While the shape of your nose is usually the result of heredity, the appearance may have been altered by injury or previous surgery.

Rhinoplasty can change:
• The size of the nose, in relation to other facial structures;
• The width of the nasal dorsum;
• The profile of the nose;
• The tip of the nose, which may be large, drooping or very upturned;
• Large, wide or upturned nostrils;
• Nasal asymmetry and deviation;

The decision to undergo surgery is a personal one and it is up to you to decide whether the benefits will achieve your goals and whether the risks and potential complications are acceptable.

• Your facial growth is complete and if you are 13 years of age or older;
• You are physically healthy;
• You don't smoke;
• You have a positive attitude and realistic expectations of the surgical outcome.

The success and safety of the procedure largely depends on your sincerity during the consultation. You will be asked about your health, desires and lifestyle.

• The reason why you want to have the surgery, your expectations and the desired result;
• Medical conditions, drug allergies and medical treatments;
• Current use of medications, vitamins, natural medicines, tobacco, alcohol and drugs;
• Previous surgeries.

• Assess your general health status and any pre-existing health conditions or risk factors;
• Examine and measure your face;
• Take photographs for medical records;
• Discuss the options and recommend the most appropriate one;
• Discuss possible outcomes of the surgery and any potential risks or complications.

Before surgery, it may be necessary to:
• Take laboratory tests or medical evaluation;
• Taking certain medications or adjusting your current medications;
• Stop smoking well before surgery;
• Avoid taking aspirin and some anti-inflammatories and natural medicines, as they can increase bleeding.

• What to do on the day of surgery (fasting time, medications, bath);
• Information about the type of anesthesia to be performed during the surgical procedure;
• Guidance on post-operative care.

The procedure must be carried out in a safe and comfortable place for the doctor and the patient, in a surgical center authorized by the Health Surveillance, with equipment and trained staff for any complications.

Be sure to ask someone to accompany you and stay with you for at least the first night after surgery.

The decision to undergo surgery is a personal one and it is up to you to decide whether the benefits will achieve your goals and whether the risks and potential complications are acceptable.

You will be asked to sign the consent form to ensure that you fully understand the procedure you will undergo and any potential risks or complications.

• Rupture of small vessels in the nose;
• Asymmetry of the nose;
• Unfavorable scars;
• Bleeding (bruise);
• Infection;
• Anesthetic risks;
• Poor healing;
• Numbness or other changes in skin sensitivity;
• Skin depigmentation and/or prolonged swelling;
• Changes in the nasal airway may occur after rhinoplasty and septoplasty, which may interfere with the normal passage of air through the nose;
• Nasal septal perforation (a hole in the nasal septum) may develop, however, it is not common and additional surgical treatment may be necessary to repair the septum. In some cases, it may be impossible to correct this complication;
• Pain, which may last;
• Cardiac and pulmonary complications;
• Suture threads may spontaneously emerge from the skin, becoming visible or causing irritation that requires their removal;
• Possibility of a new surgical procedure.

It is important that you ask all your questions directly to the plastic surgeon about the procedure you will undergo. It is natural to feel a little anxiety, to have expectations about the result or pre-operative stress. Don't be ashamed to discuss these feelings with your plastic surgeon.

If you experience shortness of breath, chest pains, or an abnormal heartbeat, seek medical attention immediately. If any of these complications occur, you may need hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure, requiring further surgery.

Following your doctor's recommendations is essential for the success of the surgery. It is important that surgical incisions are not subjected to excessive force, abrasion or movement during the healing period.

Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. Options include intravenous sedation and general anesthesia. Your doctor will recommend the best option for you.

Step 2 – Incision
Nose surgery is performed either by a closed procedure, in which the incisions are hidden inside the nose, or by an open procedure, where an incision is made through the columella, a narrow strip of tissue that separates the nostrils. Through these incisions, the soft tissues covering the nose are carefully lifted, allowing access to reshape the structure of the nose.

Step 3 – Reshaping the Structure of the Nose
Nose surgery can reduce or enlarge the nasal structures using cartilage grafted from other areas of your body. Most commonly, portions of cartilage from the septum, the partition in the middle of the nose, are used for this purpose.
Sometimes part of the ear cartilage and, rarely, part of the rib cartilage can be used.

Step 4 – Correction of deviated septum
Correcting a deviated septum and reducing the protrusions inside the nose improves breathing.

Step 5 – Closing the Incisions
Once the underlying structure of the nose is sculpted into the desired shape, the skin and nasal tissue are accommodated and the incisions closed. Additional incisions may be made in the natural ridges of the nostrils to change their size.

Step 6 – Results
A type of plaster and internal packing will support the nose as the surgery begins to heal for approximately a week. While the initial swelling subsides within a few weeks, it can take up to a year for the new nasal contour to be completely redefined. During this period, you will notice gradual changes in the appearance of your nose. Swelling may come and go and be a little worse in the morning for the first year after surgery. Rhinoplasty to reshape an obstructed airway requires careful assessment of the nasal structure as it relates to airflow and breathing. Correction of deviated septum, one of the most common causes of respiratory failure, is achieved by adjusting the nasal structure to produce better alignment.

After the procedure is complete, a type of plaster, internal packing and Micropore dressing will be placed on the nose to support and protect the new structures during initial healing.

How to care for the surgical wound, medications to take orally to help reduce the potential for infection, specific care for the surgery site, your health status and post-operative follow-up with your plastic surgeon.

• Where will I remain in recovery after surgery?
• What medication will I be given or prescribed after surgery?
• Will a dressing be necessary after surgery? When will it be removed?
• Will the stitches be removed? When?
• How long will the nose be swollen?
• When will I be able to resume my normal activities and exercise?
• When will the return appointment be?

It can take several months for the swelling to completely disappear and up to a year – and sometimes longer – for the results of the surgery to be fully seen. Although the results of rhinoplasty are generally permanent, the cartilage can continue to move and remodel the tissue, altering the result over time.

Cost is always a consideration in elective surgery. A surgeon's fees may vary depending on their experience and the type of procedure performed.

• Surgeon's fees;
• Hospital or surgical center costs;
• Anesthetist's fees;
• Prescribed medications;
• Medical exams.

When choosing a plastic surgeon to perform rhinoplasty surgery, remember that the surgeon's experience and your good relationship with him are as important as the final cost of the surgery.

• Cartilage: Connective tissue that makes up the structure of the nose.
• Columella: The narrow strip of tissue that separates the nostrils.
• Deviated septum: The cartilage that separates the nostrils is misaligned and can cause partial obstruction of the nasal airways.
• General anesthesia: Drugs and/or gases used during surgery to relieve pain and reduce consciousness.
• Hematoma: Accumulation of blood beneath the skin.
• Intravenous sedation: Sedatives given by injection into a vein to help you relax.
• Local anesthesia: Drug injected directly into the site of an incision during surgery to relieve pain.
• Rhinoplasty: Surgery to reshape the nose.

Use this list as a guide during your consultation
• Are you a specialist by the Brazilian Society of Plastic Surgery?
• Have you been specifically trained in the field of Plastic Surgery?
• How many years of plastic surgery training have you had?
• Is the installation of the surgical center in your clinic authorized by the Health Surveillance?
• Am I a good candidate for this procedure?
• What is expected of me so that the best results are obtained?
• Where and how will the procedure be performed?
• Which surgical technique is recommended for me?
• How long can I expect to recover, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications treated?
• What will my nose look like over time?