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Dr. Prabhash's Rhinoplasty Nose Surgery Clinic, Delhi, India.
In This Page : Rhinoplasty Nose job description & Before After Pictures of almost every type of nose including Augmentation
Rhinoplasty, Dorsal Hump removal Rhinoplasty, Breathing Problems and Septoplasty, Broad (Big) & Long Nose
Rhinoplasty, Nose Lenghtening for Short Nose with visible nostril, Rhinoplasty for deviated or crooked & Saddle Noses,
Cleft Rhinoplasty, Revision Rhinoplasty, Rhinophyma (Acne Rosacea or Potato Nose), Open & Close
Rhinoplasty Videos and FAQs related to Cosmetic Nose Surgery at affordable cost.
Rhinoplasty at Dr. Prabhash's Cosmetic Surgery Clinic, New Delhi, Delhi, India.
Rhinoplasty Nose Surgery
one of the most common cosmetic plastic surgery done world wide. Central part of face including forehead ,
nose and peri oral area ( lips and adjacent area) gives our face a unique feature. Nose, Being the most projected part of face is noticed first when one
sees our face. Various Rhinoplasty criteria have been defined for aesthetically pleasing nose but all these cant be used on every case. Each and
every race (Indian, Caucasian, Negroes, Asians Orientals) have different characteristic and any Rhinoplasty Nose surgery should be planned considering the
characteristic of that race. We have multiple races with minor to major variation in facial features in our country , means we have almost every type of
face and so every type of nose here. Your Rhinoplasty surgeon should be able to design and tailor surgery individually for your best. Common complaints by patient & Concerned Types of Rhinoplasty (Nose Surgery) or Nose Job / Nose Reshaping Surgery Procedures :- Broad Nose Rhinoplasty :- Osteotomy & Narrowing of Nose with Tipplasty. Hump Nose or Bumpy Nose Surgery :- ( Hump) Reduction Rhinoplasty or Nose Job with roof closure Long Nose Rhinoplasty with Drooping tip :- Tip-plasty with or without Augmentation Rhinoplasty (Nose Job) or Reduction Rhinoplasty (Nose Job) Lateral Deviation of Nose or Crooked nose - Septo-Rhinoplasty :- Straightening of Nose or Corrective Rhinoplasty (Nose job Surgery) Low Dorsum or Bridge of Nose -Dorsum Augmentation Rhinoplasty :- Augmentation Rhinoplasty or Nose Job with or without tip plasty Big or Bulky Nose:- Reduction Rhinoplasty with tip plasty. Short Nose with upturned tip and visible nostrils - Short Nose Lengthening see Augmentation Rhinoplasty below. ( for examples of all - see Rhinoplasty before and after pictures below) Commonly, combination of various Rhinoplasty or nose job procedures is needed to provide a cosmetically or beautiful nose in every Rhinoplasty or nose job.
In general, a narrow nose with optimal projection beyond face, straight dorsum (with slightly elevated tip in females), nose lip angle 105
degrees with tear drop shaped nostril is considered good. Overall , changes done during surgery are demand based, means what patient feels abnormal. Congenital and post traumatic deformities :- Rhinoplasty or nose job in such situations are designed
according to the deformities or nose and other associated deformities.
Breathing Problems Deviated Nose Septum & Septoplasty
Nose is an organ of breathing first, cosmetic next. Correction is done to improve both look and function. Any cosmetic correction is never done at the
cost of function anywhere in body. Nose works as humidifier and warmer for the air we breath. Septum, the middle wall of nose which divides it in two passages, is partly bony and partly cartilaginous.
Deviated nasal septum or DNS is a very common occurrence in general population and often considered reason of obstruction in breathing, which is not always true.
Nose is having two valve areas, external and internal, breathing difficulty occurs usually due to narrow valve area rather than deviation of septum, unless the later is very severe. Of course deviated nasal septum gives nose a
deviated look from outside and correction restores its look and when associated with procedures to open the collapsed valves, improves both look as well as breathing. Most of our male population face breathing problem which
is not due to deviated septum but external valve collapse, very common in India.
