Giuseppe Spinelli



Cosmetic Surgery

Surgery to improve the functionality and appearance of the nose. Rhinoplasty is a surgical procedure used to change the shape and size of the nose, so as to improve the general appearance of the face. Rhinoplasty has a high level of success in America, more than 100,000 Americans undergo this surgery every year.

Rhinoplasty photo gallery before and after

Panoramic rhinoplasty

Rhinoplasty is a surgical procedure that is usually performed to improve the function and appearance of a person’s nose. This surgery can reduce or increase the size of the nose as it can change its shape. The word rhinoplasty derives from the Greek “rhinos” which means “nose” and “Plassein” which means “form” (implied téchne art), therefore “the art of reconstructing the nose”. This surgery is also commonly known as “cosmetic nose surgery”.

Rhinoplasty can change the shape of the tip or the back, tighten the opening of the nostrils or change the angle between the nose and the upper lip. This surgery can also correct an aesthetically unpleasant nose, birth defects (results of facial malformations), damage caused by an accident, without neglecting the problems connected with breathing.

Not all rhinoplastics are performed for aesthetic reasons; rhinoplasty can correct structural anomalies. One of the most common conditions that can be corrected with this surgery is the deviated septum (septoplasty), which can lead to respiratory problems, chronic stuffy nose, nasal drip and even snoring. Rhinoplasty can be performed to meet aesthetic objectives (cosmetic surgery) or for reconstructive purposes to correct trauma, birth defects or respiratory problems (reconstructive surgery).

It can be combined with other surgical procedures to improve the aesthetic results that the patient wants to achieve. Rhinoplasty today is one of the most common types of maxillofacial surgery and the most common type of facial plastic surgery. According to the American Society for Aesthetic Surgery, rhinoplasty was the second most important cosmetic surgery in 2004.

In addition, according to the American Society of Plastic Surgeons, over the last two years almost 600,000 people in the US have undergone rhinoplasty. People who have undergone this surgery usually appreciate the improvement and balance achieved in their face.


Reconstructive surgery of the nose has been developed in ancient India. Rhinoplasty was used to reconstruct noses that had been amputated as punishment for the crimes committed. The precursors of modern rhinoplasty were Johann Dieffenbach (1792-1847) and Jacques Joseph (1865-1934), who made use of external incisions for a reduction of the surgical nose.

In 1973, Dr. Wilfred S. Goodman helped initiate the open technique. Before that, all nose surgeries were performed with the closed technique. At that time the approach to open rhinoplasty had gained in popularity, but was mainly used for primary surgery and not for secondary rhinoplasty (revision). In 1987, Dr. Jack P. Gunter popularized the use of open rhinoplasty as an approach to secondary rhinoplasty.

Closed Rhinoplasty

One of the most common techniques is called “closed rhinoplasty”. During this procedure, the surgeon uses incisions that are hidden inside the nostrils. This, of course, is an advantage, because it means that the scars will be completely invisible to the casual observer Although this surgery does not offer the surgeon as much freedom as an open rhinoplasty, it does offer a number of possibilities.

For some patients, this surgery provides them with everything they need. Through all the incisions made inside the nostrils, the surgeon can in fact remove or implant cartilage and bones to reduce or increase the size of the nose.

Closed rhinoplasty can be indicated, only, for functional problems and when the aesthetic corrections are small.

Open Rhinoplasty

The open technique is an intervention that has more incisions than the closed technique and the incisions are external where the incisions are made internally in the enclosure. In the open technique the surgeon makes a small incision on the columella which, after some time, will be almost invisible.

Surgeons use this technique primarily because they can control and see the effects of their surgery directly. Furthermore, more and more patients who have been given a previous rhinoplasty are treated with the open rhinoplasty technique.

Differences between open and closed rhinoplasty

Although the closed technique seems better thanks to the invisible scars, this technique is limited to those who can have this surgery and who are qualified as good candidates. This technique works best for patients who are looking for small changes. It would be correct for those who need to eliminate small nubs on the back of the nose. If there is more work to be done on the nose, patients are more likely to be treated with the open rhinoplasty technique.

The open technique is best for those who need a more complex job on their nose. However, there will be more scarring and the scar on the columella will be more evident. However, taking care of the scar correctly, it will become lighter and barely noticeable to the eye over time.

Important information
Both open and closed techniques will cause bruising and swelling, as well as other techniques.

