoplasty that requires [anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) to perform, a couple months to [recover](https://aedit.com/aedition/rhinoplasty-recovery-healing-process), and a year or more for [full healing](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures), it’s non-surgical counterpart “is only 10 minutes long and requires no downtime with minimal discomfort,” she notes. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/73KFqQVXtqmJC9fNtOTlK9/8da13478592e7c853a81d8990bd93725/LiquidRhino3.jpg}>
  A before (*left*) and after (*right*) look at one of Dr. Rajagopal's liquid rhinoplasty patients.
</CaptionImg>

In her practice, Dr. Rajagopal uses a [Restylane®](https://aedit.com/procedure/restylane) product because “it’s hyaluronic acid and can give a nice lift to the area of treatment.” Like HA filler for other areas of the face, results last up to a year, at which point they need to be touched up. Should you experience buyer’s remorse, the filler is dissolvable via [hyaluronidase injections](https://aedit.com/aedition/hyaluronidase-to-dissolve-dermal-filler).

## **2. There Are an Array of Benefits** 
Strategically placed hyaluronic acid-based filler can shape and contour the nose. “The ideal candidate is a patient who only has one or two issues with their nose that they are unhappy with,” Dr. Rajagopal shares. For example, “if the tip plunges or dips affecting the smile,” they may be a candidate, she says. Others who may benefit from filler are those with petite sniffers. “A patient with a [smaller or shorter nose](https://aedit.com/concern/nose-size) can benefit, as the product can give them volume and elevating the nasal dorsum gives a nice aesthetic result,” she explains.

It can also work wonders for [nose bump](https://aedit.com/concern/nose-bump) concerns. “When I do a [liquid rhinoplasty](https://aedit.com/aedition/what-you-need-to-know-about-liquid-rhinoplasty), I’m actually adding product to camouflage a hump,” she explains. “I will go on either side of the bump to reduce its appearance, and, oftentimes, I will add to the tip of the nose to give it a little lift and give it a nice, smooth appearance.” 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/5Os1oMBPnUpi3PiuMqMPhY/d0d228eb363ffc4bc2ea160db5b69b7e/LiquidRhino2.jpg}>
  A before (*left*) and after (*right*) look at one of Dr. Rajagopal's liquid rhinoplasty patients.
</CaptionImg>

While it’s not the same as combining a [facelift and skin resurfacing](https://aedit.com/aedition/best-procedures-to-combine-with-a-facelift), [blepharoplasty and brow lift](https://aedit.com/aedition/combining-blepharoplasty-and-brow-lift), or [rhinoplasty and chin implant](https://aedit.com/aedition/combining-rhinoplasty-and-chin-augmentation), pairing a surgical and non-surgical rhinoplasty may be beneficial for those who feel prior surgery hasn’t achieved their desired look or for those who have experienced specific complications post-op – which leads us to…

## **3. It Can Address Certain Functional Concerns** 
Those who have undergone a surgical rhinoplasty may be aware of the potential complications, adverse effects, or suboptimal results. A liquid rhinoplasty may come into play for those not interested in a traditional [revision rhinoplasty](https://aedit.com/aedition/what-you-need-to-know-about-revision-rhinoplasty). “It can help some functional concerns, especially if patients have had a rhinoplasty done and have had a middle vault collapse or have the central part of the nose slightly depressed,” Dr. Rajagopal says. “This happens when some of the cartilage has been over-resected and the internal valve or the internal part of the nose hasn’t been opened up again.”

Candidates who experience [breathing problems](https://aedit.com/concern/breathing-issues) due to the projection of the nasal tip may find relief as well. “For those who have a [droopy tip](https://aedit.com/aedition/drooping-nose-from-aging), lifting it up can improve breathing function,” she shares. “Over-resected tips or nostrils can be improved.”

## **4. There Are Risks** 
We always emphasize the importance of finding a skilled injector. While no HA fillers are indicated for use in the nose area, liquid rhinoplasty can be safe and effective in the hands of a pro. Experience is particularly important in this case, however, because the nose area is at an increased risk of [vascular occlusion](https://aedit.com/aedition/risk-of-vascular-occlusion-after-dermal-filler), which is one of the most serious filler complications. “The nose has a lot of vascular structures and those connect directly to the eye or the brain,” Dr. Rajagopal explains. If filler is accidentally injected near or into a blood vessel, it can become occluded due to the pressure. Too much pressure can limit blood flow, leading to skin necrosis (read: death) and, in the most severe cases, blindness. 

Promptly dissolving the filler with [hyaluronidase](https://aedit.com/procedure/hyaluronidase) can remedy the situation without damage, but the provider must know what to look for (including how to delineate between normal [post-injection bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) and the discoloration caused by vascular occlusion). “That’s why it’s important to find an expert who knows how to handle those complications if they do occur,” she emphasizes. 

## **5. Not Everyone Is a Candidate** 
While there is a lot a liquid rhinoplasty can do, it is not for everyone. “Someone who has multiple concerns they are unhappy with and want to change may not be a good candidate,” Dr. Rajagopal says. Filler can augment the nose, but it can’t reduce its size. “Those who have a [big nose](https://aedit.com/procedure/nose-augmentation-and-nose-reduction-solutions) but want a significantly smaller shape won’t be able to achieve it,” she explains. “[Similarly], those with a wide nose – whether it’s a wide bridge or wide nostrils – may not be a good candidate.”

For some, liquid rhinoplasty can serve as an alternative to a surgical revision, but this is not a hard and fast rule. “Someone who has had a rhinoplasty done where a cartilage or silicone implant has been used and there is no space to put the product in may not be a fit for a liquid rhinoplasty,” she shares. She makes these decisions on a “case-by-case basis.”

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/1amKjyaVhwrMNRvrQaZg9w/712e68ec614820b115a7424b63b4d78d/LiquidRhino1.jpeg}>
  A before (*left*) and after (*right*) look at one of Dr. Rajagopal's liquid rhinoplasty patients.
</CaptionImg>

## **The Takeaway**
A liquid rhinoplasty may be a ‘lunchtime’ procedure, but there’s more to it than meets the eye. Like all injections, the provider should be thoroughly vetted and the patient should go in with realistic expectations. While it can improve nose shape and contour, not every aesthetic concern can be addressed sans surgery. A consultation with a board certified plastic surgeon will help determine if you are an ideal candidate for liquid rhinoplasty. 

Aesthetics

Did you know that a liquid rhinoplasty can address certain functional concerns? And that’s not all this non-surgical treatment can offer.

What To Know About Non-Surgical Liquid Rhinoplasty, According To A Plastic Surgeon

5 Things You Should Know About Liquid Rhinoplasty

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There is a reason that [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) (a.k.a. nose job) is perennially one of the most popular cosmetic surgeries. Whether it’s performed for [aesthetic or functional reasons](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty), the procedure can be transformative. Rhinoplasty is generally considered safe and effective, especially when carried out by a board certified facial plastic or plastic surgeon. Even so, there is always a [risk of complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications) and/or unsatisfactory outcomes. Furthermore, the results of rhinoplasty, while long lasting, are still at the mercy of age and gravity, which means they can change over time.

For some patients, one or more of these factors can be reason to undergo a revision rhinoplasty. Generally speaking, secondary surgeries are [more costly](https://aedit.com/procedure/rhinoplasty-nose-job/cost) and involved than primary procedures, and rhinoplasty is no exception. In fact, the revision is considered one of the most complex in plastic surgery. With that in mind, making an informed decision with the help of a highly skilled surgeon is key. Here, we hear from two patients who had a [revision rhinoplasty](https://aedit.com/procedure/revision-rhinoplasty) to learn more about their experience and any advice they have for people considering the surgery.

## **When Is Revision Rhinoplasty Appropriate?**
Although revision rates are not published, it is generally accepted that it is around 20 to 25 percent for rhinoplasty. That means one in every four or five patients pursues a corrective surgery down the line. There are two main reasons a [revision rhinoplasty](https://aedit.com/aedition/what-you-need-to-know-about-revision-rhinoplasty) may be necessary. One is chiefly cosmetic in nature and the other has a medical component. 

1. You’re unhappy with how your nose looks and would like to further refine the results
2. Your primary surgery was meant to address a deviated septum or other anatomical issue, but did not resolve the problem(s)

Rhinoplasty has one of the longest [recovery periods](https://aedit.com/procedure/rhinoplasty-nose-job/recovery) of any cosmetic surgery. While you may be cleared to resume most normal activities after a few months, it can take a year (or more) for the  body to fully heal – that includes clearing up any residual [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery), however mild, that can influence how the nose looks. But what if your patience is not rewarded with your desired result? Or what if you have a rhinoplasty [as a teenager](https://aedit.com/procedure/youthteen-rhinoplasty) and, as an adult, aren’t thrilled with how the surgery has aged? Revision is an option.

[Functional rhinoplasty](https://aedit.com/aedition/difference-between-septoplasty-rhinoplasty), meanwhile, is medically necessary surgery often prescribed for people who have a [deviated septum](https://aedit.com/procedure/septorhinoplasty), cleft palate, polyps, or even trauma from an accident or injury. In these cases, the surgery will be considered ‘[failed](https://aedit.com/aedition/guide-to-revision-surgery)’ if the functional concern the surgeon sought to address with the procedure is not resolved after healing is complete (think: your [breathing issue](https://aedit.com/concern/breathing-issues) is still, well, an issue). Again, revision is an option.

In either instance, the first step is usually to meet with your surgeon to discuss the differences between what you were looking for and what you ended up with. You are [under no obligation](https://aedit.com/aedition/what-to-do-if-you-are-unhappy-with-your-plastic-surgery-results) to pursue revision with the same surgical team, and it is best to consult with multiple surgeons. Ultimately, choose someone who specializes in revision rhinoplasty specifically, as the secondary surgery is more nuanced.

Whether it’s the first revision or the fifth (yes, seriously), there is often a great deal of scar tissue to contend with, which may also impact the skin and its ability to be stretched and re-draped. If there is not enough cartilage available to reshape the nose while maintaining its function, grafting may be required. For all of these reasons, seeking out a highly skilled revision expert is key for both the safety and efficacy of the corrective procedure.

<BeforeAfterModule
  title={Before & Afters: Revision Rhinoplasty}
  procedureId={737}
/>

## **Patient Perspective**
Needless to say, there is a lot to consider before opting for a revision rhinoplasty. To help you understand what it’s really like to get and [recover from](https://aedit.com/aedition/rhinoplasty-recovery-healing-process) the procedure, we’ve spoken to two patients about their experiences. 

