Rhinoplasty is both an aesthetic and a functional operation
The nose is the central feature of the face and also the airway. A well-planned rhinoplasty addresses both. Reducing a dorsal hump or narrowing a wide tip without respecting the internal valve can leave a patient who likes their profile but cannot breathe through their nose at night.
In this practice the internal examination comes before the aesthetic discussion. If a deviated septum, enlarged turbinates or a collapsed valve is contributing, those are corrected in the same sitting. Patients frequently report that improved breathing was the change they valued most, six months later.
Open versus closed rhinoplasty
Closed rhinoplasty places all incisions inside the nostrils, leaving no external scar. It suits limited work: a modest hump reduction, minor dorsal refinement.
Open rhinoplasty adds a small incision across the columella, the strip of skin between the nostrils, allowing the surgeon to see and reshape the tip cartilages directly under vision. For tip work, significant deviation, cartilage grafting and all revision cases, open technique gives markedly more control. The columellar scar is typically imperceptible at six months. Dr. Khare selects the approach case by case and explains the reasoning at the consultation.
Planning for Indian facial anatomy
Much of the rhinoplasty imagery circulating online was developed for thin-skinned European noses. Indian and South Asian patients more often have thicker skin, weaker lower lateral cartilages and a broader alar base. Applying a Western template to that anatomy produces the pinched, over-rotated look that is instantly recognisable as surgery.
Thicker skin also holds swelling longer and hides fine refinement, so the underlying cartilage framework must be built strongly rather than simply reduced. Structural grafting, usually with the patient’s own septal cartilage, is often part of the plan.
- Dorsal hump reduction proportioned to the chin and forehead, not removed to a straight line by default
- Tip support built with cartilage grafts before any narrowing is attempted
- Alar base adjusted only where the width is genuinely disproportionate
- Septal and turbinate work included where the airway is compromised
- Digital morphing used as a discussion aid, never as a promised outcome
The operation and the first ten days
Rhinoplasty takes two to three hours under general anaesthesia. Modern practice avoids the old nasal packing; soft internal splints are used instead, so breathing through the nose is possible within a day or two. An external splint stays on for seven to ten days.
Bruising around the eyes is common when the nasal bones are repositioned, peaks at day three and largely resolves by day ten to fourteen. Most patients are comfortable being seen in public at around two weeks.
Recovery and the long swelling curve
- Days 1–3: splint on, mild congestion, sleeping propped up on two pillows. Bruising peaks.
- Days 7–10: splint removed. The nose looks swollen and slightly upturned at this stage, which is expected.
- Weeks 2–4: back to work and social life. Glasses must be kept off the bridge for six weeks.
- Months 2–3: roughly seventy percent of swelling has resolved; the profile is recognisable.
- Months 6–12: tip definition emerges last, particularly in thicker skin. Final assessment at twelve months.
Revision rhinoplasty
Revision cases make up a meaningful share of the rhinoplasty work in this clinic, most often patients whose tip support was weakened by over-resection at a first operation elsewhere. Revision surgery is technically harder: scar tissue is unpredictable and donor cartilage may need to come from the ear or rib.
A minimum of twelve months should pass after the first operation before revision, so tissues are fully settled. Dr. Khare will tell you honestly if a revision is likely to give only a modest improvement, rather than promising a reset.
Who performs this procedure
Every rhinoplasty case at this clinic is planned, marked, operated and reviewed personally by Dr. Ashish Khare, MCh Plastic and Reconstructive Surgery, in an NABH-accredited theatre with a consultant anaesthetist present throughout.