New techniques

There are new rhinoplasty techniques in which surgeons test themselves, which are becoming very popular. Some of these new techniques are rasping, graphite spreader, cephalic resection, strut, so-called plumping grafts and osteotomies. Each of these techniques helps treat specific areas of the nose.

Rasping is used especially when the patient wants to remove the bony hump on the nasal back or to flatten the hump downwards and make it less visible. Doctors use this technique to remove the hump also reducing the amount of bruising and swelling in the affected area.

Grafts spreader is another technique. This particular technique is useful in cases of short nasal bones, long upper lateral cartilage, thin skin and narrow noses. This technique can help patients who have large noses, or a very long nose. The spreader grafts technique requires the surgeon to cut the rectangular strips of cartilage that will be inserted between the septum and the upper lateral cartilages.

Cephalic resection is a technique that removes a protrusion of the cartilage to narrow the tip of the nose. It is used to make the nose appear longer. The strut is a rectangular piece of cartilage that is placed in the middle of the medial crus of the nasal tip. This technique is used to make the tip of the nose look rounder.

Plumbing grafts are placed under the skin, if the upper lip is acute (acute nasolabial angle) or retracted towards the nostrils. With this technique the patient’s own cartilage is inserted through the internal incisions at the base of the nose, which helps to improve the angle, and helps to counteract the aging of the nose.

The Osteotomic technique is used in rhinoplasty surgery. This technique is used to reduce the nasal hump, to correct the twisted nose, and is useful with the nose too wide. This technique is indicated for patients who cannot otherwise obtain good results for their nose.

Talk to your surgeon

To find out which technique will work best for your face and give the best results for you, you should request an appointment with the surgeon. He will examine your specific case and can inform you in detail about the best technique for you, what results to expect, the costs, how long the healing process takes and much more.

Primary Rhinoplasty

Primary rhinoplasty refers to the first rhinoplasty performed on the patient, whether it is performed for aesthetic, functional, or reconstructive reasons. Most people who undergo rhinoplasty need only one intervention to get the desired results.

Rhinoplasty may be required due to traumatic deformities. Traumatic accidents are the most frequent cause of nasal deformity. The operation allows the remodeling of any bony protuberances, and the realignment of the nasal bones.

Secondary Rhinoplasty

Revision rhinoplasty or secondary rhinoplasty, is an operation performed on the nose to correct or review an unsatisfactory result from a previous rhinoplasty or that the patient wishes to improve. An unsatisfactory result occurs from 5% to 20% of patients. There are two main reasons for performing secondary rhinoplasty.

Patients often require secondary rhinoplasty to correct an aesthetic deformity of the nose or to correct functional problems. A patient may be partially or totally dissatisfied with previous surgery or may wish to improve his results or may still have or develop a condition that makes nasal breathing difficult.

The revision procedure can be a complicated procedure. Most rhinoplasty specialists perform secondary rhinoplasty through the open approach. This allows the surgeon to directly visualize the deformity. Advances in techniques now allow satisfactory results in secondary rhinoplasty that were not possible in the past.

Functional Rhinoplasty and reconstructive

Functional rhinoplasty is intended to restore the normal passage of air through the nose and to restore a regular respiratory function.

Reconstructive rhinoplasty aims to restore the normal shape and function of the nose. Pedicled flaps can be used, the most commonly used is the frontal flap also known as the Indian flap, free vascularized flaps such as the forearm flap or Chinese.

Complex nasal reconstructions require costal osteo-cartilaginous grafts.

Functional or reconstructive rhinoplasty can be performed to repair damage resulting from one of the following reasons:

  • traumatic accident
  • autoimmune disorder
  • intra-nasal drug abuse
  • previous ill-considered cosmetic surgery
  • cancer
  • congenital anomaly

A septoplasty must be performed simultaneously with the intervention for aesthetic purposes to improve nasal respiratory function. A lower turbinectomy can be performed during surgery if turbinate hypertrophy is present.

Non-surgical Rhinoplasty

Non-surgical Rhinoplasty refers to the nose and serves to remodel its parts with alternative techniques. It can be performed as an outpatient treatment without anesthesia.

One of the most common types of non-surgical techniques uses injectable substances (we only use autologous fat) to improve the shape and structure of the nose.

Healing Rhinoplasty

After the surgery, you will need someone to accompany you home and stay with you for at least the first 24 hours. The patient returns home after rhinoplasty. In rare cases, the surgeon may recommend a hospital stay. Most surgeons prescribe antibiotics, pain medications, and steroid medications after surgery.

