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Plastic operation of the nose – rhinoplasty

The shape and size of the nose play a major role in the overall expression and appearance of the face. Deviations in shape and size affect the appearance and often also cause functional problems. This is why rhinoplasty usually involves ENT specialists and plastic surgeons working together to achieve optimal results.

Perfect Clinic can perform a rhinoplasty to achieve the look you want while resolving breathing difficulties, saving you the mental and physical strain of having two separate operations. Rhinoplasty is performed under total anesthesia and takes one to two hours. You will stay in the clinic for one or two days and can resume normal activities after a week.

Quick information

  • The size and shape of the nose fundamentally affects facial expression.
  • We use the most gentle method  - PGA Rhinoplasty - less bleeding, faster healing, no nose splint.
  • Rhinoplasty can be performed after growth and puberty at the earliest.
  • Besides the aesthetic result, rhinoplasty can improve breathing through the nose.
  • Within the Perfect Clinic, ENT surgery can be performed in one operation with rhinoplasty.
  • For classic rhinoplasty, it is necessary to wear a plaster cast for two to three weeks.

Nose shape and facial expression

Too-large nose, hooked nose, saddle nose, nostrils too narrow, bulbous tip – many people are unhappy with how their nose looks, yet often do not realize that the problem actually affects their whole face. And unlike other parts of the body, of course, we can’t really cover up our noses when we go outside. Well-chosen glasses and carefully applied makeup can mask minor nose issues, but for a more definitive change the only option is rhinoplasty.

Who is a good candidate for rhinoplasty?

Rhinoplasty is suitable for anyone suffering from an undesired nose shape or size, whether natural or acquired (such as due to injury). This can involve a range of problems: asymmetry, hooked or saddle nose, nostrils too wide or narrow, etc.

Cosmetic problems of the nose are often accompanied by functional difficulties, such as trouble breathing and repeated infections caused by a deviated septum. Patients should only have this operation once they have finished puberty and are no longer growing. It is important to be in good health before having the operation.

Before/after gallery

Plastic operation of the nose before/after rhinoplasty before and after photo

Before rhinoplasty

First you will have a consultation with a surgeon who will assess your condition, including the thickness of the skin, and the possibilities available with an operation. Your doctor needs to be informed of all medications and food supplements you take regularly and any existing medical conditions or health concerns. You may need to stop taking some medications or supplements temporarily for the sake of the operation. You will also receive all the information you need to prepare for the operation and aftercare at the consultation in writing.

Before the operation you will need to have a full examination as well as an examination by an ENT specialist in case of functional problems.


  • Patients should be in good health for the last three weeks before the operation and should inform the doctor of any infection or illness, even a common cold or virus.

Rhinoplasty operation

Rhinoplasty, commonly known as a nose job, is performed under total anesthesia. Operations on the tip of the nose only can be performed with local anesthesia. The operation usually takes one to two hours. If the operation includes correcting ENT issues, then those are addressed first and the cosmetic aspects next. Depending on the specific case the plastic surgeon will modify the soft and hard tissues of the nose to the desired shape. The incisions are made on the inside of the nose, so you will have no external scarring. After the procedure is complete, nose tampons will be inserted and a nasal splint added to keep everything in place.

PGA Rhinoplasty - the most gentle rhinoplasty you deserve

PGA rhinoplasty is a gentle method of nose surgery. Standard techniques are quite aggressive to the tissues. Closed rhinoplasty involves loosening the skin at the root of the nose using scissors from the nostrils, severing the blood vessels in the subcutaneous tissue, causing significant bleeding.

Similarly, in the closed method, the nasal bones are broken and the hump is removed from the root of the nose using chisels inserted from the nostril. The periosteum, which contains a rich vasculature, is severed, causing bleeding and large bruising. The blood clots in the tissues have the effect of creating more pronounced scars, which can ultimately affect the overall aesthetic outcome of the operated nose.


On the contrary, the principle of PGA rhinoplasty is the most gentle approach to the operated tissues of the nose. During the operation, the surgeon uses magnifying glasses and fine instrumentation. The operation is performed under general anaesthesia, when the patient is hypotensive, the tissues are infiltrated with a specially diluted solution with adrenaline. The preparation is gentle, where we try to damage the vascular system of the nose as little as possible, thus achieving less bleeding during the operation.