Rhinoplasty Surgery (Nose job) Before After - 60 years old male with severe drooping of tip with
external valve collapse leading to obstruction in breathing - first treated with Septoplasty , turbinate reduction and tip correction outside India without improvement -
Simple nose lift with external valve correction provides best correction of breathing as well as look.
Deviated Nasal Septum DNS Septoplasty & Deviated Nose Correction :- Correction of DNS with or without other
Rhinoplasty procedures or nose job procedures.
Before after picture of severe S shaped curvature of septum, this septum was curved not only in upside down plane but also in antero posterior plane, straight septum after
correction. (Note: - Please Dont see this picture if sight of blood hurts you,we have tried to blur the blood soaked areas. Complete Septoplasty involves
correction of & cartilaginous septum as well as bony part & realignment of all
structures to provide a straight nose with patent nasal passages. Deviated Nose / Crooked Nose :- deviated nose ( Abnormally healed nasal bone fracture or Congenital Deviation )
Rhinoplasty or Nose Job for correction of nose deviation.
Post Traumatic Deviation of Nose - Before After
Rhinoplasty, Patient wanted to retain other racial Characteristics like tip and Nose length which has been respected.
More Deviated Nose examples : See Revision Rhinoplasty & importance of massage below and Photo Gallery
Open & Close Nose job Surgery Videos
Rhinoplasty Video demonstration :-
Rhinoplasty India Nose job Delhi - Video by Dr. Prabhash
Closed Rhinoplasty Video by Dr. Prabhash
Dorsal Hump Reduction Rhinoplasty with correction of external & internal valves by Dr. Prabhash
Rhinoplasty Before and After
Individual Rhinoplasty procedures and before after pictures (Case Examples) - Scroll down to see individual nose types,
open and close rhinoplasty videos and rhinoplasty before after pictures for
individual nose deformities.
i) Augmentation Rhinoplasty :-
Dorsum Height Augmentation Rhinoplasty - Some amount of augmentation you will find in almost every nose job
except hump reduction, even in nasal hump reduction, cartilage graft in dorsum is needed to close open roof.
Augmentation Rhinoplasty or nose job done to elevate the depressed dorsum or tip or both.
In augmentation Rhinoplasty autogenous and artificial material can be used.
We usually use autogenous material unless there is no natural source for it.
Here in this page augmentation has been associated with other nose job procedures in almost all
cases except hump reduction and in every case only nose framework has been modified for natural & best Rhinoplasty (Nose
Surgery) results. Silicone nose implant or any other implant has not been used in any
Augmentation Rhinoplasty before & after picture of dorsum or bridge of nose augmentation
to match with tip along with tip plasty : Augmentation with septal cartilage graft : For Surgery see
Length Augmentation Rhinoplasty for Short Nose :
Short Broad Nose with visible upturned Nostril Before After
picture. Narrowing of nose with tip & septum lengthening done. Septum and complete Nose augmentation with autogenous septal cartilage graft.
Short Nose Lengthening with autogenous septal graft Before & After picture.
ii) Alar & Nostril Reduction &
Nose Tip Rhinoplasty (Nose Surgery) :
Different type of nose tip deformities, their correction and before after pictures (A) Droopy projecting tip)Tip plasty usually involves correction of nearby framework also to create a harmony with rest of nose.
Tip of nose gives us a distinct appearance and nose tip deformity is always obvious as its the most projected part of our nose.
Before after picture Tip plasty- Such deformity is usually found in occult type 0 facial cleft.
This tip plasty has been done by remodeling of nose framework (Alar & upper lateral
cartilage under local anesthesia , no artificial material used. (B) Low (Bridge) Dorsum & Bulky Tip (Big Bulky or Bulbous Tip of Nose) :-
Augmentation Rhinoplasty or Nose Job with Tip Plasty. Tip plasty to reduce bulkiness , in such noses alar cartilages
are usually hyperplastic and fat accumulation is found between cartilage framework and
skin. Ear (Conchal) cartilage has been used for nose dorsal elevation. Done under local anesthesia.
Before After Rhinoplasty for Bulky or Bulbous Nose tip and depressed dorsum - Dorsum augmentation with conchal (ear) cartilage graft with tip plasty.
