Rhinoplasty (Nose Surgery)

Rhinoplasty at Brandeis Clinic reshapes the nose — reducing a dorsal hump, refining the tip, correcting asymmetry, or adjusting overall proportions — through either open or closed surgical technique. MUDr. Lucie Kalinová performs rhinoplasty under general anaesthesia. The procedure is highly individual: the surgical plan is developed at consultation by analysing the nasal anatomy in relation to the broader facial structure, with the goal of producing a natural result proportional to the patient's face rather than a template outcome. Recovery involves nasal splinting for approximately 1 week, with swelling resolving gradually over 6–12 months to the final shape.

Rhinoplasty — surgical reshaping of the nose — is one of the most technically demanding procedures in plastic surgery because of the nose's structural complexity, central facial position, and the precision required to achieve a natural-looking result at the correct proportional scale for the individual face. **Surgical approaches:** *Closed (endonasal) rhinoplasty:* All incisions are placed inside the nostrils. This approach leaves no external scars and has a shorter recovery (less swelling, faster resolution) but provides limited exposure for complex structural work. It is appropriate for patients requiring limited tip refinement or modest dorsal reduction where the internal anatomy is accessible. *Open rhinoplasty:* A small transcolummellar incision connects the two nostril incisions across the columella (the strip of skin between the nostrils). This provides full exposure of the nasal skeleton — cartilages and bones — enabling precise work on the tip cartilages, spreader grafting, and osteotomies for hump reduction. The columellar scar is virtually invisible at 6–12 months. Open rhinoplasty is the standard approach for complex reshaping, revision cases, and procedures requiring significant tip reconstruction. **Common corrections:** - Dorsal hump reduction: the bony and cartilaginous hump is reduced and the nasal bones are medialized by controlled osteotomy to close the open roof. - Tip refinement: the lower lateral cartilages are reshaped, repositioned or reinforced with cartilage grafts to produce a more defined or appropriately projected tip. - Alar base reduction: narrowing of the nostril base for proportional correction. - Deviated nasal septum: functional correction (septoplasty) can be combined with rhinoplasty when nasal obstruction is also present. - Revision rhinoplasty: correction of outcomes from previous surgery — technically more demanding due to altered tissue planes, scar tissue, and potentially depleted cartilage supply. **Cartilage grafting:** When structural support or additional tissue volume is required (particularly in revision cases or saddle-nose correction), cartilage grafts are harvested from the nasal septum, ear concha, or ribs. The surgeon plans graft requirements at the pre-operative consultation. **Anaesthesia:** Rhinoplasty at Brandeis Clinic is performed under general anaesthesia. Total surgery time is typically 1.5–3 hours depending on complexity. **Recovery:** A nasal splint is applied at the end of surgery and removed at approximately 1 week. Significant bruising around the eyes (periorbital ecchymosis) is expected and typically resolves within 10–14 days. The nose will appear swollen for several weeks; the tip — being the most distal and poorly vascularised area — remains slightly swollen for 6–12 months before the final shape is apparent. Patients should avoid contact sports and activities that risk nasal trauma for at least 3 months. **Setting expectations:** The most common source of patient dissatisfaction with rhinoplasty is an unmet expectation that the result is visible at 2–4 weeks. MUDr. Kalinová discusses realistic healing timelines in detail at consultation.