Christopher Thomson F.R.A.C.S
Ear, Nose and Throat & Facial Plastic Surgery
Phone: +64 (03) 356 0274
Home > Facial Plastic Surgery Procedures > Rhinoplasty (Nose)

Rhinoplasty (or Nose Jobs)

ENT and facial plastic surgery specialist Chris Thomson offers rhinoplasty procedures (or "nose jobs") in Christchurch NZ.

Rhinoplasty (Rhino – latin - nose Plasty – Greek – moulding) surgery is one of the most common but also most complex surgical procedures performed by facial plastic surgeons. Because the nose is the most defining feature of the face, any alteration in the size or shape of the nose can dramatically improve one’s appearance.

Many people are interested in improving the appearance or function of their nose and seek consultation with their facial plastic surgeon. Selection of a surgeon experienced in rhinoplasty surgery is a critical step in the pathway to successful rhinoplasty surgery. arrow1more info
Rhinoplasty is a surgical procedure designed to change the shape and/or the size of the nose (cosmetic rhinoplasty), or to improve the nasal airway (functional rhinoplasty). Often rhinoplasty surgery encompasses both of these elements.

Rhinoplasty Nose Surgery Before and After pictures

Septorhinoplasty Septum Surgery Before and After pictures



  • A bump on the bridge of the nose
  • A broad nose
  • Tip deformity (too pointy, too flat, twisted, droopy, bifid (a double point at the tip of the nose)
  • Crooked nose (congenital or post traumatic)
  • Augmentation rhinoplasty for a collapsed post traumatic nasal deformity.
  • Revision surgery to correct breathing or deformity problems resulting from previous nasal surgery

Functional (nasal obstruction)

  • Septal deviation (septoplasty)
  • Alar collapse (inwards prolapse of a floppy the side wall of the nose on inspiration)
  • Co-existing sinus problems may be present in the sinuses such as chronic sinusitis or nasal polyposis. This can be dealt with at the same time with endoscopic sinus surgery

Techniques – open vs closed

Rhinoplasty surgery can be performed entirely from within the nose using hidden incisions internally (closed rhinoplasty). However a small external incision across the bridge of skin that runs between the nostrils is often necessary to allow fuller exposure of the underlying nasal skeleton (open or external rhinoplasty).  I often use this approach, particularly in cases where the anatomy is complex and difficult to define with a closed approach, where the nose is severely twisted or in cases of revision rhinoplasty where increased access is advantageous.  An open approach gives superior visualisation, less bleeding and better results and as a result has become increasingly popular in recent years.

The incision does result in numbness of the nasal tip which resolves over a few months and perhaps slightly greater swelling postoperatively which settles with time.  Your surgeon should discuss his or her preferences with the reasons why particular approach is used.  See FAQ's.

This procedure is favoured in cases where the anatomy is complex and difficult to define in a closed approach, where the nose is severely twisted or in cases of revision rhinoplasty where increased access is advantageous.

The use of an open approach has become increasingly popular in recent years. The incision does lead to some numbness of the tip of the nose which is usually transient and perhaps slightly greater swelling of the tip postoperatively. Your surgeon should discuss his/her preferences with the reasons why a particular approach is used.  See Frequently Asked Questions.

Rhinoplasty Nose Surgery Before and After pictures

Septorhinoplasty Septum Surgery Before and After pictures

Your Rhinoplasty Surgery

Usually I perform rhinoplasty surgery under a full general anaesthetic in hospital.  However patients who only require surgery to the nasal tip can have this performed under local anaesthesia in our local anaesthetic theatre facility with considerable cost savings.  Most patients stay overnight but occasionally these procedures can be performed as a day case. Once you are asleep your nose will be infiltrated with local anaesthetic to numb and shrink up the lining membrane of the nose. This helps improve visualisation and to reduce bleeding. Closed rhinoplasty is performed via internal incisions, which are closed with dissolving sutures. External surgery will involve the addition of a small incision across the columella of the nose which is closed with non absorbable sutures. Surgery frequently involves straightening of the nasal septum (septoplasty) followed by reduction or augmentation of the back of the nose and finally surgery to the tip of the nose to support it, to reduce its size or to change its shape.

Once surgery is finished I apply paper tapes to the skin over the back of the nose to minimise swelling and a plastic splint to protect the nose from trauma. Occasionally I use internal nasal splints as well to hold the septum securely in position for the first week. If internal splints are placed the nose will feel very blocked for the first week until these are removed. Otherwise, patients are generally able to move some air through their nose although they should expect to feel stuffy and blocked for 1-2 weeks.  Nasal stuffiness can be reduced by the use of otrivine spray in the first postoperative week. Swelling is quite variable and is usually at its worst on postop day 3.

External sutures, internal and external splints and nasal taping are removed 5-7 days following surgery.  At this point much of the bruising and swelling has subsided and the nasal airway will be improving although the nose will still look markedly swollen when compared to its preoperative state. Patients should expect a continued improvement in breathing or appearance over the following 6 weeks. Final results may not be seen for up to a year.

Patients should only blow their nose lightly in the first week and should avoid wearing glasses if possible for the first month following surgery. In most cases patients are able to return to work within 7-10 days. Vigorous exercise should be avoided for the first fortnight.

As with any operation, there are risks involved. On rare occasions bleeding from the nose post surgery can be significant and may require attention. Occasionally infection can occur but the incidence of this is minimised by the use of intraoperative and postoperative antibiotics.  

Patients should be aware that even in the best of hands approximately 10% of patients derive a less than satisfactory result often due to the unpredictability of healing or the difficulty of the presenting problem. A proportion of these patients may elect to undergo revision rhinoplasty surgery to correct any postoperative problems. I always discuss this risk with patients preoperatively.

Read the Rhinoplasty Advice Sheet.

Click here to view the cost of surgery.

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