### **Sam, 28, Providence, RI**
*Sam had a nose job to address concerns about the bridge of her nose and a bulbous tip. Unfortunately, the results from her first procedure weren’t satisfactory, so she decided to have a revision with another surgeon.*

<Dialogue>
  <Question party={The AEDITION}>
    What led to your revision rhinoplasty?
  </Question>
  <Response party={Sam}>
    I had a first nose job in my late teens and went to a random local surgeon purely out of convenience. We never got on very well, and, looking back, I don’t think he took enough notice of what I was hoping for from the procedure and just stuck to a standard nose shape — at least that’s what it felt like. Once I was more established in my career and had some cash available to give it another go, I asked a few friends who’d had nose jobs about their surgeons and consulted based on recommendations this time.
  </Response>
  <Question party={The AEDITION}>
    How did the second surgery compare to the first?
  </Question>
  <Response party={Sam}>
    It was honestly a completely different experience. I think, in part, that came from the fact that by the time I tried again, I’d learned to advocate for myself more than I could as a teenager. I had honest discussions with a few surgeons, discussed if what I was hoping for was realistic, and looked at some projected results that were produced from scans and photos. The actual process of the surgery was similar, though. I feel that having already done it once meant the recovery seemed less daunting than before.
  </Response>
  <Question party={The AEDITION}>
    Have the results from your revision surgery met your expectations?
  </Question>
  <Response party={Sam}>
    My new nose is as close to perfect as possible. Honestly, it wasn’t entirely what I had in mind, but my surgeon took the time to explain why this would be the best approach, and it suits me so much better than before. It’s been a couple of years now, but I still catch it in the mirror sometimes and just kind of take it in and thank myself for bearing with the process and giving it another go.
  </Response>
  <Question party={The AEDITION}>
    Do you have any advice for patients considering revision rhinoplasty?
  </Question>
  <Response party={Sam}>
    Don’t be afraid of being picky. It’s your face, after all! You’re spending a lot of money on it and you’re getting a revision for a reason, so don’t feel like you’re wasting people’s time by asking questions.
  </Response>
</Dialogue>

### **Paola, 33, Austin, TX**
*Paola needed surgery to [fix a deviated septum](https://aedit.com/procedure/septorhinoplasty) that was affecting her breathing. The first surgery was unsuccessful due to excessive scarring that left her nose looking asymmetrical, so she underwent a second procedure.* 

<Dialogue>
  <Question party={The AEDITION}>
    What led your surgeon to suggest a revision rhinoplasty?
  </Question>
  <Response party={Paola}>
    I had some complications after my original procedure that meant my nose had some scar tissue that made it look asymmetrical and overall a bit weird. There’s no other way of describing it. My surgeon and I decided to leave it a couple of years while carefully monitoring how I recovered with regular checkups. Eventually, we decided there was no further improvement, so revision was the best option.
  </Response>
  <Question party={The AEDITION}>
    Did you experience any difficulties in the period between the two procedures?
  </Question>
  <Response party={Paola}>
    It was more of a mental struggle than anything else. It’s tough when you think you’re resolving an issue and going through the unpleasant period of post-surgical healing, only being told they need to do it again. The healing time in between both procedures gave me a chance to get my head around the idea of needing further surgery. The fact that it was a medical procedure instead of an elective procedure in the first place was probably a contributing factor.
  </Response>
  <Question party={The AEDITION}>
    How was your recovery from the revision surgery?
  </Question>
  <Response party={Paola}>
    It was pretty similar to the first time. I had some bruising, and the swelling was similar, too. I think there are some tricks you pick up during recovery that are helpful to go back to a second time around. For example, after my first surgery, I found a pillow that was particularly comfortable to sleep on, so I made sure I had that all set up for when I got home. Knowing what to expect made my recovery feel smoother this time than the first time around.
  </Response>
  <Question party={The AEDITION}>
    Do you have any advice for patients considering revision rhinoplasty?
  </Question>
  <Response party={Paola}>
    My advice to others would be what I told myself at the time: It’s not something you can control. Your surgeon knows what they are doing, and you have to trust them. It can be difficult going through the whole process again, but, in the long run, it’s worth it.
  </Response>
</Dialogue>

## **The Takeaway**
In an ideal world, every procedure would end in a successful outcome. Unfortunately, for a myriad of reasons, that’s not always the case. If you are unhappy with your rhinoplasty for aesthetic or medical reasons, a revision surgery may be able to improve your results. Be sure to [choose a board certified plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) who specializes in the corrective procedure and be realistic about what can be achieved.

*Patient names have been changed

Patient Perspective

Two patients share their firsthand accounts of undergoing the corrective surgery.

What It's Like To Get A Revision Rhinoplasty Surgery

What It’s Really Like To Get A Revision Rhinoplasty

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A drop in collagen and elastin production; a loss of bone mass; a decrease in facial volume. These changes are part of getting older, and you often notice them as laxity and crepiness around the eyes, a flattening of the midface and cheeks, or jowling of the jawline. One facial feature you may not have realized is also impacted? [The nose](https://aedit.com/concern/nose-shape).

With age, the nose begins to droop as collagen is lost and the supporting structure diminishes. And, unfortunately, even a nose job from your teens or early twenties isn’t immune to effects of Father Time and Mother Nature. So, while secondary (or even primary) rhinoplasty surgery may be the answer for some, other [nose shaping solutions](https://aedit.com/procedure/nose-shaping-solutions) can help lift the sniffer back to where it belongs. Here’s what you need to know.

## **The Causes of a Droopy Nose**
Sometimes called a floppy nose or downward-pointing nose, there are a handful of reasons why we start to see the front of the nose – more specifically, the tip – fall forward with age. Not everyone experiences drooping to the same degree. But, for those who find it noticable, it can be reason enough to want to understand why it’s happening and what to do about it. 

Both guys and gals are equally susceptible to developing a droopy nose over time. Men generally begin with a more acute angle than women and the muscles acting on the tip are a bit stronger, says [Andrew Frankel, MD](https://aedit.com/provider/andrew-frankel-md-275), a double board certified facial plastic and reconstructive surgeon in Beverly Hills. Furthermore, hormones are partially to blame. Females lose estrogen with age, making the skin and tissue thinner and less supportive. Men, meanwhile, often see sagging as a result of nasal injuries that were never corrected. 

Unless it’s impacting your [ability to breathe](https://aedit.com/concern/breathing-issues), a droopy nose isn’t a cause for medical concern. But that doesn’t mean it doesn’t pose an aesthetic one. Across the board, these are the main reasons why your once perky nose may be looking a little longer and less angular these days:

### **1. A Weak Internal Structure**
As we age, it’s typical for the cartilage and ligaments inside the nose to weaken, which creates a droopy tip, says [Farhad Ardesh, MD](https://aedit.com/provider/farhad-ardesh-md-19202), a double board certified facial plastic and reconstructive surgeon in Beverly Hills. “The nasal septum is a wall consisting of cartilage and bone that divides the inside of the nose into the right and left sides,” he explains. “It is the foundation and support beam that holds up the tip of the nose.” If the front part of the septum is crooked, then the tip lacks proper support. “As the unsupported nasal tip droops down, it pulls the skin over the bridge of the nose down over the bones,” he shares. This downward pull of skin creates the appearance of a hump or makes pre-existing humps seem more pronounced.

Cartilage changes can also cause the midportion of the nose to begin to look pinched or asymmetric. In addition, as the ribbons of cartilage that make up the tip of the nose relax outward and downward, the nose may look rounder, wider, and ‘droopier’ than it used to, says [Dara Liotta, MD](https://www.facialplasticsnyc.com/), a double board certified facial plastic and reconstructive surgeon in New York City. Changes to the blueprint of the cartilage can also give way to difficulties in breathing. 

With lost tissue support, the stiffness imparted by these tissues also diminishes, causing the nose to ‘stretch’ to a degree, says Dr. Frankel. “Given that the forces acting on the nasal tip when one speaks and smiles are often directed downwards, the tip will tend to fall over time,” he explains.

### **2. Genetics**
If your parents or grandparents sport a flaccid nose, there’s a pretty good chance you will, too. Dr. Ardesh says that those genetically inclined to experience drooping should consider surgery – particular if they have cosmetic or breathing concerns. [Ethnicity](https://aedit.com/aedition/guide-to-ethnic-rhinoplasty) can also influence where and how the nasal tip sits. Some nationalities generally have a weak or small amount of cartilage that affects overall support. Trauma and previous rhinoplasty or other nasal surgery also affect how the nose ages (more on that below).

### **3. A Previous Rhinoplasty with Poor Tip Support**
Droopy tips can occur if past nasal surgeries did not provide adequate cartilage grafting to support the end of the nose. “Rhinoplasties can contribute to either more or less drooping depending on the technique utilized by the surgeon,” says [Jay Calvert, MD](https://www.instagram.com/DRJAYCALVERT/), a board certified plastic and reconstructive surgeon in Beverly Hills. For example, [open rhinoplasty](https://aedit.com/procedure/open-rhinoplasty) techniques use cartilage grafts to add support, whereas a [closed rhinoplasty](https://aedit.com/procedure/closed-rhinoplasty) approach does not employ these grafts. This can lead to more pronounced tip sagging down the line. 

### **4. The Natural Aging Process** 
The nose is not impervious to age-related shifts and alterations in the body. Changes in the bones, cartilage, fat, ligaments, and skin all contribute to the way our nose ages, says [Mary Lynn Moran, MD](https://www.marylynnmoranmd.com/), a double board certified facial plastic and reconstructive surgeon in Franklin, TN, and past president of the American Academy of Facial Plastic and Reconstructive Surgery ([AAFPRS](https://www.aafprs.org/)). “The facial bones begin to resorb, thus providing less of a foundation for the nose and the ligaments loosen, which can cause the tip to become less defined and droop,” she shares. 

There are also changes to the skin (it thins) and fat (it often resorbs), giving way to a skeletonized appearance. The ligaments that support the nose weaken and collagen fibers shorten, which causes less robust soft tissue support, Dr. Calvert explains. “All of these factors result in the descent of the tip of the nose,” he says.
 
## **The Effect on Facial Balance**
[Facial harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine) is all about proportion, which means changes to one feature (i.e. the nose) can impact the structure and aesthetic of the entire face. Here’s a few of the ways it can manifest:
 
- **The Lower Face**: As the nose becomes longer or the tip more bulbous, the distance between the lips and the base of the nose can appear shorter. A droopy tip makes the upper lip look longer (not necessarily fuller), which ages the lower face since the distance between the nose and mouth shortens.
- **The Eyes**: The nose and eyes are close to one another, and that relationship changes markedly with age. “As the shape of the eye sockets deepens, the nasal bridge can look more prominent and the eyes appear closer together,” Dr. Frankel explains. “Often, lowering the height of the nasal dorsum will have an overall rejuvenating effect on the face.”
- **The Whole Face**: As the tip begins to fall forward, it’s common for the nostrils to start to widen, which can throw the entire balance of the face off-kilter. Furthermore, when the tip droops, it can lead to the appearance of a more prominent nasal dorsum (the bone and cartilage ‘hump’ of the nose), says [Adam Kolker, MD](https://drkolker.com/), a board certified plastic and reconstructive surgeon in NYC. This might draw new attention to your sniffer. 

At this point, you might be wondering if there is anything you can do to slow down or stop the hands of time. While there is seemingly an endless stream of preventive treatments on the market today, the nose is a little more complicated. 

