One of the most common cosmetic procedures, rhinoplasty, popularly known as a "nose job" may be performed either to improve the appearance of the nose or to enhance its function. Potential physical alterations apart from work done to correct breathing problems include changing the shape and size of the bridge of the patient's nose, the tip, or the nostrils.

Beyond the usual requirement of overall good health, anyone who is dissatisfied with their appearance and who has a realistic expectation of the degree of improvement possible from the procedure is a good candidate for rhinoplasty. The cultivation of realistic expectations begins in the initial surgical consultation when patients discuss what they do not like about their noses and receive an evaluation from the surgeon. This evaluation judges their facial structure including the condition of the nasal cartilage and surrounding skin as well as the relationship of the nose to the overall proportion of their features. While there is no single "perfect" nose, the real goal of any such procedure is to achieve a pleasing overall facial harmony.

Patients are counseled to ask as many questions as they wish during initial consultations and not to move forward with a rhinoplasty procedure until they completely understand and are comfortable with the work that will be performed. Patients who have poor circulation, diabetes, smoke, or who take certain medications (such as blood thinners) may be advised to alter their behavior or, in conjunction with advice obtained from their primary care physicians to temporarily stop taking a medication or to decrease the dosage. (A patient should never stop taking a drug or change their dosage without first consulting with their primary care physician.)

In the vast majority of cases rhinoplasty is an outpatient procedure that may be performed using either a local or general anesthetic. The surgeon makes his incisions inside the nostrils and in some cases at the base of the nose allowing access to the bones and cartilage that will be altered. Depending on the extent and nature of the work to be performed, cartilage and bone may be removed, remolded, or even enhanced with grafted material. Patients should expect to receive prescriptions for both pain medication and antibiotics after the procedure and to be asked to follow a care regimen including dressing and cleaning the effected area.

For the first week after the procedure the patient will wear a nasal splint to help the nose maintain the newly achieved shape. There will be bruising and swelling, especially around the eyes, but these effects begin to improve by the third day and disappear completely within two weeks. Minor swelling may continue to be present for as much as six months, but will not be generally apparent to casual observation. Patients should be aware, however, that the nose will not completely assume its new shape until all swelling has disappeared. While most patients return to normal social activities within three weeks any strenuous activities that might cause damage to the nose, like playing sports, should be avoided.

Normally health insurance will not cover the cost of a cosmetic rhinoplasty procedure, but if the surgery is being performed to correct or to improve a breathing condition the benefits of your policy may apply. The best practice is to consult with your insurance company prior to the procedure with as accurate an estimate of the charges to be accrued as possible. Depending on the amount of work to be performed rhinoplasty may cost from $4,000 to $12,000.