“The best rhinoplasty is the one the human eye cannot detect.”
What a rhinoplasty or nose job is
A rhinoplasty is a nose job: the surgery that changes the shape and size of the nose by reshaping its framework, the bones and cartilages that support it. It is also called nose surgery or nasal surgery, and when it also corrects the septum or the turbinates to improve breathing, septorhinoplasty. It can lower a hump, refine or lift the tip, narrow the base, shorten or lengthen the nose and correct asymmetries, and in the same operation solve the functional problems that stop you breathing properly.
When someone comes to my practice to have their nose done, they almost never ask me for a specific nose. They ask me to make it stop being the first thing they see in the mirror. And that is the key to this surgery: my goal is not a “catalogue nose”, but to bring harmony back to the face. If afterwards your friends tell you your eyes look brighter, that you look more rested, and they cannot say what has changed, we have done a good job.
I am a plastic, aesthetic and reconstructive surgeon, specialising in facial and nasal surgery, and I operate in Madrid, Spain.
| Anaesthesia | General. |
|---|---|
| Duration | 2 – 3 hours. |
| Hospital stay | Short stay: a few hours of observation and, in most cases, home the same day. |
| Back to work | One week, when the splint comes off. |
| Result | The change shows when the splint is removed; final between 6 and 12 months, up to 18-24 in thick skin. |
| Price | €7,500 to €9,000 for a primary rhinoplasty; a secondary rhinoplasty, €9,000 to €19,000. |
| Where | Madrid, at HLA Moncloa and Vithas Aravaca. |
What a nose job corrects
What it improves is specific:
- The hump on the bridge, visible in profile.
- The tip: drooping, wide, bulbous or dropping when you smile.
- A nose that is too big or too long for the face, or a base that is too wide.
- Asymmetries and deviations, from birth or from a blow.
- Breathing: a deviated septum, valve collapse or enlarged turbinates are corrected in the same operation.
What it does not do: it does not swap your face for another, it is not a fashionable nose and it is not done twice if it can be done well once. The best rhinoplasty is the one you have only once in your life.
Types of nose job
There is no single approach. It is chosen according to the anatomy of each nose, the skin that covers it and what needs to change. These are the distinctions that matter:
- Closed or open rhinoplasty. In the closed approach all the incisions are inside the nose and no scar is visible; in the open approach I add a small incision on the columella, the strip of skin between the two nostrils, which lets me see the whole framework and is almost imperceptible. The open approach gives more control in complex noses; the closed one is enough for many corrections.
- Preservation, structural or hybrid rhinoplasty. Keeping the original anatomy as far as possible when the framework is good, or giving support with grafts of your own cartilage when the base is weak; I often combine the two. I explain it in preservation versus traditional rhinoplasty.
- Ultrasonic rhinoplasty. It is the technology I use on the bone in my routine practice, with less bruising, less pain and less swelling than with the classic chisel. The ultrasonic technique is always combined with the techniques explained above. It has its own page, with the comparison against the traditional method: ultrasonic rhinoplasty.
- Primary or secondary rhinoplasty. Primary is the first time; secondary, tertiary or revision rhinoplasty is the one that corrects a previous operation. It is a different, more complex operation.
- Post-traumatic rhinoplasty. A nose broken or deviated by a blow has its own rules. A pre-operative CT scan will help determine the right strategy.
- Ethnic rhinoplasty. In ethnic rhinoplasty thick skin and weak cartilages are common. It often requires specific support techniques and more patience until the final result.
- Septal perforation. It is a separate and very important chapter of reconstructive septorhinoplasty. The aim is to repair a perforated septum (due to trauma, disease, infection or substance use) to restore or preserve the support of the nose itself.
Functional rhinoplasty: septum, turbinates and breathing better
A nose that does not breathe well is not just an aesthetic problem. A deviated septum, enlarged turbinates and valve insufficiency, when the nose closes as you breathe in hard, are corrected with surgery, and in my practice they are planned together with the shape: septoplasty and turbinoplasty are done in the same operation as the aesthetic rhinoplasty, as in this septoplasty and turbinoplasty case.
If you run out of air when you exercise or notice your nose closing when you take a deep breath, read nasal valve insufficiency: why you breathe poorly.