[Laser treatments](https://aedit.com/aedition/laser-prejuvenation-for-younger-patients) may be able to treat the skin on and around the nose, Dr. Calvert notes. And, for some, he says injecting fillers in the columella may also help support the tip. Those with a naturally acute angle between their lip and nasal tip can prevent it from progressing by having rhinoplasty to change the relationship between the septum and tip cartilages. “Rhinoplasty surgery is only indicated when an individual desires improvement of changes that can already be seen, not as a proactive measure,” Dr. Kolker clarifies.
 
It should be noted that, even if you had rhinoplasty as a teenager or young adult, there’s no guarantee that the previous surgery will make the nose resistant to drooping, especially the tip. “It depends upon the technique used and whether the surgeon cut cartilage away to achieve the desired cosmetic result (‘reductive rhinoplasty’) or if the surgeon added structure to build the new shape of the nose in an architectural way (‘structural rhinoplasty’),” Dr. Liotta says. “Cutting away the cartilage in a primary rhinoplasty can make these changes worse and can cause asymmetry and more drooping with time, while building a new structure can help keep the underlying structure of the nose strong and prevent, or limit, drooping.”

Other than that, there isn’t much to do preemptively. Sure, healthy lifestyle choices are always the way to go since they can help minimize a breakdown of collagen and elastin, but, unfortunately, chromosomes and gravity always prevail. 

## **How to Correct a Drooping Nose**
If a droopy nose is what you focus on every time you look in the mirror, there are ways to fix it — and they’re not all surgical. But, of course, surgery is usually the most transformative option since it provides the longest lasting improvement and the most structural support. “All noses are dynamic and will change over time,” Dr. Kolker says. “While many rhinoplasty techniques include maneuvers to support and stabilize the nasal tip – including a variety of cartilage graft techniques – these noses are nevertheless subject to the same laws of genetics and physics that affect all noses.” With that in mind, below are the surgical and non-surgical treatment options for addressing a drooping nose:

### **1. With Surgery**
Rhinoplasty is the most traditional way of correcting major nasal issues. If a crooked septum is causing your droopy nose, Dr. Ardesh says a [septoplasty](https://aedit.com/aedition/difference-between-septoplasty-rhinoplasty) can be performed in tandem. But, as we’ve mentioned, technique matters. “Rhinoplasty and septoplasty surgeries can create a droopy nose tip years after surgery,” he cautions. During a [septorhinoplasty](https://aedit.com/procedure/septorhinoplasty), your plastic surgeon will remove portions of the septal cartilage, but not all of it. “Then, we carve the cartilage into support beams called grafts that we place to enhance the structural integrity of the nose,” he shares.

At her practice, Dr. Liotta is seeing many patients in their [forties](https://aedit.com/aedition/best-skincare-routine-products-ingredients-for-40s) and [fifties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-50s-60s-70s) coming in for what she calls ‘nasal rejuvenation’ surgery. “These patients don’t want to change their look,” she says. “They just want to get back to the more refined and airbrushed look that they had when they were younger.” Where is this renaissance of [rejuvenation rhinoplasty](https://aedit.com/procedure/rejuvenation-rhinoplasty) coming from? “I think this stems from the Zoom culture — people staring at themselves in ways they hadn’t previously,” she shares. “These aren’t the patients obsessed with their selfies and striving for perfection.” As such, Dr. Liotta says her nasal rejuvenation surgery also optimizes breathing by restoring structure and support, a big plus for those that suffer from poor breathing that may result with age.
 
### **2. With Fillers**
There are also non-surgical options to consider as long as you know they will not provide the same result as a surgical fix. “[Liquid rhinoplasties](https://aedit.com/procedure/liquid-rhinoplasty) use hyaluronic acid fillers, such as [Restylane®](https://aedit.com/procedure/restylane) or [Juvéderm®](https://aedit.com/procedure/juvederm), under the skin of the nose, which may help enhance the side views of the tip and nasal bridge,” Dr. Ardesh says. They can also help push the tip of the nose up, so it appears as if it’s not falling. 

Yet, the results of liquid rhinoplasty are temporary (think: six to 12 months), and, if there’s too much blunt definition at the tip, it can further weigh down the nose. “Liquid rhinoplasties performed in patients who do not have adequate support to the lower half of the nose can result in poor appearance and even compromised breathing,” he warns. In addition, using fillers to improve a descending tip can create more of an obtuse angle between the top of the nose and lip to help soften the degree of flaccidity.

### **3. With Neuromodulators**
Injecting neuromodulators (read: [Botox®](https://aedit.com/procedure/botox), [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), and [Xeomin®](https://aedit.com/procedure/xeomin)) can, however briefly, help to lift the tip. Placing any one of these products into the small muscle under the nose (i.e. depressor septi nasi) can help lessen the extent of drooping when smiling. It’s not a permanent fix (it lasts the standard three to four months you can expect from all neurotoxin injections), but, for those bothered by their tip and not willing to undergo surgery, the subtle and short-lived change can be just what the doctor ordered. Strategically placed [neuromodulator injections](https://aedit.com/procedure/muscle-paralysis-rhinoplasty) can also be used to smooth bunny lines around the nose.

### **4. With Threads**
There is no denying that [thread lifts](https://aedit.com/aedition/pdo-thread-lift-for-facial-rejuvenation) are having a moment, and the nose can also benefit from their minimally invasive lifting powers. In some patients, threads can ever-so-slightly pick up the nasal tip. But, unlike other more predictable and lasting measures, Dr. Ardesh cautions that thread lift results are not very effective and only last a few months before the tip of the nose falls back down. At best, it’s a short-lived solution.

## **The Takeaway**
If you feel like you woke up one morning with a different nose, you are not alone. The facial feature is not immune from the effects of gravity and aging, which, for many, manifest as a drooping tip and the elongation of a once perky and proportional sniffer. If you are unhappy with the way these changes are impacting you aesthetically or functionally, there are both surgical and non-surgical treatment options. 

Age-Related Drooping Nose: Causes, Symptoms, Surgical And Non-Surgical Treatment Options

The Truth About Why Your Nose Is Drooping

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If there is one [plastic surgery trend](https://aedit.com/aedition/biggest-medical-aesthetics-trends-of-2022-for-face-body) you can count on, it’s that [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) (a.k.a. nose job) will always be one of the most popular procedures. According to the American Society of Plastic Surgery (ASPS), some 350,000 ‘[nose reshaping](https://aedit.com/concern/nose-shape)’ surgeries were performed in 2020 — making it [number one on the list](https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf) of top cosmetic surgical procedures. 

Even so, the ever-present rhinoplasty is said to be one of the most challenging procedures to perform simply because of the complexity and individuality of each person’s nose. Not a one-size-fits-all procedure, various factors play into a successful rhinoplasty, including a patient’s ethnicity. The concept of ‘[ethnic rhinoplasty](https://aedit.com/procedure/ethnic-rhinoplasty)’ refers to the need to take differences in nasal anatomy (e.g. skin thickness) and perceptions of beauty between cultures into account when considering if the feature is harmonious to the rest of the face. 

Here, we’re speaking to top plastic surgeons about the nuances of rhinoplasty.

## **The History of Rhinoplasty**
Since its inception, rhinoplasty has always been a multinational, multicultural, and multi-ethnic procedure. The history of rhinoplasty stems from Egyptian manuscripts dating back to around 3000 BC, followed by reconstructive rhinoplasty treatises from India around 1550 BC, says [Corey Maas, MD](https://www.maasclinic.com/), a double board certified facial plastic and reconstructive surgeon in San Francisco and president of the American Academy of Facial Plastic and Reconstructive Surgery ([AAFPRS](https://www.aafprs.org/)). “Modern rhinoplasty was [described](https://www.abfprs.org/about/h_father.cfm) by otorhinolaryngologist John Orlando Roe, who went on to develop elective rhinoplasty surgery,” he explains. “Many early cultures and ethnicities had described versions of this procedure, which, in the modern era, were largely performed by surgeons — later known as facial plastic surgeons — in the treatment mainly of disproportionately large noses.”

Rhinoplasty has always been one of the most ‘mainstream’ cosmetic surgeries, yet, thanks to social media exposure and a trend toward transparency, more people are opting for the surgery and deeming it socially acceptable than ever before. “By definition, everyone has some type of ‘ethnic’ nose,” Dr. Maas notes. But, technically speaking, the term ‘ethnic rhinoplasty’ describes a procedure performed on an individual of non-Caucasian descent, including religious and cultural identities. “The discussion of ethnic rhinoplasty and its differences thus becomes one of generalizing the differences in nasal anatomy between cultures and where these differences become disproportionate enough from the average ‘attractive nose’ in various cultural groups to have individuals seeking balance in facial features,” he explains.

In all cases, rhinoplasty surgically and permanently modifies the nose's internal structure to enhance its outer shape and appearance. As a result, the patient and everyone else sees the external nasal shape and contour, says [Jonathan Sykes, MD](https://aedit.com/provider/jonathan-sykes-md-953), a board certified plastic and reconstructive surgeon in Beverly Hills, CA.

## **What’s Different About Ethnic Rhinoplasty**
In Caucasian patients, Dr. Maas says that modern rhinoplasty generally [balances facial features](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine) by creating a straighter bridge (a.k.a. dorsum) by reducing a hump. “During surgery, assuring that the width is defined between vertical lines dropped from the inside corner of each eye is also important,” he adds. 

However, suppose the techniques used in a Caucasian nose job are also used on a non-Caucasian patient. In that case, the person will complain that they don't see a difference, warns [Michael Somenek, MD](https://aedit.com/provider/michael-somenek-md-30787), a double board certified facial plastic and reconstructive surgeon in Washington, DC. “I frequently encounter this issue with ethnic patients seeking a [revision](https://aedit.com/aedition/what-you-need-to-know-about-revision-rhinoplasty) with me,” he explains. “The way ethnic rhinoplasties vary is that often the cartilage or infrastructure of the nose is relatively weak and the skin is thick.”

In these situations, “cartilage and support via grafts from the nose, ear, or ribs, are added to address the external contour and shape,” Dr. Somenek says. As a result, there are additional sites to heal (besides the nose) with cartilage grafting, though the recovery is relatively minimal.
 
Not every ethnic rhinoplasty surgery is the same, yet the fundamentals of the procedure remain steadfast. Certain ethnicities — mainly those of Hispanic, African American, and Middle Eastern descent — are addressed somewhat similarly since the chief goal is usually an overall reduction in the [size of the nose](https://aedit.com/concern/nose-size). As Dr. Somenek explains, this often involves:

- Narrowing the nostrils
- Refining the nasal tip
- Narrowing the nasal bones
- Removing a dorsal hump

Even so, he adds that it’s imperative to respect the ethnicity of the person being operated on and understand that the nose still needs to balance with the other facial features. “Some proportions, particularly the nostril width, are typically a little wider than a Caucasian nose,” Dr. Somenek notes. “Because of this, even though I may narrow the nostrils in ethnic rhinoplasty, I am conservative to maintain some relative proportions to the rest of the nose.”