(C) Flat Broad Tip :
Tip-plasty for falt broad tip (these cases usually have hypertrophied alar cartilages)
Rhinoplasty Nose job before after -
Hyperplastic alar cartilages- hyperplastic variant of type 0-type 14 facial cranial cleft- a cleft nose variant without a visible cleft - feature of cleft on surface is
increased distance between eyes.
(D) Low / Depressed Tip :
Nose tip Augmentation for depressed tip
Nose tip plasty before after picture : This depressed tip is an example of binders Syndrome (Central face hypoplasia-
Nose, maxilla ( upper jaw) and chin (Mandible) Hypoplasia ( Underdevelopment ). Tip and dorsal nose augmentation with coastal cartilage (rib cartilage).
E) Ala & nostril reduction :
some people have wide and big ala & nostrils. side wall of nose surrounding
nostril is called ala. a wide nostril is usually associated with a low tip and low dorsum. correction of involves reduction of ala & narrowing of nostril with
or without tip plasty and augmentation of dorsal bridge of nose ( see picture iii below)
(Dorsal hump reduction, cartilage graft to smoothen dorsum, tip-plasty, narrowing of nose with Internal Osteotomy)
Rhinoplasty with alar base nostril reduction before after picture (Photo).
iii) Septo-Rhinoplasty with Nostril Adjustment & Tip Plasty :
Rhinoplasty or Nose Job with tip plasty.
septal cartilage for elevation of bridge of nose, tip plasty and osteotomy - under general anaesthesia.
Septo-Rhinoplasty before after picture: Wide or broad depressed nose with depressed tip
- Septoplasty to harvest septal cartilage graft (best graft material for nose augmentation), osteotomy to make
nose narrow tip plasty and nostril reduction.
iv) Short , Long & Broad NosesA) Broad nose or Wide Nose :- Big broad noses fall in different category and some
variation is founddepending upon race and ethnicity. Big nose with dorsal hum common in roman,
Long and high nose hump and with or without droopy tip
is often found in Punjab and Afghanistan. Broad or Wide Nose with lack of tip definition Before after
Rhinoplasty picture :
Rhinoplasty Before After for Broad Nose with wide nose tip- This nose was one of extreme broad nose treated with Nose reduction, osteotomy and tip plasty.
B) Extreme Broad Nose
One of extreme broad nose with dorsum irregularity (history of dorsal hump reduction and
Rhinoplasty somewhere else) , deformed flat tip, supra-tip depression , huge ala and wide nostril -
before after Rhinoplasty picture or photo
C ) Long Nose Rhinoplasty
: Long Nose with dorsal
hump and very droopy tip is also called hawk nose. Long Nose with deviated & drooping tip - Before after
Rhinoplasty for long nose correction, long nose with drooping tip before after Picture
D) Low & wide dorsum with broad & low tip :-
Rhinoplasty or Nose Job with tip-plasty.
An Example of Asian Rhinoplasty Low and flat dorsum and very wide ala and nostril is seen in African nose..
Low Broad dorsum Broad tip - Before after Rhinoplasty tip-pasty picture.
Low broad dorsum with wide drooping tip - Rhinoplasty before after picture- Dorsum
and tip augmentation with correction of drooping tip and creation of a sleek nose.
v) Dorsum hump or Bumpy (nose) with or without drooping tip :-
Hump nose or bumpy nose also called Roman Nose.
Hump reduction rhinoplasty involves reduction of hump (rasping or hump excision) as per requirement.
If roof is left as such or simply approximated with osteotomy possibility of open roof deformity is very high, so we are doing
roof closure along with valve correction to provide cosmetically and functionally perfect nose. see nose reduction video for detail.
Example case here Hump Reduction Rhinoplasty or Nose Job with tip plasty & Narrowing of nose in male.
Before After Picture Rhinoplasty or Nose Job with Hump Reduction,
Correction of supra-tip depression, Tip plasty for elevation of tip of nose as well as narrowing and Correction of wide nasal base.
