FACESURGICAL
Rhinoplasty in Murrieta
Rhinoplasty is a surgical procedure that reshapes the nose to improve facial harmony, correct structural irregularities, or enhance nasal breathing. The procedure can address concerns such as a dorsal hump, wide or bulbous tip, asymmetry, or a crooked nose, and may be performed for cosmetic, functional, or combined purposes.
At a Glance
- Rhinoplasty is one of the most commonly performed cosmetic surgical procedures in the United States, with approximately 220,000 procedures annually[1]
- Two approaches are used: open rhinoplasty (external incision on the columella) and closed rhinoplasty (incisions entirely inside the nose)[4]
- Reported revision rates reach up to 15%, while complication rates are approximately 3%[4]
- Final nasal contour may take up to a year to fully refine as swelling gradually resolves[3]
Overview
Rhinoplasty changes the size, shape, or proportions of the nose by adjusting bone, cartilage, and soft tissue. It is one of the most commonly performed facial plastic surgeries in the United States, with approximately 220,000 procedures performed annually according to ASPS data.
There are two surgical approaches. Open rhinoplasty uses a small incision across the columella, the tissue between the nostrils, and provides full visualization of the nasal framework. Closed, or endonasal, rhinoplasty places every incision within the nasal passages. It leaves no visible external scar and typically produces less postoperative swelling.
Rhinoplasty may be cosmetic, functional, or both. Cosmetic rhinoplasty changes the external shape of the nose. Functional rhinoplasty treats structural problems that interfere with breathing, including a deviated septum or narrowed nasal valve. When appearance and airflow both need attention, they can be addressed during the same procedure.
What to expect
- Consultation and nasal analysis including photography and discussion of goals
- Preoperative assessment of nasal anatomy, airway function, and skin thickness
- Administration of general anesthesia or intravenous sedation with local anesthesia
- Incisions placed inside the nose (closed approach) or across the columella (open approach)
- Elevation of nasal skin to expose the bone and cartilage framework
- Reshaping of the dorsum, tip, and nasal bones as planned
- Harvesting and placement of cartilage grafts if needed for structural support or augmentation
- Correction of septal deviation or internal valve narrowing if functional improvement is indicated
- Closure of incisions and placement of internal splints or soft packing
- Application of an external nasal splint to protect and support the nose
How a rhinoplasty works
- The surgeon reaches the nasal framework through an open incision across the columella or through closed incisions inside the nasal passages. The nasal skin is then elevated to expose the underlying bone and cartilage.
- To reduce a dorsal hump, excess bone and cartilage along the bridge are removed or reshaped. Osteotomies, which are controlled fractures of the nasal bones, may be used to narrow the bridge or correct asymmetry.
- Tip refinement may involve reshaping, repositioning, or grafting the lower lateral cartilages. Suture techniques, cartilage trimming, and structural grafts can change tip projection, rotation, and definition.
- Cartilage grafts may be taken from the nasal septum, ear, or occasionally the rib. They can augment, support, or reconstruct parts of the nose. Spreader grafts placed along the dorsal septum can widen the internal nasal valve and improve breathing.
- Once reshaping is complete, the skin is redraped over the framework and the incisions are closed. Internal splints or packing may be placed, followed by an external splint that supports the nose during early healing.
- Shape and airflow are determined by the same structures, so they are examined together. Reducing a dorsal hump narrows the roof of the nose. Spreader grafts hold the internal valve open. A deviated septum may explain both why a nose looks crooked and why it does not move air. Dr. Banthia is board-certified in facial plastic and reconstructive surgery and in otolaryngology-head and neck surgery, so the airway and aesthetic assessments occur at the same visit rather than through a later referral.
- Revision rhinoplasty is different from a first operation even when the concern sounds the same. Scar tissue has replaced normal planes, cartilage that would ordinarily be available for grafting may already have been used, and the remaining anatomy limits what can be changed. That assessment comes first at a revision consultation, before discussing what the nose could look like.
- The framework is not the only limit on what rhinoplasty can change. Skin thickness determines how clearly the underlying cartilage work will show. Thick skin drapes over fine tip work and can conceal it, while thin skin reveals every edge and graft. Dr. Banthia assesses the skin envelope with the nasal structure because a plan that ignores it can produce an operation that went well but a change the patient cannot see.
When it's recommended
- Dorsal hump or bump on the bridge of the nose
- Wide, bulbous, drooping, upturned, or hooked nasal tip
- Nasal asymmetry or crooked nose
- Nose size disproportionate to facial balance
- Wide nasal bridge or enlarged nostrils
- Deviated septum causing breathing difficulty
- Nasal obstruction due to internal valve collapse
- Nasal deformity from prior trauma or injury
- Congenital nasal deformity
Is a rhinoplasty right for you?
Reach out to learn more from Dr. Vishal Banthia.