How nose surgery works with me
The consultation. I look at the nose at rest and in movement, check how you breathe and listen to what bothers you. If the problem is specific and visible, surgery is indicated; if the dissatisfaction is vague and general, I prefer to wait and, sometimes, to ask for a psychologist’s assessment first. Knowing when to say no is part of operating well. 3D simulation is available for this procedure and helps us talk about the same thing.
The operation. Through a closed or open approach depending on the case, I reshape the cartilages and bones that support the nose. I work on the bone with ultrasound. It takes between two and three hours, under general anaesthesia for greater patient safety and surgical precision.
When you wake up. You wear a light splint over the bridge for seven days to protect the bones and, in my routine practice, silicone tubes inside the nose that let you breathe from the very first moment, instead of the classic packing. Pain is uncommon: the discomfort of the first few hours is controlled with oral painkillers.
Age. I do not operate before the nasal bones have finished forming. In women the face matures earlier, between 16 and 18; in men it keeps growing until 18-19, and I prefer to operate after 18. With a teenager who asks for it and parents who have doubts, I do not push: I offer repeat appointments every few months to see whether the problem persists, and we often operate once they come of age.
Recovery after a nose job
After a week I remove the splint and most patients go back to their social life and work; with the ultrasonic technique bruising is minimal. No sport with a risk of a blow to the nose for two months, and the final result between six months and a year, up to two in thick skin. The week-by-week timeline and aftercare, from cold compresses to glasses and sun protection, are in rhinoplasty recovery.
Rhinoplasty risks
Every operation has risks, and I would rather tell you about them than let you discover them in a consent form. The common ones are mild and pass on their own: slight bleeding in the first few days, bruising and swelling, congestion in the first weeks, changes in sensation at the tip that gradually fade, and small irregularities you can feel to the touch while the bone heals. The serious ones are rare: infection, septal perforation, adhesions inside the nose or a shift caused by a blow in the first weeks. There is also the possibility that the result is not what was expected; good pre-operative planning reduces that risk. According to published series, between 3 and 10 % of rhinoplasties end in a revision, almost always for a minor touch-up. What reduces that risk most is the right indication, a technique that respects the tissues, solving the breathing problem in the same operation, well-managed aftercare and clear expectations from the first consultation.
When this is not the right surgery
If your nose has already been operated on and the result is not what you expected, what you need is a secondary rhinoplasty, which is planned differently.
If your nose was broken or deviated by a blow, post-traumatic rhinoplasty has its own timing and technique.
Nose job before and after
Nothing explains a rhinoplasty better than seeing a nose before and after, with its technique and timing. In my rhinoplasty gallery there are primary, functional and revision cases, with photos months later, once the result has settled.
Having your nose done in Madrid
I operate in Madrid, Spain, at HLA Universitario Moncloa and Vithas Aravaca. As well as operating, I teach: I run an intensive rhinoplasty course with live surgery for surgeons, and I talk about this surgery in the press and on podcasts, as in invisible rhinoplasty.
If you are thinking about taking the step, come for a consultation: the best rhinoplasty is the one you have only once, and for that you have to choose the first one well.
Nose job FAQ
What types of nose job are there?
By approach, closed (no visible scar) or open (with a small incision on the columella). By technique, preservation, structural or hybrid, and ultrasonic when the bone is worked with a piezoelectric device. By timing, primary or secondary. And by purpose, aesthetic, functional or both at once, which is the most common in my practice.
How long does rhinoplasty recovery take?
One week with a splint; after that, normal life except sport with a risk of a blow to the nose, which has to wait two months. The final shape arrives between six months and a year. Week by week, in rhinoplasty recovery.
What are the risks of a nose job?
The common ones are mild and pass: slight bleeding, bruising, congestion and changes in sensation. The serious ones are rare. Between 3 and 10 % of rhinoplasties need a touch-up according to published series; the best prevention is the right indication and a technique that respects the tissues.
At what age can you have a nose job?
When the nasal bones have finished growing: in women, between 16 and 18; in men, preferably after 18. With minors, in addition, the problem has to be specific and visible, and the expectations clear.
How much does a nose job cost in Madrid?
With my usual technique, between €7,500 and €9,000; a revision rhinoplasty, between €9,000 and €19,000. These are the figures in my 2026 price guide, and I explain what each case depends on in the price of rhinoplasty.
What if I just want to breathe better?
A deviated septum, valve collapse and enlarged turbinates are corrected with surgery, in the same operation as the shape of the nose. If you run out of air when you exercise, start with nasal valve insufficiency.