Before After Pictures Reduction Rhinoplasty Hump Reduction, Tipplasty Broad Nose Correction in Female
VI ) Post traumatic nose deformity :- (Broken Saddle Nose with nostril and airway stenosis or blockade) :-
Augmentation Rhinoplasty or Nose Job with tip plasty and reestablishment of nasal passages. Case Example-
Post traumetic (road traffic accident) broken nose with nose blockade, correction with nasal passage restoration and iliac crest bone graft
for dorsum augmentation.
X) Cleft Rhinoplasty : Nasal deformity associated with cleft lip and palate :-
Cleft Rhinoplasty or Nose Job with tip plasty & correction of Cleft lip nose deformity along with base of nose ( Maxilla)
Cleft Lip Palate & Cleft Nose Deformity Correction -
Cleft Nose Correction involves correction of base of nose i.e. adjacent maxilla (jaw bone) which is less developed in
cleft lip cases along with nose correction. Almost every structure of nose id deviated deflected and deformed
including bony and cartilaginous septum, alar cartilage , upper lateral cartilage , nostrils and ala with alar
base- so correction involves every aspect of nose along with bone grafting or implant augmentation of jaw bone or maxilla.
Details you may see in our research paper on cleft lip nose deformity - link is there in publication page.
for Details of Cleft lip and palate - Visit Cleft Lip and Palate Page.
For details on open Rhinoplasty & cleft nose correction you go through our research paper on cleft nose & open
Rhinoplasty - please visit Research & Publications page - Composite correction of a unilateral
cleft lip nose deformity and alveolar bone grafting on pubmed or Indian Journal of plastic surgery
X ) Revision Nose Surgery for Crooked Deformed Nose :-
Revision Rhinoplasty or Nose job Revision is for those who are not satisfied with their
result of primary surgery. as such best opportunity to provide the best result is in first surgery,
but sometimes patient wants some more change, or some changes are deliberately left for second stage ( rare). In such Cases Revision
Can be done after 3 to 6 months after first surgery, depending upon magnitude of dissection in first surgery and resolution of swelling. In our
Cases, We do all possible changes in one go only but we are getting cases for revision
Rhinoplasty first operated elsewhere, this is one example.
Revision Rhinoplasty Before After : (History of hump reduction and
else 3 years back ) presented at our clinic for revision Rhinoplasty (Nose
Surgery)with Long Deviated Nose with Severe DNS (Septum totally out of midline) Bony Hump, Supra-tip
Depression Deviated & Drooping tip - Natural Septo-Rhinoplasty (No artificial material used).
xi ) Rhinophyma
Cosmetic Rhinoplasty or nose job .
Before after picture Rhinophyma or potato nose correction : Rhinophyma is exaggerated activity and growth of sebaceous
glands of tip of nose which discharges creamy white oily substance. Discharge instead of coming out becomes collected in glands.
side view of face is called profile view. It shows projections and depressions of Face. nose and chin affect
the profile view most. Augmentation or reduction may be needed to provide a beautiful appearance.
Before and after picture of profiloplasty (augmentation
Rhinoplasty & correction of jaw projection.
xii ) Reconstruction Rhinoplasty :
Before After Picture of Nose Reconstruction Using forehead Flap and Framework
Reconstructed with coastal (rib) cartilage. Color is hyper pigmented (dark) at this moment , it takes around two
years in acquiring natural color. Only Natural tissue has been used no artificial material.
Rhinoplasty Septoplasty Surgery Procedure & Recovery Time
1) What are open and closed approaches for Rhinoplasty?
Ans:- in Closed Rhinoplasty approach, incision for modifying nasal framework, are entirely inside the nose, no visible
mark outside. In Open Rhinoplasty , the same inner incisions are connected externally either in mid columella
(middle pillar of nose between nostrils when seen from basal view) or at lip columella Junction. Over the time they
heal well and practically there is no visible scar in long term. We use nose lip
junction natural line to enter nose means through natural fold line, so no
additional line even in Open Rhinoplasty .
2) which Rhinoplasty or nose job approach is preferable, open or close?