The surgeon may recommend cold packs for 1 or 2. Most people choose to stay at home for a week, even if it is not careless to go outside. It is highly recommended that the patient wear a hat to protect themselves from the sun in case he goes outside.

If there are external sutures, they are usually removed 4 or 5 days after surgery. External protection is usually removed one week after surgery.


The hematoma usually lasts two weeks. Due to the healing of wounds after a rhinoplasty, moderate movements and settling of the nose occur in the first year.

Rhinoplasty Risks

It is extremely important to follow all instructions given by your surgeon before and after your rhinoplasty to minimize risks and complications. Although rhinoplasty is generally considered safe and successful, complications can arise and unpredictable results are possible with rhinoplasty as with any other surgery.

Some of the most common risks include:

  • bruise
  • swelling
  • blood clots
  • infection

Adhesions may also occur, which are the scars that form in bridging through the nasal cavity from the septum to the turbinates. Adhesions are rare, but cause nasal obstruction to breathing and usually need to be removed. At the time of septum surgery a hole can be inadvertently made, this hole is called septum perforation and can cause chronic bleeding of the nose, crusting, difficulty breathing and whistling or wheezing.

If too much basic structure of the nose (cartilage and / or bone) is removed during surgery, this can cause the skin of the nose to take on a shape that can result in a deformity called “polly beak”. Similarly, if the septum is not properly supported, the back of the nose can sink with consequent deformity called “saddle nose”.

If the tip of the nose is too much rotated during a rhinoplasty the nostrils can become too visible and create a pig-like appearance. If the cartilages of the tip of the nose are removed in excess during a rhinoplasty, this can give a crushed appearance to the tip of the nose. If the incision of an open rhinoplasty is made along the entire columella, numbness in the nose can occur to varying degrees which can take up to several months to resolve.

Furthermore, the aesthetic result of rhinoplasty is not always predictable. After surgery the bones can become detached, the cartilage and the soft tissues and can change shape over time. It is extremely important that the patient does not suffer any type of trauma to the nose after surgery, since any pressure applied to the entire treated area can affect the final result of the rhinoplasty.

Furthermore, the results in some rare cases may not meet the patient’s expectations, and an asymmetry is possible. Revision or secondary interventions may occasionally be required to improve the results achieved with the original intervention. The best way to ensure a satisfactory outcome from rhinoplasty is to find an experienced surgeon.

Rhinoplasty is a safe, effective and fast procedure. Every day there are more interventions performed all over the world and surgeons offer a wide range of options to get the best results from this surgery. Rhinoplasty is not just an intervention to correct or perfect a physical condition, it also aims to strengthen the patient’s confidence and help him or her to have a better quality of life.

After the nose operation, the patient should return to his daily activities soon. Rhinoplasty is an intervention that, with adequate care, does not interfere with the patient’s quality of life and must show results in a very short time. Like any other aesthetic or plastic surgery, rhinoplasty is not to be taken lightly. The search for a specialized and highly experienced surgeon who routinely performs rhinoplasty is an essential condition.

This intervention requires little or no downtime depending on the patients’ cases. If you are looking for an effective and cutting-edge method to significantly improve your appearance with safety and efficiency, then rhinoplasty is definitely the intervention to consider. Rhinoplasty is one of the fastest growing cosmetic procedures in both America and Europe. Every day more and more people undergo cosmetic nose surgery to feel better about themselves and with others.

With today’s technologies, having rhinoplasty is always easier, safer and more convenient. However, treatments require a conscious decision-making process. If you are thinking of having a rhinoplasty you will probably have questions about this surgery.

Some of the questions could be the following:

  • Am I a good candidate?
  • Does the nose operation work for me?
  • What are the healing times?
  • What should I expect from this intervention?
  • Which surgeon should you contact?

The deeper you know the rhinoplasty the better you will feel before facing the operation and you will have more chances of success. Rhinoplasty is performed to improve a person’s appearance.

Every day the techniques of this intervention are improved to offer patients better results and with less discomfort. Today, the power of the Internet allows you to keep up with everything you ever wanted to know about cosmetic nose surgery.

Find the right surgeon

Rhinoplasty involves many choices. The first and most important is the selection of a surgeon to rely on. Dr. Giuseppe Spinelli is an accredited maxillofacial surgeon with great experience in rhinoplasty operations. It operates only in accredited health facilities, adheres to a strict code of ethics and fulfills all the requirements of this procedure and medical training, embracing the standards and innovations that concern rhinoplasty intervention and patient safety.

