Rhinoplasty usually takes two to three hours, though complicated procedures may take longer and simpler procedures may be shorter. Rhinoplasty may be performed as a closed procedure through incisions inside the nose. Usually, however, I make a small cut between the nostrils to open the nose. Better visualisation with an open approach allows me to be more accurate in shaping structures inside the nose. With time this incision should be barely visible.
General anaesthesia is used for most operations, although for tip work local anaesthesia and sedation is recommended. Cuts are made inside the nostrils and usually also a small cut is made between the nostrils (open rhinoplasty approach). The skin of the nose is lifted away to expose the skeleton. This skeleton of cartilage and bone is then modified to give the nose its new form. Tissue may be removed, reshaped or added to. Once reshaping is completed, the wounds are closed and a nasal shield may be applied to be worn for about 2 weeks after surgery. Depending on the extent, the duration of surgery may be between 1 and 4 hours.