Ans:- preferred approach depends upon amount of work needed in any particular nose. Both can be done in
any nose, close is preferred for minor modifications. Open approach provides clear view of entire nasal framework so
fine manipulations are always better with this. All the incisions are kept inside nose in both approaches and
not visible outside except that a mid collumellar incision or lip columella junction incision joins
incisions of both sides in open approach. No noticeable scar in both cases. For severely crooked noses, we are doing complete dismembered
Rhinoplasty, its an
extension of open Rhinoplasty in which individual components of nose framework , both bony and cartileginous are modified separately to straighten deviated
septum. Please mind in deviated nose, its not only the septum which is deviated, but upper and lower lateral cartilages are also devitaed and each one needs
modification. So septoplasty alone in such cases is insufficient. Dismembered
Rhinoplasty gives beautiful result even in most difficult cases.
3) How long the Rhinoplasty or nose job surgery takes?
Ans :- may take one and half to two and half hours , depending upon amount of work needed.
4) General or local anesthesia for Rhinoplasty or nose job ?
Ans:- local and nerve block anesthesia is sufficient for most of cases. Short term general anesthesia is used for osteotomy (cutting and inward mobilization) of nasal bones.
For a complete Septo-Rhinoplasty
(Nose Surgery) general anesthesia is preferable to local as its safer, more controlled and
more comfortable for patient, also it allows surgeon to work in a comfortable environment which is most important for fine cosmetic and functional manipulations.
5) What manipulations usually done in Rhinoplasty / Septoplasty / SeptoRhinoplasty
(Nose Surgery) or nose job.
Ans:- A complete Rhinoplasty usually involves correction of bony and cartilaginous dorsum ( the part of
base of nose visible in front view), tip correction ( narrowing or elevation) , correction of nostrils and lip nose relationship.
Overall all work needed in a nose are done simultaneously, depending upon individual requirement.
In , septoRhinoplasty, septum is dealt along with rest of nose, straightening, debulking etc are done , again
decided by need of individual nose. Besides this septum provides the best possible source of cartilage for dorsum
augmentation or tip work. so septoplasty is often added to Rhinoplasty (Nose
Surgery) as it corrects septum as well as provides
autogenous material for use in rest of procedure.
6) What about breathing difficulty in Rhinoplasty or nose job ?
Ans:- Nose has two valve areas , internal and external. In an otherwise normal looking nose , itís the internal valve
collapse which causes breathing difficulty and needs to be widen with spreader graft. In a nose with drooping
tip, external as well as internal valves are affected and need correction.
7) Rhinoplasty Recovery After Surgery : How much is recovery time after
nose job surgery?
Ans:- surgery takes around two and half hours . recovery from general anaesthesia is almost instant after
You may feel little tiredness for a few hours (2-3). Mobile and may take normal diet after 5-6 hours.
Nose will be packed for 48 Hours. Discharge from hospital after 6-8 hours or next morning. Dressing on nose 7 days.
Your nose will look normal to others but you will feel swelling at 2 weeks.
After three weeks , nose looks almost normal , in newer shape, but mild ( undetectable) swelling is still there.
It takes around three months before nose looks almost normal with all evidences of surgery resolved except very
little amount of edema ( Swelling ) which is unnoticeable.
8 ) Any difference in Female & Male Rhinoplasty.
Ans : Male Rhinoplasty is always believed to be a separate entity , as male noses are usually more
deformed also expectations in male is always more than females, their thick skin makes result late to appear.
In our practice we see every nose as a different and individual entity be it male or female
contrary to the common belief in plastic surgery society our male patients are equally happy. In females skin is usually thin and shape
of nose appears well after Rhinoplasty.
9) what are materials used for nose augmentation?
Ans:- materials used for augmentation can be autogenous ( from patients own body) or artificial materials. Autogenous :- 1. Cartilage:
from nasal septumómost commonly used.
conchal cartilage ( from ear) or rib cartilage. 2. Bone:- pelvic bone ( iliac creast)
Calvarial ( outer table of skull ) Artificial materials:-
10) Which material is better autogenous or artificial ?
Ans: use of autogenous material is always better whenever available and applicable. use of artificial material is second choice. in most of noses
remodeling of nose bony and cartilaginous framework itself is sufficient to give desired result, if not
cartilage harvested from septum , or ear cartilage or any other option is chosen for.
