What Is a Rhinoplasty?
“Rhinoplasty” means changing the shape of the nose. A few related terms often come up: septoplasty refers to changing the shape of the septum, the partition between the two nasal passages; septorhinoplasty refers to reshaping both the septum and the nose; and “nose job” is simply a colloquial term used interchangeably with rhinoplasty.
While the names vary, all nasal surgery shares the same fundamental goals: to improve how a patient breathes, how the nose looks, or both.
The nose is composed of three layers. The outermost is the skin and soft-tissue envelope. In patients with thicker skin, the amount of definition achievable in the tip is more limited; in those with thinner skin, small irregularities in the underlying structure are more likely to show. This envelope can occasionally be refined (thinned by removing soft tissue, or augmented with fascia grafts and/or fat), but in most cases it is left unchanged during surgery.
The middle layer is the structural framework of bone and cartilage: the nasal bones, the upper lateral cartilages, the lower lateral cartilages, and the septum. These are the structures reshaped during rhinoplasty and septoplasty to refine the appearance and function of the nose. Cartilage grafts are typically taken from the septum to strengthen the nose and help prevent the nasal valves from collapsing during breathing.
The innermost layer is the mucosa, the internal lining of the nose. It is not reshaped during rhinoplasty, but it is often gently mobilized to reach the cartilage being modified. Protecting this lining during surgery is important to avoid complications.
To reach the bone and cartilage, incisions are required. In an open (external) rhinoplasty, a small incision is made across the columella, the narrow strip of tissue at the base of the nose between the nostrils, connecting to incisions hidden inside the nostrils. In an endonasal (closed) rhinoplasty, every incision is made inside the nostrils. Each approach has advantages and trade-offs, but the approach itself does not determine the result. Rhinoplasty is an art, and just as every artist has their own style, every surgeon has their own approach.
Preservation rhinoplasty is a technique first described more than a century ago and practiced by a small group of surgeons for well over fifty years. Over the past decade it has gained wider adoption through international collaboration among surgeons, and it remains an excellent option for certain cases.
Dr. Namin’s Philosophy
There is no reason to operate unless you are bothered by the appearance of your nose, have difficulty breathing through it, or both. Surgeon and patient should proceed only once the goals of the operation are clearly defined and mutually agreed upon.
In truth, there is no firm line between “cosmetic” and “functional,” a distinction that has gained traction largely because of the role insurance plays in healthcare. The ultimate goal of rhinoplasty is to improve a patient’s quality of life and self-confidence.
During your consultation, Dr. Namin will ask what bothers you about your nose, along with your history of any prior nasal surgery, nasal trauma, and breathing difficulties. He will then develop an operative plan and a simulated preview of the anticipated result. That simulation is not a guarantee; it is a tool for communication, helping ensure that Dr. Namin’s vision aligns with yours. Together you will review the risks of the procedure and the recovery to expect.
Before moving forward with an operation of this kind, it is essential that Dr. Namin and the patient share a clear agreement on the goals, and that the patient understands both the potential complications and the recovery ahead.