### **Nasal Anatomy**
The nasal structure is inherently different between Caucasian patients and non-Caucasian patients. Due to disparities in bone, cartilage, tissue, and skin thickness, the surgical approach is of a different viewpoint; otherwise, adverse effects, like [breathing issues](https://aedit.com/concern/breathing-issues) and poor healing, may be the procedure's outcome. 

Furthermore, Black, Asian, and Middle Eastern noses have variations in the nasal skeleton and skin soft tissue envelope (SSTE) that separate their anatomy from the Caucasian anatomy, explains [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in New York City. “Often, Caucasian rhinoplasty is a reduction rhinoplasty (taking down a hump or making the tip smaller),” she says. “With a Black or Asian nose, it may require an augmentation rhinoplasty to build the dorsum and the tip while narrowing the base of the nose and tip.” 

As far as the Middle Eastern nose goes, there may be a dorsal hump, but there may also be the need for augmentation to the tip. “These changes are most often suited to an [open approach](https://aedit.com/procedure/open-rhinoplasty), as multiple grafts are often necessary,” Dr. Levine adds. Open rhinoplasty makes incisions across the thin skin and tissue between the nostrils, whereas a [closed approach](https://aedit.com/procedure/closed-rhinoplasty) hides the incision within the nose.

The primary reason why almost any patient seeks surgery is to correct a bulbous or too wide tip, a wide or [humped bridge](https://aedit.com/concern/nose-bump), a droopy tip, or a [deviated septum](https://aedit.com/procedure/septorhinoplasty). Most ethnic rhinoplasty procedures consider the different anatomical variations and aesthetic goals of each ethnicity, yet there is no denying that some faces call for a more prominent nose, while others can support a more upturned, petite one.

There are infinite variations of rhinoplasty that can be accomplished to best present the nose's appearance while bringing balance to the face. For this reason, Dr. Sykes doesn't like to think of techniques as being Caucasian or ethnic. Instead, he looks at the interplay between the SSTE and the infrastructure to achieve an elegant result. “Some noses require removal or subtraction of infrastructure, and others require grafting or augmentation of the infrastructure,” he explains. “In many cases, the perfect combination is some augmentation and some reduction.” This is never determined by a set formula but rather an “individual sculpting of that particular nose,” he adds.

### **Expertise**
As you’ve likely gleaned, all rhinoplasty surgeries are complicated and detail-oriented. This is why it’s vital to seek out a board certified facial plastic or plastic surgeon who specializes in the procedure. Those with an emphasis on performing ethnic rhinoplasty, specifically, are an even better choice. 

To confirm expertise, review a surgeon’s [before and after images](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) to judge that the results they achieve are on par with what you want to accomplish. This also allows you to see if they have operated on patients who have similar features to your own. Dr. Maas’ advice? Find a surgeon who has performed at least 1,000 nose surgeries in a multicultural city to help ensure a positive outcome.

## **Keep What You Like, Get Rid of What You Don’t**
The most challenging aspect of ethnic rhinoplasty is retaining the features of the face or nose the patient doesn't want to alter. Many feel that certain cultural distinctions are what make them unique, which means the goal of the procedure is to eliminate what they don't like about the nose without disrupting other facial features or even aspects of the nose that they feel positively contribute to their look. “There’s an art to understanding how to achieve this and which features are best kept and refined as opposed to removed,” says [Kevin Tehrani, MD](https://aedit.com/provider/kevin-tehrani-md-91), a board certified plastic and reconstructive surgeon in NYC.

Needless to say, it is crucial not to try to make an ethnic nose look like a Caucasian one, which is why your surgeon must preserve certain features. With that in mind, these are some of the most common requests:

### **The African American Nose**
- **Areas of Concern**: A wide bridge and a flat tip due to thick skin.
- **The Request**: A bit more projection, a thinner bridge, and less prominent nostrils. “These patients (as well as Asian patients, too) often desire to build up a relatively flat or poorly defined bridge of the nose and reduce the thick appearance of the tip of the nose caused by skin and cartilage thickness," Dr. Maas explains.

### **The Asian Nose**
- **Areas of Concern**: Typically, a flat, broad nose and an under-projected tip and bridge.
- **The Request**: More tip and dorsal projection. Dr. Maas explains that much of Asian rhinoplasty involves techniques of augmenting and/or building up disproportionately small noses or loss of part or all of the nose. 

### **The Mexican & Latin Nose**
- **Areas of Concern**: The most common are a bulbous or broad tip coupled with a wide bridge and poor projection.
- **The Request**: A refined and more elevated tip and a reduction of any humps. 

### **The Middle Eastern Nose**
- **Areas of Concern**: A thick, bulbous tip and a wide bridge; a deviated septum is also common.
- **The Request**: More definition in the tip of the nose and a reduction of the hump, which often requires reducing or removing excess cartilage and bone.

### **The Native American Nose**
- **Areas of Concern**: A too-narrow bridge with poor projection.
- **The Request**: A soft, natural slope from the bridge to the tip.

While this can serve as a guide, the variation in what noses look like and what patients want is not always quite so predictable. “Some patients desire a small and very stylized nose whereas others want a more natural appearance,” Dr. Sykes explains. “I feel that it’s important to have a lengthy consultation with the patient to understand what they want to achieve.” During the consultation process, any good plastic surgeon should always be upfront and honest about what is achievable while considering the patient’s desires. “The consultation varies by individual and cannot be generalized to a given ethnicity,” he says.

## **The Importance of Skin Type**
The skin on the nose, known as the nasal skin envelope, influences how surgeons perform rhinoplasty and what the result will look like in the end. Those with darker skin tend to have a thicker nasal skin envelope. That skin thickness can limit the overall nasal tip definition that’s achievable. “That is why it is so important to create a strong, supportive foundation in the nasal tip so that when the skin redrapes over the new underlying cartilage, it can have more definition,” Dr. Somenek explains. It's also imperative to know that, postoperatively, there is an increased risk of prolonged [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) in the tip. 

Despite the longer healing time, the benefit of thicker skin is that it can help minimize contour irregularities overlying the cartilage. In addition, due to the thicker support and structure, the skin can provide a definition and shape that lasts. At the same time, it can create a more bulbous tip, Dr. Tehrani says. 

While changing the SSTE is (relatively) easy to do, getting the skin to blanket down and assume its new structure is more complicated. “As a general rule, the thinner the skin, the easier to see the underlying change made; the thicker the skin, the more difficult it is to see underlying cartilaginous changes,” Dr. Sykes shares. For this reason, in thicker-skinned patients, structure and cartilage is often added via grafts to address the outer nasal contour. This can make it more challenging — though not impossible — to achieve a ‘small’ nose. 

To improve the nose yet not disrupt the facial features, it's vital for the nose, which is at the center of facial appearance, to live in and even create harmony amongst the other features. Generally speaking, the onus is on the surgeon to understand the patient's desires, offer complete transparency on what’s possible, practice the appropriate technique, and retain proportion. “If a nose looks over-operated upon, it draws too much attention from other features and detracts from overall facial attractiveness,” Dr. Sykes cautions. 

## **The Takeaway**
No two noses are the same, and that is especially the case when you consider ethnic differences in nasal anatomy. The goal of any rhinoplasty is to preserve the appropriate features. “Using the incorrect technique will lead to a suboptimal or unharmonious result,” Dr. Levine says. “The anatomy dictates a different approach.” Therefore, it’s essential to choose a board certified plastic surgeon with a deep understanding of the nose and a well-documented history of operating on them.

Top plastic surgeons break down the history and nuance of ethnic rhinoplasty as it relates to treating non-Caucasian patients.

Expert Guide To Ethnic Rhinoplasty

What You Need To Know About Ethnic Rhinoplasty

pouriya-kafaei-R7TamY6uA74-unsplash (1)

Prospective patients, be aware: rhinoplasty — the [cosmetic or reconstructive surgery](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty) that addresses [nose shape](https://aedit.com/concern/nose-shape), [nose size](https://aedit.com/concern/nose-size), and/or [breathing concerns](https://aedit.com/concern/breathing-issues) — functions on its own timeline. While the healing process is relatively straightforward, it can take 12 months or more for the true result of the surgery to emerge. Needless to say, patience is required.

If you’re looking for instant (or instant-ish) gratification, non-surgical [liquid rhinoplasty](https://aedit.com/procedure/liquid-rhinoplasty), which involves injecting filler to sculpt the nose, may be an option. [David Shafer, MD](https://aedit.com/provider/david-shafer-md-153), a board certified plastic and reconstructive surgeon in New York City, actually prefers the non-surgical alternative for many patients, though he concedes that “there are some things surgical rhinoplasty can do that liquid can’t.” 

During your initial consultation, your surgeon should listen to your desired results, explain what is (and isn’t) achievable, and recommend the best way to create it. If a surgical rhinoplasty turns out to be right for you, set a calendar alert for one year post-surgery for the full reveal. In the meantime, here’s what the days in between will look like during your [recovery from rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job/recovery).

<BeforeAfterModule
  title={Before & Afters: Rhinoplasty}
  procedureId={1004}
/>

## **The First Few Days After Rhinoplasty**
Plan to go home the same day as your [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) surgery (with the help of a friend or loved one) and to spend the first two to four days post-op taking it as easy as possible. “You don’t have to be bedridden, but you should definitely be resting,” says [Samuel Hahn, MD](https://aedit.com/provider/samuel-hahn-md-20403), a double board certified facial plastic and reconstructive surgeon in Cockeysville, Maryland. “Even though rhinoplasty is not a big area of surgery, your body still needs proper rest to recover.” 

He directs patients to limit exertion to “non-strenuous daily activities.” You may be able to return to at-home tasks, like working on a computer or talking on the phone, quite quickly, but there is to be no heading to the gym just yet. “The first couple days, you’re going to be constantly aware that you just had surgery,” Dr. Shafer says. “You’re going to have swelling, you’re going to have some discomfort, you might be taking some pain medication.” 

Due to [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) in the nasal passages, you’ll feel congested and will likely have to breathe through the mouth. For those early days (and weeks) to come, you’ll have to [sleep on your back](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures) to avoid pain and help decrease swelling. Swelling will start about 24 to 48 hours after surgery. As the swelling goes down, [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) around the nose and under the eyes may appear — though it’s important to remember that every patient is different. “Some might have no bruising, another might look like they took a punch to the face,” Dr. Shafer says. Most patients fall somewhere in-between those two extremes.

It’s important to understand that swelling and bruising subside over the course of several months, and your new nose won’t be visible in these early stages. The good news? The most discomfort is during this initial, brief recovery period. “After several days, the worst of it is over,” Dr. Shafer confirms. 