Among Implants silicone is more acceptable for dorsum and Medpore for paranasal augmentation.
We usually dont use implants, if needed we use it in a different way so that Implant becomes incorporated part of nose rather than separate
many people think cosmetic surgery always needs use of artificial material, its a big confusion, cosmetic
surgery is surgery which is intended to improve your look when function problem is not there, in fact almost every cosmetic surgery involves improvement of both look
11 ) Any rest required ?
Ans: yes, Rest for six hours after surgery, its better to take leave from work for 10-12 days
(due to dressing, otherwise all regular smooth movements are allowed 6-7 hours after rhinoplasty, avoid exertion and heavy work for a week at
least. There will be dressing on your nose for 7-10 days if osteotomy has been done , for 5 days if not. Follow up visits required
first after 48 hours, second on 7-9th day. Some exercise and minor massage (individualized for every type of rhinoplasty) between 3 weeks to
6 weeks further improves your result, especially in rhinoplasty for deviated nose.
12 ) What about Recovery time, Follow up, Unsatisfactory Result & Touch ups?
Ans: Recovery Time & Follow ups : Rhinoplasty is a day care procedure, you will be discharged
on same or next day. 1st visit after 2 days for pack removal. next between 8-10th day depending upon type of procedure for all
dressing removal. After removal of dressing nose looks pinched and irregular, due to irregular swelling inside plaster splint.
Swelling will increase for 48-72 hours and nose looks more regular with swelling and you are socially presentable now.
You cant touch nose for 3 weeks. we keep Nose softer between 3 to 8 weeks & during this period you may change shape and
alignment with little massage and manipulations which you will be described on visit after 3 weeks and
reviewed weekly direct or through mail depending upon situation.
Please mind these steps are very much important and helps you get the desired shape. Specially in broad and deviated noses
(some deviation is there in 90 % cases) you cant get a good result without it. We dont like to accept patients who cant
comply in follow ups. Examples you may see on our facebook page and here in this pic. Result is well visible after you start
massage but finally improvement continues till one year. Please mind rhinoplasty is game of patience and its not for
those who want very fast result.
Please mind these follow ups are essential.
Unsatisfactory Result : We try to do the best for you but everything in this world has got limitations.
Most of our patients are satisfied and happy but we got 6 (1.5 %) unsatisfied patients also, unfortunately, they were
lost in follow up. As such this number is very very small but still we respect individuality of every patient. Sometimes even our
best possible work may not satisfy you. Whenever you think you are unsatisfied you should consult your primary surgeon first,
whoever he or she is, as he/she knows your problem best plus at least he will not try to misguide you. No surgeon or doctor
wants to provide unsatisfactory result, we all are trying to provide you the best but we are simple human beings
doing our job and not god who can do everything. Moreover most of small problems can be solved during follow up with minor or
non-surgical manuevers. Touch up Procedures : Usually we do entire procedure in one go but some times some small procedures which can be better done later
or if you feel that something is required, Touch-up procedure may be required (usually 3-4% cases). small procedures under local anaesthesia which doesnot need reopening nose should be done at least 6 months after surgery. Any major procedure should be
defferred fot at least one year best if two years. In our cases for touch ups or revision surgeon's charge is fully free, other
charges we try to keep minimum so that you dont need to bear financial load again.
13 ) Any association with psychological or psychiatric problem in Rhinoplasty ?
Ans: yes, Psychological and psychiatric problems are not very uncommon in cases of rhinoplasty
like rest other face cosmetic surgery procedures. Psychological stress due to job or problems in personal life may depress you and
make you think that these problems are due to your bad face or nose, which may not be correct. Also surgery may aggravate
your psychological or psychiatric problem which can be bad for you. So if you are facing any sort of psychological or psychiatric
problem or ever faced it in life you should clearly tell this to your doctor.
Most of people try to hide their psychological problem and think it may affect
their image. Its not true, in today's era almost every person is facing some
psychological stress and its better to solve it rather than going for surgery. Your medical history is important and
Its always better to bring family members with you.