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What Are the Steps of a Rhinoplasty Procedure? 

Patricia Villate | December 5, 2023 | Posted in Rhinoplasty Surgery

A rhinoplasty procedure includes creating an incision, reshaping the structures of the nose, correcting a deviated septum if applicable, and closing the incision. Of course, every plastic surgery will proceed differently, as each patient has a unique nose and goals for reshaping it. Some rhinoplasties may require more work than others, e.g., if the patient desires a significant transformation. In addition, some patients may want changes to the nose that improve its function, as well as aesthetic enhancements that create a more pleasing shape and contour. 

Before having a rhinoplasty, it’s essential to consult with Great Neck plastic surgeon Thomas W. Loeb, M.D. He is one of New York City’s top rhinoplasty surgeons and favors a natural-looking rhinoplasty outcome in harmony and balance with the face. He also specializes in revision rhinoplasty for patients with disappointing results with prior surgical procedures. Here is what to expect for a rhinoplasty procedure.  

Nasal Analysis and Consultation 

The first step of a rhinoplasty procedure is a patient consultation, as the surgeon must ensure they are a good candidate for the procedure, have reasonable expectations for the outcome, and are prepared for the recovery process. Next, the surgeon performs a “systematic analysis of patient’s frontal, lateral, and basal nasal views which provides a background to identify changes to ideal aesthetic proportions and how to surgically restore them while maintaining gender and ethnic congruency.” 

This analysis plays an essential role in tailoring surgical plans, ensuring functional improvements, and fostering effective patient-surgeon communication. The actual steps in a rhinoplasty are as follows:  

Administering Anesthesia 

Rhinoplasties are typically performed under general anesthesia, although you may decide to discuss the possibility of intravenous sedation with the surgeon instead. In either case, you must adhere to fasting guidelines—including water restriction—before the surgery. You’ll be continuously monitored the entire time you’re under anesthesia to ensure your comfort and safety. 

Making the Incision 

Once the anesthesia has taken full effect, the surgeon creates the incision. A rhinoplasty may sometimes be performed with an open incision, which is made across the columella, i.e., the “strip” of tissue that separates the nostrils. However, many surgeons like Dr. Loeb prefer the closed approach to minimize scarring. With this approach, the surgeon hides the incisions inside the nostrils. 

Performing the Alterations 

After making the incision and gently raising the skin to allow for access to the nasal structures, the surgeon can begin making the desired changes. If you’re experiencing breathing issues due to a deviated septum, the surgeon can straighten the septum to improve functionality. Aesthetic changes may be achieved by removing cartilage or bone to reduce size and reshape some areas and adding cartilage grafts to increase size in other areas. 

Closing the Incision 

After sculpting, resizing, and reshaping the nose, the surgeon will reposition the tissue and skin. Then, the surgeon closes the incision. 

Monitoring the Patient 

After closing the incision, the anesthesiologist or nurse anesthetist will continuously monitor you as you gradually wake up. You’ll likely feel groggy and sleepy for a while, and you’ll need an adult to drive you home and stay with you during the initial recovery. 

Schedule a Consultation with Dr. Thomas Loeb, M.D. 

During his decades-long clinical career, Dr. Thomas Loeb has developed an enduring reputation as a rhinoplasty specialist. As a widely hailed, board-certified plastic surgeon, Dr. Loeb takes great care during the pre-surgical planning process, ensuring that each patient is fully informed of the procedure and has reasonable expectations for the outcome.  

As a board-certified plastic surgeon, Dr. Loeb prioritizes patient care and safety, as well as the patient education process. Schedule a consultation for a rhinoplasty or rhinoplasty revision with Dr. Loeb in his Great Neck, NYC office. 


Plastic and Reconstructive Surgery – Global Open, Evidence-based Nasal Analysis for Rhinoplasty, 

Mayo Clinic, Rhinoplasty, 

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