I usually recommend that patients wait until they are at least 15 or 16, and possibly older for boys, before undergoing rhinoplasty. This is because the nose may not be fully developed at a younger age.
Rhinoplasty is sometimes performed in conjunction with nasal septum surgery for airway problems. During your consultation you will be asked about your medical history, breathing problems, allergies that may cause nasal stuffiness, and if you are a chronic user of a nasal spray.  
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. It is not a good idea to have a rhinoplasty if you do not know what it is about your nose that bothers you.
In evaluating you for rhinoplasty, a routine and painless examination of your internal nasal structures will be performed. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied.

INDICATIONS

Some of the common indications/reasons why people request a rhinoplasty include:

  1. your nose appears too large for your face
  2. there is a bump on the nasal bridge when viewed in profile
  3. your nose seems too wide when viewed from the front
  4. the nasal tip droops or plunges
  5. the tip is thickened or enlarged
  6. your nostrils are excessively flared
  7. your nose is off-center or crooked
  8. previous injury has made your nose asymmetrical

A rhinoplasty can usually enhance self image and people who undergo the procedure for that reason are usually happy with the outcome. It is also important to understand that the shape of your nose can be changed to a degree, but the extent to which that can be done is dependant on the initial shape of the nose. Mostly problematic areas can be improved and refined rather than give you a totally different nose.

PROCEDURE

There are generally two approaches to a rhinoplasty. The first approach is called a “closed rhinoplasty” where the incisions are all made inside the nostrils. The second approach is called an “open rhinoplasty where there are incisions made inside the nostril as well as across the tissue separating the nostrils which is called the columella. There are different indications to these approaches and the choice between them depends on your nose and the goals set out for the procedure.

Through these approaches various reshaping procedures can be performed including:

You may not need all the above procedures and it is important to understand what the exact operative plan is for your nose.

After the procedure, you will have a nasal splint in place which covers your nose. In some cases, there will be a need to insert nasal plugs in the nostrils but these will be removed 24 hours after the surgery.

The first couple of days after surgery, you should restrict your activities and sleep with your head elevated. This will help to minimize swelling and reduce the possibility of minor bleeding, which is not uncommon.

Generally, bruising around the eyes and cheeks is most apparent during the first three days following surgery. Most discoloration will disappear within a week. A few days after surgery, you can begin to use makeup as a concealer, if desired. Noticeable swelling may last for several weeks. You may need to continue wearing the nasal splint for up to a week, during which time you should avoid getting it wet.

The goal of rhinoplasty is a nose that looks natural and blends harmoniously with your other facial features.

DISADVANTAGES / COMPLICATIONS

Complications are usually rare but some that may occur include:

  • Anaesthetic complications
  • Bruising and long-term swelling
  • Bleeding
  • Infection
  • Unattractive scarring
  • Septal perforation
  • Patient dissatisfaction / unsatisfactory results
  • Asymmetry
  • Numbness of the nose
  • Overcorrection of the problematic area such as the dorsal hump
  • Nasal obstruction
  • Damage to deeper structures such as nerves and tear ducts

These complications may require further surgery.

In general, a rhinoplasty is a very rewarding operation.