Recovery & aftercare
- An external nasal splint is typically worn for approximately one week after surgery
- Internal splints or packing, if placed, are usually removed within a few days
- Bruising around the eyes generally resolves within 10 to 14 days
- Initial swelling subsides within a few weeks, though subtle swelling may persist for several months
- Most patients return to desk work and light daily activities within 1 to 2 weeks
- Strenuous exercise and contact sports should be avoided for 4 to 6 weeks
- Eyeglasses should not rest on the nasal bridge for several weeks to prevent displacement
- The final nasal contour may take up to a year to fully refine as residual swelling resolves
Alternatives
- Nonsurgical rhinoplasty using injectable dermal fillers (for minor contour corrections only)
- Septoplasty alone (for functional nasal obstruction without cosmetic changes)
- Alar base reduction (for isolated nostril width concerns)
Frequently Asked Questions
- Rhinoplasty is surgery that reshapes the nose to change its appearance, correct structural problems, or improve breathing. It can address a bump on the bridge, a wide or drooping tip, nasal asymmetry, or an obstruction caused by a deviated septum.
- Rhinoplasty is performed under general anesthesia or sedation, so patients do not feel pain during the procedure. Afterward, most patients describe congestion, pressure, and mild to moderate discomfort rather than sharp pain. The discomfort is typically manageable with prescribed or over-the-counter pain medication.
- Rhinoplasty is generally considered safe when performed by a qualified, board-certified surgeon. Reported complication rates are approximately 3%. As with any operation, rhinoplasty has risks, which are discussed during consultation.
- Most patients return to desk work within 1 to 2 weeks. The external splint remains in place for about one week, and bruising around the eyes typically fades within 10 to 14 days. Initial swelling resolves over several weeks, but the final nasal shape may take up to a year to fully refine.
- Open rhinoplasty uses a small incision across the columella, the tissue between the nostrils, to provide full visualization of the nasal structures. Closed rhinoplasty places every incision inside the nose, leaving no visible external scar and typically causing less swelling. The changes required determine which approach is used.
- Rhinoplasty may not be appropriate when facial growth is incomplete, when a person has body dysmorphic disorder or unrealistic expectations, or when an active nasal infection or uncontrolled medical condition raises surgical risk. A thorough evaluation during consultation determines candidacy.
- Frequently, yes. The septum, turbinates, and internal valve sit within the same framework that gives the nose its external shape. Dr. Banthia examines airflow and appearance together. If both require treatment, they can be addressed in one operation. If the problem is limited to the airway, he says so and develops a functional plan rather than a cosmetic one.
- Cosmetic work is self-pay. When breathing problems are also being treated, the functional portion is often handled through insurance. The division between cosmetic and functional work is established before anything is scheduled and reviewed at the consultation. No figures are published on this site because the cost depends on what the operation involves.
- Yes. Revision surgery involves scarred planes, unpredictable healing, and a limited supply of cartilage when septal cartilage has already been harvested. At the consultation, Dr. Banthia explains what another operation can realistically change on that particular nose, including when waiting longer is more appropriate than proceeding now.
- Consultations for rhinoplasty are available at Dr. Banthia's Murrieta office (39755 Date St, Suite 105, Murrieta, CA 92563); Dr. Banthia's Carlsbad office (2390 Faraday Ave, Carlsbad, CA 92008). Contact the office to schedule an appointment at the location most convenient for you.
Rhinoplasty risks & candidacy
Who should avoid this
- Body dysmorphic disorder or unrealistic expectations regarding surgical outcomes
- Incomplete facial growth (typically before age 15 in females and 17 in males)
- Active nasal or sinus infection
- Uncontrolled bleeding disorders or use of anticoagulant medications without medical clearance
- Active cocaine use (causes mucosal inflammation and compromised nasal blood supply)
- Poorly controlled depression or other psychiatric conditions (surgery should be deferred until stabilized)
- Significant medical conditions that increase surgical risk (uncontrolled diabetes, severe cardiopulmonary disease)
- Less than one year since a previous rhinoplasty (final results are not yet apparent)
Possible risks
- Swelling and bruising around the nose and eyes (expected and typically resolves within 2 to 3 weeks)
- Bleeding or nasal congestion in the early postoperative period
- Infection at the surgical site (uncommon with proper wound care)
- Nasal septal perforation (rare, may require additional surgical repair)
- Change in skin sensation or persistent numbness around the nose
- Breathing difficulty due to internal scarring or structural changes
- Asymmetry or contour irregularity requiring revision
- Scarring (visible columellar scar with open approach, typically fades to a fine line)
- Unsatisfactory aesthetic result requiring revision surgery
- Anesthesia-related risks
Your practitioner
Dr. Vishal Banthia, MD, FACS
Dr. Vishal Banthia is a double board-certified facial plastic surgeon practicing in Murrieta and Carlsbad, California. He is certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery, and is a Fellow of the American College of Surgeons. His practice is surgical and face-only: facelift, neck lift, eyelid surgery, and rhinoplasty. He lectures internationally, has published peer-reviewed research indexed in the National Library of Medicine, and received the American Academy of Otolaryngology's Humanitarian Travel Award for cleft lip and palate surgery in Honduras.
Sources & references
This article draws on 6 sources, including peer-reviewed research, leading medical institutions.
Government & research
Medical institutions
Medically reviewed by Dr. Vishal Banthia, MD, FACS · Last reviewed: 2026-09-22