Finding the right surgeon is important in your research process. The first step is always to make an appointment for an initial consultation. In the initial consultation, the surgeon will analyze your case and let you know if you are a good candidate for rhinoplasty. You can also talk to your surgeon about your expectations, how rhinoplasty will be performed, what the recovery times are. The surgeon will also tell you the costs of the surgery and will present you with payment options if necessary. In the initial consultation, you can ask your surgeon questions such as: How long have you been performing rhinoplasty?

Rhinoplasty questions

Once you have decided that you have established that rhinoplasty is right for you, the next step is to book an appointment with a qualified maxillofacial surgeon.

During the consultation you can ask questions that may include:

General Questions on Rhinoplasty:

  • Is it the right intervention for me?
  • Are there alternatives to surgery and which would you recommend for my case?
  • Am I a good candidate?
  • What results should I expect?
  • What is the next step to have surgery?
  • How much does the intervention cost?
  • How can I pay for the surgery?
  • Can it be done on an outpatient basis?
  • Do I need to present new blood tests or x-rays before rhinoplasty?
  • How soon can I have surgery?

Questions regarding the intervention:

  • How is the surgery performed?
  • What success rates are expected for this intervention?
  • How much experience do you have with the surgery?
  • How often does rhinoplasty work?
  • What are the associated risks?
  • What are the complications that could develop from surgery (short and long term)?
  • Where will the intervention take place?
  • What are the operating times?
  • What kind of preparation do I need before surgery?
  • What should I bring with me before the nose operation?
  • Do I have to have a relative or friend during my stay for the surgery?

Questions about what to expect after surgery:

  • How long will I have to be healing after the surgery?
  • How will I feel after the operation?
  • How much pain is there after the surgery?
  • How long should I wait before I completely recover?

Questions to ask about returning home:

  • Is it necessary to have someone to take me home after rhinoplasty surgery?
  • What kind of care do I need at home?
  • Do I need someone to help me after my rhinoplasty surgery? And if so, for how long?
  • Are there activity limitations and how long for healing?
  • What kind of diet should I keep after the nose operation?
  • What symptoms should I watch for and what should I report to the surgeon after cosmetic nose surgery?
  • When should I contact my surgeon?
  • What drugs should I take after rhinoplasty?
  • Is there anything I should avoid after nose surgery (for example: heat or sun)?
  • Do I need bed rest after the nose operation and for how long?
  • How long before being able to return to work after rhinoplasty?
  • Do I need to wear bandages or special clothing? And if so, for how long?
  • How soon can I resume my normal activity?

Please provide your surgeon with full details of your medical history, the history prior to the surgery. Discuss the medications you are taking and the health conditions you can exhibit. The more the surgeon knows about you, the more he can make a proper assessment for you, which will also help you get the best results from the rhinoplasty.

Rhinoplasty benefits

The benefits of a rhinoplasty can be enormous! When we have improved our physical appearance, we feel safer, both in social interactions and in career paths, and this is true for both men and women. Rhinoplasty can improve a person’s overall appearance and how it is perceived by others, giving a stronger self-confidence.

Suitability for Rhinoplasty surgery

As with all medical interventions, a consultation with an expert in rhinoplasty surgeon will help you discover if you are a good candidate for rhinoplasty.

Intervention planning

Are you thinking of a rhinoplasty? Make sure all your questions are answered before submitting to this intervention.

When you meet the surgeon, make sure you are aware of all the recommendations necessary for the pre-surgery phase, recovery times, treatment and recommendations for post-operative rhinoplasty.

What are the side effects of Rhinoplasty?

Necessary rhinoplasty is relatively safe and has some mild side effects. The most common side effects are temporary bruising, numbness, swelling and a tingling sensation. Patients must inquire from their doctors about the side effects of rhinoplasty that may affect their specific situation.

Cost Rhinoplasty

The cost of rhinoplasty depends largely on the surgeon, the type of rhinoplasty performed and whether the patient requires rhinoplasty in conjunction with other interventions. Many surgeons offer payment and financing plans that make the rhinoplasty intervention accessible to everyone.

Rhinoplasty consultation

Be sure to address all the details about your surgery with the surgeon. He can answer all your questions about the surgery, what to expect, how long the healing process takes, what drugs to take after the procedure and many other details.