Rhinoplasty is the surgery I perform most often. Most of my surgical work is noses, and a good number of those noses share one challenge: thick skin, weak cartilage and little definition at the tip.
In this guide I explain what a rhinoplasty actually does, the technique I work with, who is a good candidate and who is not, and what you can expect from recovery.
What rhinoplasty is and what it can achieve
Rhinoplasty is the surgery that changes the shape of the nose and, when there is an obstruction, its function as well. We work on the bone and on the cartilage to change the profile, the tip, the width or a deviation.
The goal is not a standard nose. It is a nose that looks like yours, in proportion with your eyes, your cheekbones and your chin. When the result draws attention to itself, something was not done well.
When there is also a deviated septum and that makes it hard for you to breathe, the surgery is called septorhinoplasty and corrects both things in the same surgical procedure.
Ultrasonic rhinoplasty: why I work with this technique
I am one of the first surgeons in Colombia to bring the ultrasonic instrument into rhinoplasty, and today it is what I operate with in most of my cases.
The difference is concrete. The traditional technique shapes the bone with hammer and chisel; the ultrasonic instrument does it with high-frequency vibration, which works the bone tissue without damaging the skin or the surrounding vessels. That makes it possible to sculpt the dorsum with more precision and with less trauma to the tissues.
For you, the practical translation is a more manageable recovery and fewer bruises in the first few days. It does not eliminate the swelling or shorten the time the nose needs to settle, but it does change the starting point.
Thick-skinned noses: the most common challenge on the coast
A significant share of the patients I see in Barranquilla have a nose with thick, oily skin, weak cartilage and a wide base. It is an anatomy that responds differently: no matter how much the structure is refined underneath, thick skin tends not to let that definition show.
In these cases it is not enough to remove; you have to give support. That is why in many of these noses I use cartilage grafts, and when the patient’s own septal cartilage is not enough, I take a rib graft. It is a resource that demands specific training and that few of us surgeons in the city handle.
If you have this type of nose, it is only fair that you know from the consultation that your result takes longer to define than that of thin skin. Promising you otherwise would be failing to tell you the truth.
Who is a good candidate for rhinoplasty
You are a good candidate if your facial growth is complete, you are in good health, you do not smoke or can stop for as long as we tell you to, and you come with a specific expectation about what bothers you about your nose.
It is not the right time if you are going through an emotional process that is placing all your expectations on surgery, if there is an uncontrolled illness, or if what you are looking for is someone else’s nose. Nor is it if the main problem is respiratory and has not yet been studied.
There are consultations that end without surgery, and it is right that they do. My job is not to operate on everyone who walks in: it is to solve a problem for you, and sometimes the correct answer is to wait, to treat something else first or to refer you to another specialist.
What the full pathway looks like
In my practice surgery is one stage within a pathway, not an isolated event.
Consultation. We examine your nose on the outside and on the inside, we talk about what bothers you and about what is possible to achieve with your anatomy. From there come the surgical plan and the tests you need.
Preparation. Before you go into surgery you are seen by the functional and bioregulatory medicine team. We prepare the ground so that you arrive in better condition and respond better to the surgery.
Surgery. It is performed in a licensed operating room, with an anesthesiologist and a full team. The time depends on what has to be done in your case: a revision nose does not take the same as a primary one.
Recovery. It is the stage patients most underestimate and the one my team looks after most closely. It includes follow-up visits, home care and supporting technology to manage the swelling.
Secondary and revision rhinoplasty
I frequently operate on noses that have already been operated on, some with several surgeries behind them. They are more demanding cases: there is scar tissue, the anatomy changed and often there is not enough cartilage left to rebuild.
If you come with a previous surgery that did not turn out the way you expected, the first thing is to understand what was done and what is left. Then we assess whether it is worth operating again and at what point, because a recently operated nose needs time before a revision.
It is a scenario in which caution matters more than haste.
Risks and safety
Every surgery carries risks, and rhinoplasty is no exception: bleeding, prolonged swelling, temporary difficulty breathing, healing problems or a result that needs a later adjustment.
What can be done is to reduce the probability of them happening. That means operating in a licensed operating room, with an anesthesiologist, with complete preoperative tests and with a correct indication. And it also means your part of the work: following the instructions, attending the follow-up visits and letting us know in time if something is not going well.
No one can guarantee you a result. What I can commit to is judgment, technique and support throughout the whole process.
Frequently asked questions
Find the answers to the most common questions here.
How much does a rhinoplasty cost?
I do not publish surgery prices, and it is a position I share with the scientific society I belong to. The cost depends on what your case needs: whether it is primary or revision, whether it requires grafts, the surgical time, the team and the institution where it is performed. After the consultation you receive a detailed quote for your case.
Does rhinoplasty leave a visible scar?
When it is done through the open approach, a small scar remains on the columella, the skin that separates the nostrils. Over time it tends to fade considerably. With the closed approach the incisions are inside the nose.
How long does it take to see the final result?
The nose deswells in stages. In the first weeks you already notice a change, but the definitive shape is revealed little by little over the following months. In thick skin that process is slower, and it is worth knowing from the start.
Can the nose become deformed after a rhinoplasty?
An operated nose changes over the years, just as the rest of the face changes. What should not happen are deformities caused by a poorly supported structure, and that is why I insist on reinforcing the structure instead of only reducing.
What if I already had surgery and did not like the result?
It gets assessed. I review what was done, what tissue is still available and whether it is the right time to operate. In revision surgery, patience is part of the treatment.
Can I fix my nose with hyaluronic acid instead of surgery?
Hyaluronic acid makes it possible to camouflage small irregularities, not to reduce a nose or correct a deviation. It is a temporary resource with precise indications. In the post on types of rhinoplasty I explain when it makes sense and when it does not.
How long do I have to stay off work?
It depends on the type of work and on your case. You need a few days of rest and to avoid physical exertion during the period we tell you about in the consultation.
Is it true that rhinoplasty improves breathing?
It can improve it when there is a deviated septum or another obstruction and it is corrected in the same procedure. If your problem is only aesthetic, the surgery should not make your breathing worse.