### **Pain Management After Rhinoplasty**
Plastic surgeons’ approach to pain management is informed in part by the [addictive nature of opioids](https://aedit.com/aedition/opioid-crisis-plastic-surgery-recovery-pain-management). You’ll likely receive a few days of prescription pain medication to take as needed during that initial recovery period only. After that, over-the-counter pain meds should suffice. Following the first 72 to 96 hours, sensations of pain will start giving way to feelings of pressure. “Most people will start to feel pressure between their eyes, forehead, and cheeks,” Dr. Hahn explains. “Then the pain starts lessening.” 

## **Resuming Normal Activities After Rhinoplasty**
After the initial downtime, rhinoplasty patients can resume non-strenuous tasks as their body feels able. In those first few weeks, Dr. Shafer suggests avoiding any activities that raise the heart rate or blood pressure, which can increase swelling.

After about two to three weeks (and, importantly, a follow-up visit where your surgeon will give you clearance) expect to be able to [return to the gym](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures), starting slowly with light cardio. After about four weeks, Dr. Hahn’s patients often resume strength training, yoga, or any other activity that puts stress on the face. As with any recovery period, listen to your body (and your surgeon) and take your time before returning to vigorous activity. 

## **Final Rhinoplasty Results**
Your plastic surgeon should take care to explain exactly what to expect from surgery, recovery, and results — and, when it comes to results, that means setting a [realistic timeline](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures). “I go over expectations with patients multiple times, so they have a good understanding of what to expect,” Dr. Hahn shares. “If you give a false presentation of what their results may be, you may have an unhappy patient even if it’s a good surgery.” 

Because the nose is a particularly vascular part of the body, with a lot of blood flowing to and from the it, postoperative swelling can linger. Dr. Hahn estimates that most patients will have visible swelling for three or four weeks after surgery. After that, it’s usually a few more months of subtle swelling that, he says, “they themselves alone will notice.” 

It can take up to a year for the final results to be fully visible and settled. For a patient who requested subtle adjustments to the nose, those changes often take the longest to become noticeable. “The tip of the nose tends to remain swollen the longest,” Dr. Hahn notes. “Especially for someone who wants tip work done, I advise them that they won’t see the final results for quite a while.” 

As the nose is settling, Dr. Shafer says other procedures like [neurotoxins](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) and [fillers](https://aedit.com/aedition/how-to-reshape-your-face-with-filler-botox-injectables) are still available to you. Keep in mind that, should you want to continue to tweak the appearance of the nose with a liquid rhinoplasty, your injector should be aware of and experienced in treating surgical rhinoplasty patients. “Once you’ve had surgery, it changes the anatomy of the nose, and you need an experienced doctor to avoid complications,” Dr. Shafter cautions. Of course, once the swelling goes down and the bruises have faded, you may not ever need anyone to touch your new nose again.

You’ve asked questions, looked at pictures, and read stories, but what can you really expect from the rhinoplasty recovery process? We’ve got you covered.

A Plastic Surgeon's Guide To Rhinoplasty (Nose Job) Recovery And Healing

Expectation vs. Reality: Recovering From Rhinoplasty

etty-fidele-nF8eo2nX374-unsplash

Even in a post-pandemic world, there is still an appetite for [combining different cosmetic procedures](https://aedit.com/aedition/best-aesthetic-procedures-to-combine-to-maximize-appointments) — when possible — in order to achieve optimal results and maximize downtime. One classic pairing that plastic surgeons often recommend due to the harmonious result it creates: [rhinoplasty](https://aedit.com/procedure/nose-shaping-solutions) and [chin augmentation](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures). Here, we break down the benefits and balance of the common combo.

## **The Benefits of Combining Rhinoplasty & Chin Augmentation** 
As we’ve covered, [facial harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine) is about proportion, and changing the proportion of the nose can have an impact on the appearance of the chin. So, it should come as no surprise that it’s common to combine [nasal surgery](https://aedit.com/aedition/difference-between-septoplasty-rhinoplasty) with [chin enhancement](https://aedit.com/procedure/chin-enhancement-solutions) procedures — and some patients even tack on a few more things. “Very often, they’re also combined with a little submental liposuction to really define the jawline along its whole length,” says [Dara Liotta, MD](https://www.facialplasticsnyc.com/), a double board certified facial plastic and reconstructive surgeon in New York City. She calls this combination of [rhinoplasty](https://aedit.com/procedure/open-rhinoplasty), [chin implant](https://aedit.com/procedure/alloplastic-chin-implant), and submental liposuction a “profile makeover.” 

Pairing these procedures (in the right patient) helps balance the face and allows the results of the individual procedures to make the greatest impact, Dr. Liotta says. “Combining procedures to achieve a more ideal profile can actually help the results of rhinoplasty look more natural —  like your profile was meant to be like that,” she notes. 

Another benefit? [Minimizing cost and downtime](https://aedit.com/aedition/how-much-cosmetic-surgery-costs). “Combining procedures minimizes downtime and saves a bit of money because there’s one anesthesia and one recovery,” says [Jennifer Levine, MD](https://www.drjenniferlevine.com/), a double board certified facial plastic and reconstructive surgeon in NYC. “Who doesn’t like that?” In addition to the potential cost savings, you also can consolidate your healing time when you safely undergo [more than one procedure](https://aedit.com/aedition/best-surgical-and-non-surgical-cosmetic-procedures-to-combine) at the same time. “With a rhinoplasty, you will have a cast and sometimes stitches for six to seven days,” she explains. “The chin implant has a bandage and stitches for the same amount of time.” 

## **The Best Candidate for Rhinoplasty + Chin Augmentation** 
So, how do you determine if you are an ideal candidate to combine rhinoplasty and chin augmentation? “Someone who has a recessed chin and/or has poor definition in the neck area is a good candidate for these procedures,” says [Edward Kwak, MD](https://aedit.com/provider/edward-kwak-md-74), a double board certified facial plastic and reconstructive surgeon in NYC. “And a good candidate for rhinoplasty is someone who wants to change the [shape of their nose](https://aedit.com/concern/nose-shape), [improve breathing function](https://aedit.com/concern/breathing-issues), or both.”

In some cases, the contour of the chin may be creating an optical illusion of sorts. “Many times, patients may feel that their nose is too large, but really the nose looks bigger because the chin is too small,” Dr. Levine notes. Even so, people don’t always appreciate the [role of the chin](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures) in balancing the face. “Chin augmentation is often overlooked because most of us look more at the other parts of our face,” she adds, yet a [2010 study](https://pubmed.ncbi.nlm.nih.gov/20115968/) found that as many as 81 percent of patients may see the benefit of pairing rhinoplasty with chin augmentation. 

It should be noted, however, that some patients — specifically, those who have issues with their mandible or maxilla (i.e. jawbones) — may require more advanced treatment. “These patients would need a more extensive procedure for their lower face,” Dr. Levine cautions. Additionally, those with extensive dental concerns may not be a good candidate for these procedures. “If the teeth are not aligned well, it may indicate a bigger issue,” she says. 

## **Performing Rhinoplasty + Chin Augmentation Together**
When combining rhinoplasty, chin augmentation, and liposuction, it’s up to your surgeon to decide what order they will operate in. “I personally like to do the submental liposuction followed by the chin implant and then the rhinoplasty last,” Dr. Liotta says. By doing the nose last, patients can wake up from [anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) and start icing as soon as possible, which should help minimize [bruising and swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery). “I think it makes for a better, easier, recovery,” she explains.

If they are being performed at the same time, Dr. Levine also places the chin implant first. “It is considered a clean procedure, while the nose itself is less sterile,” she says. But, if the procedures are being performed at separate times, she usually schedules the rhinoplasty first. The reasoning? The nose is typically what bothers the patient the most.

## **Recovering from Rhinoplasty + Chin Augmentation**
Regardless of the procedure(s), Dr. Kwak always stresses the importance of preoperative and postoperative care with his patients. “It is very important to note that one’s final result is determined by this care — no strenuous activity, no touching of any incisions or casts, etc.,” he says. Recovering from any cosmetic surgery requires patience, but rhinoplasty, in particular, takes time. Dr. Kwak notes the healing journey for this pair takes approximately a year.

### **Recovering from Chin Augmentation**
Interestingly enough, Dr. Liotta finds that patients actually have a harder time recovering from the chin implant than the rhinoplasty. “I think people are used to seeing the black eyes and swelling of rhinoplasty recovery, and they’re prepared mentally to wait a full year for final results,” she explains. “But the recovery process after chin implant is much less publicized and written about, so I find that patients have a harder time with the small amount of swelling and tenderness that go along with it.” Feeling like your chin is “huge” after surgery is normal, Dr. Liotta says. The final results of chin implants and submental liposuction are seen around six months post-op. 

Dr. Levine has patients wear a stretchy chin strap and ice the area for the first 48 hours. After that window, the strap is removed. “Bruising is rare but possible, and there will be some generalized swelling in the area for at least a week,” she says. Sleeping with the head elevated for about two weeks is also recommended.

Additionally, chin augmentation patients may require a [soft foods or liquid diet](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery) for several days as they heal, as chewing can irritate the newly adjusted tissue and muscle, Dr. Kwak says. [Vigorous activity or exercise](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) is discouraged for the first few weeks, but it can soon be resumed — along with a normal work schedule — within about 10 to 14 days, he adds. “Remember that although your fabulous results may be visible right away, they can continue to improve for up to six weeks as your swelling gradually reduces,” he cautions. 

### **Recovering from Rhinoplasty**
Most patients who undergo rhinoplasty surgery (with or without chin augmentation) should be prepared to take two weeks off from work and daily activities. “The early stages of recovery are the most difficult, mostly due to swelling, which leaves you with a stuffy nose,” Dr. Kwak says. Once that step is over, most patients report recovery is easier and less painful than expected. 

You’ll have a small plastic cast on the nose and a few stitches under the nose for about a week. When the cast and stitches are removed, most people only have a tiny bit of residual black eye. “Black eyes fully resolve by around 10 days,” Dr. Liotta shares. Although it does take a full year to enjoy the final results of rhinoplasty, “you can return to normal activity without anyone knowing you did anything” after about a week and half, she says. 

With that said, be prepared to experience residual swelling for 12 months. Dr. Liotta tells patients to expect around 85 percent of the swelling to be gone in a month and 95 percent in six months. All the swelling is generally resolved by the one-year mark.

## **The Takeaway**
Whether your aesthetic concerns center around the shape and [size of your nose](https://aedit.com/concern/nose-size) or the [prominence of your chin](https://aedit.com/concern/chin-shape-and-size), evaluating the proportion of those two facial features before choosing to undergo a cosmetic procedure is important to ensure the most balanced outcome. For some patients, combining a rhinoplasty with a chin augmentation (think: permanent chin implant or [temporary filler](https://aedit.com/procedure/chin-augmentation-with-soft-tissue-fillers)) will be the best way to maximize your time, budget, and results.

Whether you’re concerned about the size of your nose or the prominence of your chin, evaluating those two features in tandem is the best way to ensure the most optimal result.

