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According to the American Society of Plastic Surgeons (ASPS), in 2005, 298,000 Americans had rhinoplasty, the second most popular surgical cosmetic procedure that year. Also known as nose reshaping surgery or a nose job, the average cost of a rhinoplasty procedure is $3,511, or roughly 1,633 boxes of Kleenex.

Although the documented history of rhinoplasty begins in India in 500 B.C., it was in the mid to late 1800s when doctors in Europe and America began experimenting with surgical procedures designed to enhance the shape, appearance, and functionality of the nose. These procedures, though far less advanced than today’s surgical methods, worked to restore a proportional nose shape after an injury, and to correct constricted breathing or birth defects.

One might argue that the current popularity of rhinoplasty began in Hollywood almost 100 years ago. As reported by The Los Angeles Examiner on May 5, 1930, "Having one's nose shaped to fit the talkies is the most popular thing in Hollywood now. Hollywood plastic surgeons agree that more than 2000 facial beautification operations have been performed among film players within the past few years." Today, I questions whether there's a celebrity out there who hasn't had some type of work to enhance their appearance in the spotlight. The long list of stars who, according to GoodPlasticSurgery.com, are rumored to have had nose jobs include supermodel Giselle Bunchen, actress Kate Hudson, and singer Gwen Stefani. The Before and After pictures are astonishing!

As defined on medicine.net, an online physician’s resource, rhinoplasty is a “cosmetic procedure, often performed to enhance the appearance of the nose.” During the procedure, “the nasal cartilages and bones are modified, or tissue is added. The aim is to improve the visual appeal of the nose.” Rhinoplasty can be used to enlarge or reduce the nose, as well as reshape the bridge and nose tip. According to Cosmetic Plastic Surgery, an online cosmetic surgery resource, “there is no minimum age requirement for this procedure; however, surgeons normally prefer that the nose is fully developed. On average, a girl’s nose is fully developed by age 13, and a boy’s nose is fully developed by age 15.”

Although there is much that a good cosmetic surgeon can do with a nose, common changes made during rhinoplasty include:

• Restructuring the tip of the nose by adding or removing cartilage at the tip then stitching the cartilage together. A low nose-tip can be raised by adding cartilage for support, removing extra cartilage in the septum, or repositioning the cartilage

• Reshaping a hump on the nose’s bridge by removing excess cartilage and bone

• Correcting the wide, bony portion of the nose by breaking the bones of the nose then repositioning them inward

• Reducing a nose with a wide base by removing tissue at the base of the nose and moving the nostrils closer together

• Minimizing wide nostrils by removing small wedges of skin from their base and bringing them closer together

• Changing the angle between the nose and the lip by trimming the septum

To date, there are two types of surgeries available to patients considering a nose job: open rhinoplasty and closed rhinoplasty. These two procedures are differentiated by the type of incisions that the cosmetic surgeon makes during the surgery. For minor nose reshaping, most surgeons choose closed rhinoplasty. Using this method, the doctor makes incisions within the nose then separates the skin of the nose from the bone and cartilage. Once exposed, bone and cartilage can be removed, reshaped, augmented, or rearranged to achieve the desired look. After the cartilage and bone have been reconstructed, the skin is re-draped over the newly shaped cartilage and bone and the incisions are closed.

For major nose reshaping, surgeons will choose open rhinoplasty. In this procedure, the surgeon makes incisions inside of the nose as well as in the columella, the vertical strip of skin separating the nostrils. Nasal augmentation using a silicone implant has also become an option for individuals seeking a change in face. In this procedure, incisions are made along the nose, creating space for a soft, medical-grade silicone implant. This procedure is largely used to increase the height of the nose and refine nasal tip projection.

Rhinoplasty can be performed under local anesthesia or general anesthesia and usually takes place in a doctor's outpatient surgical office. Although the amount of time varies with the degree of nose reshaping necessary, this surgery usually lasts between one and three hours with most patients returning home the same day. Immediately after the surgery, the surgeon inserts a soft material inside the nose to maintain the nasal structure. An external splint, which is typically worn for one week, is also applied. This helps to maintain the nose’s new shape, as well as provide protection during the healing process.

Following the surgery, the nose and the area surrounding it are commonly bruised and swollen. Bruising, which disappears within about one week if the nasal bones are not broken and two if they are, may extend to the eyes and, in some cases, to all areas of the face. Depending upon the type of rhinoplasty a patient has, a patient’s swelling can take anywhere from one week to six months to completely abate. Whereas swelling improves in one to six weeks following closed rhinoplasty, open rhinoplasty can take one to six months before normality is returned. Numbness of the tip of the nose is normal and usually lasts for several weeks.

Approximately two weeks after surgery, all splints, stuffing and bandages are removed. Although closed rhinoplasty stitches need not be removed, open rhinoplasty stitches are removed about a week after surgery. In most cases, patients can return to work within a week and exercise can be resumed within a month. However, surgeons suggest that patients avoid all contact sports for at least 6 weeks. The final results of rhinoplasty are usually visible within 6 months, but in some instances it has been known to take up to two years. Although discomfort after a nose job is minimal, pain medications are taken for two to five days following the closed rhinoplasty surgery and four to ten days after open rhinoplasty.

The cost of rhinoplasty is variable. According to Plastic Surgery Research.info, an online, cosmetic surgery informational resource, the total price of rhinoplasty can range between $3,000 and $12,000. This quote comprises three fees: the surgeon’s fee, the anesthesiologist’s fee, and the facility fee. The most costly aspect of rhinoplasty is the surgeon's fee. It is also the one that is the most difficult to estimate. Factors such as the surgeon's training, skill, experience, location, and they type of cosmetic changes to be performed all contribute to the final surgeon’s fee. That said, despite the temptation to go with a cosmetic surgeon who fits easily into the budget, it is important to choose a board-certified plastic surgeon from the American Board of Plastic Surgery who has extensive rhinoplasty experience specific to the patients needs.

Rhinoplasty procedures are not covered by insurance unless it is performed for medical reasons. Broken noses caused by accidents or modifications to the nasal passage made to aid breathing, among other medical necessities, are usually covered, at least in part.

For more information about rhinoplasty, consult your cosmetic surgeon or visit the links below. Also, to view a video of the surgery (be warned, it’s graphic), click HERE.