PGA rhinoplasty can be done open, where we make an incision in the columella area, where the resulting scar remains under the nose after surgery, or it can be done closed, from an incision in the nostril, without scarring. During the preparation we try not to unnecessarily disturb the subcutaneous ligaments, which have an influence on maintaining the stability of the skin surface of the nose. We do not remove the bump at the root of the nose with a chisel, but grind it down, and after breaking the nasal bones with a piezoelectric saw, we push the bump in the area of the root of the nose inwards, thus shaping the root, the so-called push down technique.


Preparation of the nasal cartilage is also performed gently, without aggressive reduction of the cartilaginous parts of the nose. If the patient has a protruding septum, it can be flattened during surgery on the external structures of the nose. We fix the sculpted nasal bones to the nasal septum with sutures, so that after the surgery we do not need to put a plaster on the nose, but just put a plaster on the nose, which is removed 14 days after the surgery.

In standard rhinoplasty, after the nose surgery, we insert tampons into the nasal passages and the patient breathes only through the nose after the surgery, a plaster is placed on the nose. In PGA rhinoplasty, no tamponade is inserted into the nose because the skeleton is stabilized with internal sutures and instead of a cast on the nose, the patient has only a patch. The patient is discharged from the hospital the next day, bruising and swelling in the face is minimal, and he breathes freely through his nose. PGA rhinoplasty is not suitable for all types of nose. It is used in primary rhinoplasties where the nasal root is not wide. This method is not used for atypical noses and for secondary rhinoplasties.


Post-rhinoplasty care

Most patients stay in the clinic one or two nights after the procedure, although patients who have modifications to the tip of the nose performed under local anesthesia can go home the same day. The nasal tampons force patients to breathe through the mouth, which can be uncomfortable. Please keep in mind that the swelling and bruising last for several days after the procedure. The nasal tampons are removed after two days. This can be done by the doctor or at home by the patient. To remove, first take the packing under the nose off and then carefully pull the tampons out with tweezers.

The edges of the nostrils should be cleaned every day with a Q-tip dipped in disinfectant. The nasal splint is fixed with tape and should remain on the nose for two weeks, after which the doctor or patient removes it. Then the nose can be washed, but the splint should be put back in place overnight for the next week. This prevents unintentional injury to the nose while sleeping.

After removing the splint you can begin doing pressure massage. Start at the tip of the nose and continue in a line toward the base of the nose. Press your nose for thirty seconds in each spot with two fingers, repeating the massage 10 to 15 times per day for the first month. Massages are very important to prevent scarring and relax the skin.

before rhinoplasty after rhinoplasty
Before the operation After the operation

Recovery and returning to everyday activities

You should avoid physical activity for a week after rhinoplasty. After that you can resume light office work, but you will need to keep wearing the splint, which can make it awkward appearing in public. You can return to normal physical activity and exercise three weeks after your operation.

rhinoplasty - before rhinoplasty - after
Before the operation After the operation
before nose surgery after nose surgery
Before the operation After the operation

Possible complications associated with rhinoplasty

Rhinoplasty is a surgical procedure and as such involves the same risk of general complications as any other surgery. Primarily this involves the risk of excessive bleeding, scarring or infection. Complications specific to this procedure include development of post-operative adhesions or cysts, constriction in the nasal cavity, and not achieving the desired shape. While you can get a pretty good idea of the results after taking off the splint, do keep in mind that the final shape will be visible only after the tissues have fully healed, several months after the operation.

Unwanted changes in the nose can be caused by choosing the wrong operating technique, which is why we encourage patients to choose an experienced surgeon with proven results. An unsuccessful rhinoplasty is all the more serious because unlike other parts of the body, the nose cannot be covered up and reoperation is often complicated.

Duration of rhinoplasty results

The nose takes on its definitive shape several months after the procedure, at which point the results are permanent.

M.D. Roman Kufa and his thoughts on rhinoplasty

  • “Nose operations are among the most challenging, because they are usually done through an incision inside the nostril. All surgical instruments (chisel, scissors) and bone modifications go through this incision. Open rhinoplasty is still used sometimes, where the skin of the nose is lifted off the bone, but even then the procedure requires a great deal of imagination and experience from the operating surgeon.”

Where do we perform rhinoplasty?

You can come in for a consultation at any of our branch offices in Prague, Brno or Liberec. There you can meet with a specialist to discuss your expectations and desired results. The procedure itself will take place at our clinic in Prague.


What is PGA rhinoplasty and what are its benefits?

  • It is a gentle method of rhinoplasty where the surgeon tries to cause as little damage as possible to the vasculature of the nose, thereby reducing bleeding and speeding up healing. After this type of surgery, it is not necessary to insert a tamponade into the nose and instead of a plaster, there is only a patch on the nose. The patient breathes freely through the nose.