Combining Rhinoplasty And Chin Augmentation: Benefits, Candidates, Recovery

The Benefits Of Combining Rhinoplasty And Chin Augmentation

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Septoplasty and rhinoplasty are the two major ways to surgically alter one’s nose. And though the two sound similar and deal with the same basic territory, there are major differences in each procedure. A [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job) addresses cosmetic issues with the nose, such as bridge height, a bulbous or droopy nose tip, or nostril issues, explains [Edward Kwak, MD](https://aedit.com/provider/edward-kwak-md-74), a double board certified facial plastic and reconstructive surgeon in New York City. A [septoplasty](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty), meanwhile, corrects the nasal cartilage for improved breathing. 

In even simpler terms: “A septoplasty is considered a functional surgery because it makes your nose function better, while a rhinoplasty is considered a cosmetic surgery because it can make you look better,” says [Roxanne Grawe, MD](https://www.roxyplasticsurgery.com/), a board certified plastic and reconstructive surgeon at ROXY Plastic Surgery Center in Powell, Ohio. Though disparate, the two procedures are often performed at the same time, depending a patient's needs. 

Ahead, we’ll further explain the similarities and differences between rhinoplasty and septoplasty surgery.

## **What Is Rhinoplasty?**
The most well-known form of nasal surgery, rhinoplasty (a.k.a. nose job) is a surgical procedure that alters the external shape of the nose. Rhinoplasty is “always associated with external contour irregularities,” says [Lee Ann Klausner, MD](https://aedit.com/provider/lee-klausner-md-41), a double board certified facial plastic and reconstructive surgeon in NYC. An accident or breakage caused by trauma to the nose or simply aesthetic preference about how a patient wants their nose to look, may be cause for a rhinoplasty. There’s also a procedure known as a ‘[revision rhinoplasty](https://aedit.com/aedition/what-you-need-to-know-about-revision-rhinoplasty),’ which is a secondary surgery that corrects a previous, unsatisfactory attempt. Since rhinoplasty is a cosmetic procedure, it will most likely not be covered by health insurance.

### **Rhinoplasty Recovery & Results**
The outcome of a rhinoplasty will depend on your vision for a new nose, Dr. Grawe says. “A rhinoplasty can make your [tip more defined](https://aedit.com/concern/nose-shape), remove a [dorsal hump](https://aedit.com/concern/nose-bump), make your [nose smaller](https://aedit.com/concern/nose-size) or shorter or narrower or [tilted](https://aedit.com/concern/nose-angle) differently,” she says. “All your desires should be discussed with your surgeon ahead of time, so you are on the same page prior to surgery.”

On surgery day, you’ll likely be admitted for an outpatient procedure and be able to return home after surgery. The procedure often requires [general anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), Dr. Grawe notes. As she explains, there are two types of rhinoplasty — [closed rhinoplasty](https://aedit.com/procedure/closed-rhinoplasty), which “requires incisions only on the inside of the nose,” and [open rhinoplasty](https://aedit.com/procedure/open-rhinoplasty), which necessitates a small incision at the bottom of the nose. “The decision between the two has to do with your surgeon’s preference and what needs to be changed with the nose,” she says.

Depending on the goals of the procedure, the surgeon may break your nose, which will leave you with [bruises](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) below the eyes after surgery. You’ll be sent home with a splint on the outside of your nose that will be removed about five to seven days later.

For six months after surgery, Dr. Kwak advises his patients to avoid strenuous activities, even vigorous nose blowing. You’ll also have to refrain from activities like [smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health) and drinking, wearing makeup, tannings, facials, [working out](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures), and traveling until medically cleared. “Generally, patients look fantastic at the one-month mark (or earlier), although swelling and asymmetries are to be expected until approximately the one year mark,” he says. 

## **What Is Septoplasty?** 
In contrast to rhinoplasty (which can address any number of external nasal issues), septoplasty hones in on the central nasal cartilage — the portion of the nose that separates your nostrils. As Dr. Grawe explains, the septum is like the walls of the house, providing stability to your nose and also allowing for streamlined air movement through the nose. 

For those dealing with [breathing or functional concerns](https://aedit.com/concern/breathing-issues), “a septoplasty opens up airways for improved breathing,” Dr. Kwak says. “This helps patients who suffer from a long list of nasal problems, including nosebleeds, sinus infections, snoring, and migraines.” Since septoplasty is usually considered a medically necessary procedure (read: not cosmetic surgery), it may be [covered by insurance](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures). 

### **Septoplasty Recovery & Results**
Like rhinoplasty, septoplasty is typically an outpatient procedure. During the surgery, “the cartilage in your nose will be straightened and supported with suture techniques and sometimes cartilage grafting,” Dr. Grawe explains. Depending on your specific needs, “you will have a small incision inside your nose or on the columella (the bottom of your nose),” she adds. Often, the surgeon will end the surgery by placing an internal nasal splint, which helps [decrease swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery). Many providers allow patients to go home the same day. 

After surgery, you can expect “very little” discomfort, Dr. Grawe shares, but there will likely be some swelling around the nose and cheeks. Your breathing should improve within two weeks of the procedure. Since septoplasty often involves straightening the septum, it may, in turn, straighten the nose itself. It should be noted that this is a side effect — not the goal — of this surgery.

## **Which Procedure Is Best for You?**
As with any reconstructive or cosmetic surgery, the most important factor in a successful procedure is proper communication with a [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) provider. Once a surgeon understands your reasons for seeking nasal surgery and your goals for a modified nose, they can recommend the best course of action (or even share if non-surgical options, like [liquid rhinoplasty](https://aedit.com/procedure/liquid-rhinoplasty), could suit your needs). In the meantime, all you need to do to help decide which procedure — septoplasty or rhinoplasty — is right for you: take a deep breath.

Determining the right nasal surgery for you can come down to one question: Do you have trouble breathing?

Septoplasty vs. Rhinoplasty: What's The Difference?

ayo-ogunseinde-THIs-cpyebg-unsplash

In a perfect world, every plastic surgery patient would be thrilled with the outcome of their procedure. In reality, there are an array of both functional and aesthetic reasons why someone [may not be completely satisfied](https://aedit.com/aedition/what-to-do-if-you-are-unhappy-with-your-plastic-surgery-results) with the results. This is especially true of [rhinoplasty](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty) and surgical alterations for the nose. 

Just like there are many reasons why a patient might decide to get a nose job, there are numerous ways to perform rhinoplasty. Due to the complex nature of the procedure, it might not always go as planned. “It is not surprising then that people seeking revisions of their initial rhinoplasty is quite common,” explains [Andrew Frankel, MD](https://aedit.com/provider/andrew-frankel-md-275), a Beverly Hills-based double board certified facial plastic and reconstructive surgeon. “Although the rate of patients who seek out revisions is not published, it is generally accepted that it is around 20 to 25 percent.”

To better understand why a patient might want or need a revision rhinoplasty, we’ve talked to two specialists about the ins and outs of the procedure.

## **What Is Revision Rhinoplasty?**
As its name suggests, [revision rhinoplasty](https://aedit.com/procedure/revision-rhinoplasty) (a.k.a. secondary rhinoplasty) is a corrective surgery that aims to address the function and/or appearance of a nose that has already been operated on. “Revision rhinoplasty is the most difficult of all plastic surgical operations,”  Dr. Frankel says. 

One such reason is because of how rhinoplasty techniques have evolved over time. “Older rhinoplasties were reductive where a lot of cartilage was removed, which decreases support,” explains [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), a board certified plastic and reconstructive surgeon at UCLA. “This created less support and can create asymmetry in the shape of the nose.” Another issue? “The procedure used to be very cookie-cutter and may not look natural on all face shapes and sizes,” he says. 

Since revision rhinoplasty requires revisiting a wound created by a previous procedure, there are several factors a plastic surgeon must consider before operating:

- **Scar Tissue**: “There is often a great deal of scar tissue present that has distorted the underlying delicate anatomy to the point of being unrecognizable — if it is not missing entirely,” Dr. Frankel says. 
- **What Lies Beneath**: “Once the anatomy has been uncovered, it needs to be reshaped and there might not be any cartilage left to do this,” he explains. In such cases, grafting is required, but grafted tissues “are not necessarily ideal for the needs each case warrants.”
- **Skin Condition**: Past scarring can impact the skin, too. “The internal lining and skin might be too scarred and may not be able to stretch and re-drape over the structure that cannot be replaced,” Dr. Frankel says. 
- **Functionality**: Needless to say, the nose still needs to function, too. “The airway must always be considered and maintained, which can be challenging in patients who still want a smaller nose but who need additional structure,” he notes. 

To restructure the external shape and internal workings in alignment with the patient’s desires, a precise and individualized procedure plan is needed. 

## **Why Patients May Seek Revision Rhinoplasty** 
When consulting with new patients, plastic surgeons emphasize that [results can take six months to a year](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) (or more) to be fully realized. Rhinoplasty falls into the ‘year or more’ category. But what if you still don’t like the outcome? Or what if there is an underlying complication? These are just a few of the reasons patients may seek a revision rhinoplasty:

- **Complications**: “Rhinoplasty is a delicate and complicated operation and is fraught with potential for asymmetries, irregularities, prolonged swelling and functional problems such as difficulty breathing and runny nose,” Dr. Frankel explains. The anatomy may not heal the way it intended to, which can be an issue moving forward. 
- **Aesthetic Goals**: For some, a change in taste may lead to revision — especially if a patient underwent the procedure as an [adolescent](https://aedit.com/procedure/youthteen-rhinoplasty). “The outcome is highly subjective, and, in our current society, the expectations of patients are increasing due to [social media](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) and the idealized versions that they are comparing themselves to,” Dr. Frankel says. 
- **Past Experience**: “The patients who are in search of a revision specialist are often fragile due to having prior bad experiences,” he shares. “This makes them wearier with greater scrutiny on every detail.” A previous negative outcome should not deter a patient from seeking out a highly skilled, [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) provider. 
- **Innovations**: In the rhinoplasty world, there have been [updates to technique and strategy](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs), which may lead some to feel that a secondary experience could yield a more favorable outcome. 

All of these are valid reasons for a patient to consider a revision surgery, though consulting with a board certified plastic surgeon is the best way to determine if you could be a candidate.

## ** The Right Candidate For Revision Rhinoplasty**
Revision rhinoplasty isn’t just about a second procedure. In some cases, patients have already undergone multiple surgeries. “Revisions make up about 30 percent of my practice,” Dr. Roostaeian shares, adding that he has consulted with patients who have had seven or eight previous corrective procedures. Neither of our experts has a specific number of past surgeries that will count a patient out of future work. Instead, they examine the physical state of the nose and the patient's health. [Smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health), lifestyle, expectations, and, of course, the internal damage from past surgeries will all factor into a candidate's prospects.   

