Prof. Alfredo Borriello
Plastic, Aesthetic and Reconstructive Surgery
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Plastica

Rhinoplasty

What is Rhinoplasty?

Rhinoplasty is a cosmetic surgery procedure that reshapes and resizes the nose, improving facial harmony and, when necessary, respiratory function. It is one of the most sought-after procedures in plastic surgery, capable of correcting congenital defects, trauma-related issues, or simply aesthetic aspects the patient wishes to improve. The primary goal is to achieve a nose that is proportionate to the face, respecting the patient's individual features and ensuring a natural, harmonious result.

How does Rhinoplasty work?

The procedure is performed through internal nasal incisions (closed technique) or with a small incision on the columella (open technique). The surgeon reshapes the nasal cartilage and bone to achieve the desired shape. During the operation, cartilage grafts may be harvested from the nasal septum, ear, or more rarely from rib cartilage, to reconstruct or reinforce weak nasal structures. The choice of technique depends on the complexity of the case and is determined during the pre-operative consultation, analyzing the nasal anatomy with the aid of photographs and digital simulations.

What types of Rhinoplasty are there?

There are several types of rhinoplasty based on the patient's needs: • Cosmetic rhinoplasty: to improve the appearance of the nose by correcting dorsal humps, tip shape, nasal wings, or asymmetries • Functional rhinoplasty: to correct breathing problems caused by septal deviations or turbinate hypertrophy • Revision (secondary) rhinoplasty: to correct or refine the results of previous surgeries, often more complex due to the presence of scar tissue • Septoplasty: to straighten a deviated nasal septum and improve airflow • Tip rhinoplasty: focused exclusively on reshaping the nasal tip, without modifying the bridge

Rhinoplasty is recommended for those who wish to improve the appearance or function of their nose. Ideal candidates are individuals in good overall health, with complete bone development, and realistic expectations about the outcome. The most commonly treated conditions include: • Pronounced dorsal hump • Wide, bulbous, or drooping nasal tip • Overly wide or asymmetric nostrils • Deviated nose due to trauma or congenital defects • Breathing difficulties related to structural obstructions • Disproportion between the nose and other facial features

The procedure is not recommended in the following cases: • Under 18 years of age, when nasal structures have not yet completed their development (except in special cases related to severe breathing difficulties) • Unrealistic expectations regarding achievable results • Uncontrolled chronic conditions, such as unmanaged diabetes or coagulation disorders • Active smokers, as smoking impairs tissue healing and increases the risk of complications • Psychological instability or body dysmorphic disorders

How long does the procedure take?

The procedure generally takes 1-3 hours, depending on the complexity of the case. It is often performed as day surgery or with one overnight stay to allow adequate monitoring in the first post-operative hours. Full recovery takes 7-14 days, during which a rigid nasal splint is worn to protect the reshaped structures. Swelling and periorbital bruising are normal in the first 48 hours and gradually subside. Return to daily activities typically occurs after one week, while sports activities should be avoided for at least 4-6 weeks.

Is anesthesia required?

Yes, rhinoplasty requires general or local anesthesia with sedation, depending on the complexity of the procedure and patient preferences. For simpler procedures, such as correction of the nasal tip alone, local anesthesia with conscious sedation may suffice. For more complex procedures involving bones and septum, general anesthesia is preferred to ensure maximum patient comfort and optimal operating conditions for the surgeon.

When are the results visible?

Initial results are visible after the splint is removed, approximately 7-10 days after surgery. At this stage, the nose will already appear improved but will still show some degree of swelling. About 70-80% of the swelling resolves within the first 2-3 months, while the final result is appreciated after 6-12 months, when even the residual tip swelling has completely resolved. Thinner skin tends to show results more quickly, while thicker skin requires slightly longer waiting times.

Is the procedure painful?

Post-operative pain is generally mild and well managed with common painkillers. The most common sensation reported by patients is nasal congestion similar to a severe cold, caused by internal swelling. Nasal packing, when used, is removed after 24-48 hours. During the first nights, it is advisable to sleep with the head elevated to reduce swelling and promote faster healing.

Will there be visible scars?

With the closed technique, incisions are entirely internal to the nose, leaving no visible external scars. With the open technique, the small incision on the columella (the septum between the nostrils) heals excellently and becomes virtually invisible within a few weeks, thanks to the thinness of the skin in this area and the microsurgical suturing technique used.

Before and After

What patients say
Giusy
MioDottore.it
I visited Dr. Alfredo Borriello because I had problems with nasal breathing. He detected a deviated septum issue. From the very first moment he inspired trust and confidence, but aside from his undeniable human side, what I appreciated most of all was his professionalism in his work. The surgery went perfectly, with a post-operative period of ZERO PAIN, and he followed up on everything. He managed not only to give my nose a NATURAL appearance, which is extremely rare, but also to resolve my BREATHING problem that I had for years. Now, in addition to having the physical appearance I always wanted, I also breathe magnificently! I will always be grateful to the doctor who gave me a second life.
Anonimo
Estheticon.it
I had surgery more than 8 years ago. Everything was perfect, the doctor is a meticulous man, a true professional in his field! Without any alteration to my face, my nose is beautiful and perfect but absolutely not "fake". He works very naturally - in fact, I'm the one who has to tell people: they don't even notice my surgery. I highly recommend him. Trust him and be wary of photos that are sometimes not truthful.
carola oliva
esperienza ottima !!!! ho effettuato una rinoplastica a marzo 2025, e mi sono trovata benissimo , non avrei mai pensato di dirlo ma la rifarei altre 10 volte !! Il dottor Borriello è stato fin da subito la mia scelta . Oltre la parte estetica è stata curata nei minimi dettagli anche la parte funzionale . I dolori post operazione , sono tutti molto sopportabili così come la rimozione dei tamponi . Sono molto contenta del risultato ottenuto ;))
giugno 2025

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Prof. Alfredo Borriello
Plastic, Aesthetic and Reconstructive Surgery
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+39 081 780 8051
info@alfredoborriello.it
Viale Antonio Gramsci 30, Napoli
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