## **What To Do If You’re Interested in Revision Rhinoplasty** 
You know you’re not happy with the results of your rhinoplasty, but what comes next? Arriving at the decision to undergo a revision may require even more thorough research and vetting than any of your previous procedures. Here are seven things to think about before going under the knife again:

### **1. Consider The Timing**
“There is no specific amount of time any patient must or should wait before having a corrective surgery,” Dr. Frankel says. “This depends on the type of problem.” In fact, you might not even want to wait until the previous procedure is fully healed. “For example, patients who have a bump or irregularity on their dorsum two months following their operation or those who feel their nose is too short are better off having their revision sooner than later because the wound contraction will only make matters worse over time,” he explains. In other cases, patience is necessary. “If the issue is that the nose still looks too wide or big, time will often work in that patient's favor,” he notes. “Things might improve to the point where further surgery is not necessary.” Depending on where you are in the healing process, a conversation with your surgeon can shed some light on what to expect.

### **2. Do Your Research**
A revision rhinoplasty requires a highly skilled aesthetic surgeon to address the issue at hand and will likely cost more than the first rhinoplasty. “[Meet with at least two surgeons](https://aedit.com/aedition/how-i-found-my-plastic-surgeon-its-surgery-not-a-spa-appointment) and try to determine if you are a good fit,” Dr. Frankel encourages. Consider whether or not the provider communicates well, has presented a clear plan, and is upfront about any potential limitations. Another suggestion? Ask to see lots of before and after images from each prospective surgeon, Dr. Roostaeian recommends. At that point, you should be able to assess the risk and determine what is best for your needs and goals.

<RelatedContent
  title={15 Questions To Ask Your Doctor During A Consultation}
  slug={questions-to-ask-your-doctor-during-plastic-surgery-consultation }
/>

### **3. Check Your Medical History** 
If you find a new provider for your revision rhinoplasty, make sure they have all the necessary details about your previous surgery. There are several types of rhinoplasty that a surgeon can perform and, because rhinoplasties of the past were often reductive, Dr. Roostaeian says having this information is advantageous to the new provider. Those who underwent rhinoplasty after an accident or traumatic event should also disclose this information.  

### **4. Know Your Concern** 
Be as specific as possible when consulting with providers for revision rhinoplasty. “Mentally, know what shape, size, and changes you want and verbalize it,” Dr. Roostaeian says. “The more specific you are, the more it helps us.” As he explains, being able to clearly articulate what’s bothering you will allow your surgeon to better understand what they need to do. “We want to be goal-oriented when we operate, so you shouldn’t be ambiguous,” he notes.

### **5. Understand the Risks**
There is risk involved with any surgery, and that’s even more so the case with revision procedures. It’s important to recognize that creating further trauma in the nasal area will leave behind additional scar tissue, and the cumulative scarring may make it difficult to achieve the results a patient desires. There is the added risk of complication as well. 

### **6. Know When to Walk Away**
Depending on the patient’s history, an experienced surgeon will not sugar coat the truth if a patient’s health will not allow for further revision. “I once consulted with a woman who’d undergone 34 prior rhinoplasties. Her skin was in jeopardy of necrosing altogether, so that was the deal breaker,” Dr. Frankel recalls. And it’s not just about physical health. Mental wellbeing must also be taken into account. “The operation becomes more technically challenging with each successive attempt and patients become more and more [frustrated or depressed](https://aedit.com/aedition/treatment-for-post-plastic-surgery-depression-blues-during-recovery), so there is much to consider,” he says.

<RelatedContent
  title={Managing Expectations: Achieving Desired Outcomes Safely}
  slug={how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety }
/>

### **7. Plan For Recovery** 
Since revision patients have already undergone at least one rhinoplasty, they know what to expect from the [recovery process](https://aedit.com/aedition/preparing-for-a-smooth-recovery-from-plastic-surgery). Generally speaking, [healing from the revision](https://aedit.com/aedition/what-its-really-like-to-get-a-nose-job) will be a familiar experience. With that said, it’s important to follow any pre- or post-op care instructions laid out by your surgeon for best results. 

## **The Takeaway**
Those who are unhappy with the results of a previous rhinoplasty may be good candidates for revision rhinoplasty, but it should be approached with careful consideration and realistic expectations. “There are an infinite number of ways that a nose can become disfigured after a poorly performed rhinoplasty, and there is an unlimited number of nuanced techniques for handling them,” Dr. Frankel concludes. “It comes down to the artistry and creativity of the revision specialist and their commitment to rendering the best possible outcome.”

Rhinoplasty may not always yield desired results, which is where revision surgery comes into play. The experts weigh in on what to know about going back for another procedure.

Revision Rhinoplasty: Guide To Safety, Surgery, Recovery

Considering Revision Rhinoplasty? Here’s What You Need To Know

shutterstock 1282181029

Since the time of the ancient Greeks, mathematicians, philosophers, and scientists have been searching for an elusive secret: What makes someone beautiful? Whether its Fibonacci’s Golden Ratio, to Leonardo da Vinci’s Vitruvian Man, or Charles Darwin’s competing theories of selection, we’ve long been obsessed with pinpointing the precise formula that makes one person’s face more aesthetically pleasing than another.

Enter [artificial intelligence (AI)](https://aedit.com/aedition/artificial-intelligence-in-healthcare-doctors-offices-operating-rooms). The science-fiction staple is now our modern reality, and researchers have been employing the technology — essentially a genius-level, one-track mind — in everything from rideshare apps to Alexa and, now, aesthetics.

## **The Study: Machine Learning, Rhinoplasty, & Aging**
Led by associate professor [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), researchers in the Department of Plastic and Reconstructive Surgery at UCLA recently completed a study that brings us one step closer to objectively quantifying what defines beauty.

Why is that so significant? The answer lies in matching art with science. “As plastic surgeons, we try to be as science-based as possible to be certain everything is working for our patients,” Dr. Jason explains. “We can think we’re creating beauty. But without a way to measure that objectively, we’re not really using the scientific method.”

The UCLA researchers, including plastic surgery residents Sean Saadat, MD, and Robert Dorfman, MD, set out to test whether or not existing machine learning technology (which forms complex calculations based on a set of test images) could accurately recognize what humans consider beautiful. While the initial results showed promise, they quickly realized the high degree of subjectivity would require a greater quantity of images to get objective results.

So, they shifted focus — instead honing in on just one of the many facets of beauty: youth. The surgeons used established AI technology capable of detecting a person’s age more precisely than the human eye to an accuracy within four months. “If you gave me a hundred photos could I guess virtually their exact age? No,” Dr. Jason says. “This proves that the computer is figuring out something that we simply cannot. It’s incredible.”

For the test subjects, researchers passed over the obvious options like [facelift](https://aedit.com/procedure/smas-facelift) and [brow lift](https://aedit.com/procedure/endoscopic-brow-lift) patients (we already know those procedures reduce apparent age), instead choosing a sampling of Dr. Jason’s most common clients: 100 female [rhinoplasty patients](https://aedit.com/aedition/what-its-really-like-to-get-a-nose-job), ranging in age from 16 to 72 years old. The results were eye-opening. In patient after patient, the machine returned a postoperative age that was, on average, three years younger than the preoperative age.

## **The Results: Objectivity in a Subjective Field**
Surgeons have long suspected that certain changes to the nose (like refining and rotating the tip, for example) make patients seem younger. “Conceptually, we’ve known for awhile that a droopy tip is associated with facial aging,” Dr. Jason shares, adding that the study, [recently published in the Aesthetic Surgery Journal](https://academic.oup.com/asj/advance-article-abstract/doi/10.1093/asj/sjz259/5648144?redirectedFrom=fulltext), represents “the first time rhinoplasty has been proven to show a decrease in age.” 

While textbooks and journal articles rarely (if ever) correlate facial rejuvenation and rhinoplasty, Dr. Saadat says it should come as no surprise that the popular cosmetic surgery procedure has such an impact. 

When the nose is out of balance with the rest of the face, it draws undo attention to itself, Dr. Saadat explains. A rhinoplasty aims to [manipulate the angles of the nose](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs) — the highlights and shadows — to bring it into better harmony with the surrounding facial features. Refining the nose opens up the face, highlighting the lips and eyes. “Bright, open eyes are a key indicator of youth,” he says. “In youth, facial harmony is optimized. You look more awake, more alive.”

Long term, Dr. Saadat foresees the study’s findings being a critical component of evaluating facial rejuvenation patients. “Of course, [not every aging patient needs a rhinoplasty](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty), but it’s an important piece of the puzzle, particularly when we’re fat grafting the mid-face,” he explains. “In some patients, maybe we balance it with a rhinoplasty to keep everything in proper proportion for the most natural results.”

## **The Future of AI in Aesthetics**
So, what do these findings mean for the future of aesthetic medicine more broadly? According to Dr. Saadat, figuring out how beautiful a person is on a scale of one to 10 misses the point. The focus instead is on using AI data — symmetry, proportion, and shape — as a tool to complement our more subjective sense of beauty. “It’s about asking: ‘What would this individual look like were they to be improved in their objective aesthetic harmony,’” he says.

The technology may prove particularly useful in facial reconstruction cases, allowing surgeons to “reverse engineer” what changes would yield the most pleasing outcome for the patient. “Artificial intelligence could provide a roadmap for reconstruction, rather than having to rely solely on what’s in the mind of the plastic surgeon,” Dr. Saadat says. 

Down the road, plastic surgeons may even be able to pinpoint the subtle differences in technique that create the most ‘beautiful’ result. “Over time, if we run enough numbers and enough people use this technology, we may be able to potentially figure out those differences” Dr. Jason says.

On the flip side, machine learning may also help patients in their search for the perfect plastic surgeon. “We may be able to get an objective score for a surgeon’s quality of work,” he adds, while conceding there will always be an element of subjectivity. “Whether you agree with it or not, that’s a question everyone will have to answer for themselves,” he shares.

## **The Takeaway** 
No matter how close we come to objectively cracking the beauty code, subjectivity will always remain. After all, it’s humans who have to tell the technology what is beautiful in the first place. “You feed the machine a bunch of photos, and the computer gets smarter and smarter,” says Dr. Jason. “But, absolutely, the input affects the output.” Given human nature, it’s unlikely that we’ll abandon our own individual sense of beauty, even when faced with quantifiable AI data. Beauty — for now — remains in the eye of the beholder.

Now Trending

A new study is using artificial intelligence to bring us one step closer to objectively quantifying what defines beauty. So, what does it mean for the future of aesthetic medicine?

New Study Shows How Artificial Intelligence Is Bringing Objectivity To Aesthetics

How Artificial Intelligence Is Bringing Objectivity To Aesthetics

shutterstock 621064124 (1)

We all have that friend who, according to their doctor, “needed” a [nose job](https://aedit.com/procedure/open-rhinoplasty), and then we have friends who simply wanted one. So, what’s the difference?

One of the few procedures that are common among men and women and performed from [teenage years](https://aedit.com/procedure/youthteen-rhinoplasty) through [adulthood](https://aedit.com/procedure/rejuvenation-rhinoplasty), rhinoplasty (a.k.a. nose job, nose surgery, nasal surgery) can be classified as both a medically necessary plastic surgery procedure and an elective cosmetic surgery depending on how and why it is performed.

Generally speaking, your friend who “needed” the procedure likely had what is called a ‘functional’ rhinoplasty, during which a surgeon worked to resolve internal structural issues — in addition to potentially making aesthetic changes. Because the surgery was performed for medical reasons, it very well may have been covered by insurance (typical of plastic and reconstructive procedures but not cosmetic ones).

Your friend who wanted to change the shape, size, or appearance of her nose without an underlying medical condition, meanwhile, probably underwent what is known as a ‘cosmetic’ [rhinoplasty](https://aedit.com/procedure/ultrasonic-rhinoplasty). The cosmetic surgery procedure focuses exclusively on the external bone structure and usually requires patients to pay out of pocket.

[According to the American Society of Plastic Surgeons](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf), there were some 215,000 rhinoplasties performed in the U.S. in 2018 alone, and that statistic accounts for both functional and cosmetic procedures. If you’ve been considering a nasal surgery, here is a guide to the two classifications.

## **What Is a Functional Rhinoplasty?**
First things first, a functional rhinoplasty is a medically necessary procedure that is used to [correct breathing problems](https://aedit.com/procedure/endoscopic-rhinoplasty) and sinus concerns. While we may not be able to see the inside of the nose, there can be structural issues that pose medical risks. 

“The nose is the organ of breathing,” says [Oren Friedman, MD](https://aedit.com/provider/oren-friedman-md-1609), a Philadelphia-based board certified facial plastic surgeon and director of facial plastic surgery at the University of Pennsylvania. “We are meant to breathe through the nose and not the mouth.”

As Dr. Friedman explains, the most common reason a patient seeks a functional rhinoplasty is to improve breathing. Patients who have a deviated septum (i.e. a narrow or crooked nasal passage caused by genetics, accident, or trauma), for example, may require a septoplasty to straighten or repair the septum. Beyond correcting a deviated septum, a rhinoplasty can “strengthen the sidewalls of the nose, so that the nasal sidewalls do not collapse and, therefore, obstruct airflow when the patients breathe in,” he shares. For cases of congenital abnormalities of nasal anatomy (think: cleft lip nasal deformities), meanwhile, Dr. Friedman says “highly specialized surgical care of the nasal tip cartilages and skin” is required.

For patients dealing with intense allergies or sinus infections that cause the turbinates (i.e. small structures inside the nose that clean and humidify air that passes through) to swell, nasal surgery may be able provide relief. 

There are three pairs of turbinates in each nose, and, when the lower set (read: inferior turbinates) become swollen, they can cause nasal obstruction and make it more difficult to breathe. To fix the structural issues, doctors may recommend a turbinate reduction. While non-surgical treatments, like radiofrequency, can sometimes do the trick, surgery might be needed.

“Some patients require septum straightening surgery as well as turbinate reductions, however, we generally advise against removing significant portions of nasal turbinate tissue,” Dr. Friedman warns. “Turbinate tissue is vital to the function of the nose — namely, humidifying, warming, and filtering the air are enhanced by the presence of turbinate tissue. Removal of too much turbinate tissue will lead to irreversible nasal problems. Ask your surgeon to not remove much or any turbinate tissue when you undergo nasal surgery.”

Whether performed individually or in tandem, both a septoplasty and turbinate reduction take six months to a year to heal. While improved breathing can be expected, turbinates will grow back in time and the septum may never be perfectly straight.

## **What Is a Cosmetic Rhinoplasty?**
Cosmetic rhinoplasties, on the other hand, focus on the outside of the nose (i.e. the part of the nose you can visibly see). Typically, patients that undergo the cosmetic procedure are dissatisfied with the appearance of their nose. A rhinoplasty can be used to:

- [Reshape and resize the nose](https://aedit.com/procedure/ethnic-rhinoplasty)
- [Address crookedness and asymmetries](https://aedit.com/procedure/revision-rhinoplasty)
- Change the base or bridge of the nose (or both!)
- Conceal a hump or bump
- Correct a pinched or bulbous nasal tip 

“The most common structural reasons for which patients seek cosmetic rhinoplasty include a prominent hump or bump along the bridge of the nose that they wish to be reduced, prominent and bulbous tip cartilages of the nose that they wish to be made smaller and triangulated, and a crooked nose that a person may wish to straighten out,” Dr. Friedman says. “The structural components that most often need to be altered, therefore, include the nasal bones as well as the tip cartilages.”

While the surgery is limited to the nose, the results can help to balance the entire face. At the end of the day, cosmetic rhinoplasty surgery isn’t a medical necessity, but it can boost confidence and make patients more comfortable with their appearance. 

## **Comparing Rhinoplasties** 
There are plenty of differences between a functional rhinoplasty and a cosmetic rhinoplasty, but at least one thing is true of each: the procedure improves a patient’s quality of life. While it may be easy to classify one as purely aesthetic and the other as medical, many rhinoplasty surgeries end up being a combination of the two.

“This is one of the most common procedures for specialized nasal surgeons, and it gives an opportunity for the surgeon to enhance a patient's quality of life on two different levels,” Dr. Friedman says of the combination surgery. “First, we are able to improve their quality of life through improvements to their appearance, and secondly we are able to improve their quality of life through improved nasal breathing.”

Regardless of the reasoning behind the rhinoplasty, the recovery and healing processes are similar — though there are subtle differences. “If the nasal bones need to be contoured in a cosmetic procedure, there will likely be some external bruising which would not be present if only internal nasal surgery was being performed,” Dr. Friedman notes. “Other than the slight bruising that might occur, the internal swelling of the nose generally resolved in one week for each of the different types of nasal surgery.”

At the end of the day, most people enjoy the results of their procedure by the six-month mark, but it can take up to a year for the nose to fully heal. Additionally, it is important to discuss with your surgeon whether or not your procedure is purely functional, purely cosmetic, or a hybrid because it will impact whether your insurance provider covers some part of the cost.

## **The Takeaway**
Regardless of which type of rhinoplasty you’re after, the procedure is best performed under the care and guidance of a specialized surgeon to avoid complications and the need for revisions down the road. 


“Excellence in outcomes for these types of nasal surgeries relies on the surgeon's expertise in this highly sub-specialized field,” Dr. Friedman explains. “In order to avoid the need for revision rhinoplasty due to failure of the first operation, it is very important the patient make the extra effort to identify a plastic surgeon who specializes in both internal and external nasal surgery.”

Some people need a rhinoplasty for medical reasons, while other people want one due to aesthetic concerns. Here, a guide to the two classifications and what it means for patients.  

Difference Between Cosmetic Rhinoplasty and Functional Rhinoplasty

Cosmetic Rhinoplasty vs. Functional Rhinoplasty: What’s The Difference?

shutterstock 1074678923-min

_Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors — and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery._

_So, how do you know when you've found The One? There are a few important factors. For starters, he or she must be board certified by the [American Board of Plastic Surgery](https://www.abplasticsurgery.org/), must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility and operating room. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search._

_The below interview has been edited for length and clarity._

## **Elizabeth, 52**
My two aesthetic plastic surgery experiences were at two extremes: the worst and the best.

The first time I had surgery was more than 12 years ago. I wanted my [nose reshaped](https://aedit.com/procedure/rhinoplasty-nose-job) and, during the consultation, was convinced by the doctor that I should also have a [chin implant](https://aedit.com/procedure/alloplastic-chin-implant) and some [liposuction](https://aedit.com/procedure/liposuction). The surgeon I chose was older — probably in his sixties at the time — and I figured he’d had lots of experience. He’d also appeared on _Oprah!_, which, in 2005, was a big deal. The first time I went to the surgeon's office, I took a friend from the beauty industry with me, and we were both impressed. Maybe less by him and more by his art-filled Upper East Side office and name-dropping, but I felt that if he’d had a successful practice for years, I’d be safe in his hands. Now, more than a decade later, I can see the red flags I missed.

### **The Immediate Warning Signs**

For starters, he smoked a cigar throughout our consultation. Seriously. He also talked at me the entire visit, bragging about his accomplishments and not really taking any time to get to know me or understand my concerns. He (successfully) upsold me on more surgery procedures — that chin implant and lipo — when I’d only come in about my nose. He never showed me his operating room, which was in the same building as his office. I also dismissed negative reviews I’d read online. At the time, chat rooms and community boards were relatively new and, while I did look at them, I didn't take them seriously. They were littered with negative comments about him, mostly referring to the fact that he had a terrible bedside manner. I should have paid closer attention. 

I could write a book about my negative plastic surgery story, but one detail sums up the experience: I woke up in the middle of my surgery to the doctor banging on my nose. That was emblematic of everything that followed. He botched my nose job, taking too much off the end and making my nostrils look over-exposed. He also left stitches inside my nose that caused an infection. He put in a chin implant that was too large and he overdid the liposuction, causing the skin in my stomach to permanently tighten and twist. In the end, he accepted no responsibility for anything and, while I did try to pursue legal action, my lawyer told me to save my money and put it toward reconstructive surgery. 

### **Second Time Around**

It was during the pursuit of corrective surgery for my nose that I found the [best surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist). I first met him when I developed the infection in my nose. I’d been treated so poorly by the first doctor that, when the pain started, I didn’t trust him to take care of it. So, I searched online for the type of procedure I wanted and board certified plastic surgeons who had rave reviews when it came to nose jobs. I called the one whose name came up most often. I was desperate and scared. I explained my story to the nurse on the phone, which she communicated to him, and told me that even though he was done seeing patients for the day, he would wait at the office for me until I could get there. I was so thankful. He immediately put me on antibiotics and followed up with me until the infection was gone. 

He also helped outline the surgical procedures he thought would help me and explained that I would have to allow my nose to fully heal and wait a year before I could go under the knife again. In our follow-up meetings, he took the time to understand what I wanted and even asked me to draw a picture of what I wanted my nose to look like. He was an excellent communicator and clearly explained the kind of result I could realistically expect from these new plastic surgery procedures. He seemed to both understand what I wanted and be capable of creating it for me. I trusted his artistic skill as much as his medical acumen. I did wait a year until the second surgeon could do my corrective surgery. He restored my nose and removed the oversized chin implant. 

### **Lessons Learned**

I learned a lot during those two years of surgery and recovery. First, don’t dismiss what you read online. The negative reviews are good cautionary tales, but the positive ones are also important. People are more apt to pound out angry comments, but when someone takes the time to write about exemplary work, that’s just as telling. I also believe you should trust your gut. There were warning signs with the first doctor — the smoking, the over-talking, the disinterest in me — that made me wary, but I repressed that anxiety because of this doctor’s fancy office and television appearance. Always listen to your inner voice. Beware of any doctor who goes overboard telling you everything they think is "wrong" about you and all the additional cosmetic procedures they think you "need." If you go in for a nose job, that’s what you should be discussing. Finally, consider a surgeon with a specialty in the specific procedure you want. The second surgeon I chose is known for nose jobs — it’s what he does the most often. That turned out to be one of the most important things for me.

One patient explains how she learned to trust her instincts when vetting plastic surgeons.