Understanding Rhinoplasty and Septorhinoplasty Surgery
A Clear Guide to Cosmetic Refinement and Functional Breathing Correction
Rhinoplasty is one of the most impactful procedures in facial aesthetics. It can smooth a dorsal hump, refine the tip, straighten the bridge, or restore balance to the profile.
For many patients, the goal goes beyond appearance. A deviated septum or internal nasal blockage can make it difficult to breathe comfortably. When both goals are addressed in a single surgery, the procedure is called septorhinoplasty.

Whether you are seeking harmony in your facial features or long lasting relief from airway obstruction, rhinoplasty can improve both confidence and quality of life.
Rhinoplasty reshapes the external framework of the nose by adjusting bone, cartilage and soft tissue. It can:
When breathing issues are present, internal corrections are added. This is known as septorhinoplasty and addresses:
The goal is always the same. Create a nose that looks natural and functions well.
Rhinoplasty or septorhinoplasty may be right for you if your concerns involve either the appearance of your nose or the way it functions.
You may be a candidate if you:
A consultation with a facial plastic surgeon is the best way to determine which approach will help you achieve your goals.
Rhinoplasty and septorhinoplasty can create significant improvements in both breathing comfort and facial balance. Before and after photos help you understand:
Browse the full gallery to see refinements that look seamless and proportional.
Rhinoplasty is done under general anesthesia and typically takes 1 to 3 hours.
There are two main surgical approaches:
A small incision is made across the columella. This approach offers the most visibility and precision for reshaping the tip, straightening the bridge or correcting complex anatomy.
All incisions are placed inside the nostrils. This approach avoids a visible external incision and is ideal for select patients needing less extensive work.
During septorhinoplasty, the deviated septum is straightened and internal blockages are corrected at the same time that external refinements are made.
Every patient heals at a different pace, but typical experiences include:
At practices with advanced recovery protocols, options such as photobiomodulation therapy can help reduce swelling and bruising, especially after revision rhinoplasty or more complex surgeries.
Light therapy supports healing after rhinoplasty by helping swelling and bruising resolve more quickly. After surgery, the nose naturally becomes inflamed as tissues adjust and fluid builds. Photobiomodulation uses blue, yellow and near infrared light to calm that response and improve circulation.

Blue light keeps the skin clean. Yellow light improves lymphatic drainage. Near infrared light reaches deeper tissues to reduce inflammation and support faster recovery.
Patients often feel less pressure and congestion after treatment. Light therapy is especially helpful after revision rhinoplasty or more detailed structural work, where controlling swelling plays an important role in comfort and final refinement.
Rhinoplasty is one of the most demanding procedures in plastic surgery. Precision, experience and an artistic eye are essential.
Look for:
Dr. Richard Balikian combines twenty years of surgical experience with an approach rooted in preservation, balance and natural refinement. His goal is a nose that fits your face and functions comfortably in daily life.
If you are exploring your options, a personalized consultation will help you understand your anatomy, your goals and the most effective surgical plan.
Whether your concern is cosmetic, functional or both, you deserve a result that feels natural, confident and in harmony with your facial features.
What’s the difference between rhinoplasty and septorhinoplasty?
Rhinoplasty focuses on cosmetic reshaping of the nose—refining the bridge, tip, profile, or symmetry. Septorhinoplasty includes functional work (septum repair, internal airway support) plus aesthetic adjustments, balancing form and breathing.
When is septoplasty alone sufficient instead of full rhinoplasty?
If your main concern is nasal obstruction due to deviated septum (without aesthetic dissatisfaction), septoplasty (sometimes combined with turbinate reduction) may suffice. A recent meta-analysis of RCTs confirmed septoplasty improves obstruction symptoms at 6 and 12 months compared to non-surgical approaches.
Does adding functional work (septum/turbinates) affect aesthetic outcome?
Modern techniques aim to perform functional and cosmetic correction in integrated fashion. One study found that functional or aesthetic factors can each influence patient satisfaction post-septorhinoplasty; balancing both is key.
Can tranexamic acid (TXA) help reduce bleeding in rhinoplasty / septorhinoplasty?
Yes. A recent meta-analysis across rhinoplasty and septoplasty procedures showed adding TXA significantly reduces intraoperative blood loss compared to controls.
Which is better: open approach or closed (endonasal) rhinoplasty?
A 2022 systematic review of outcomes found that open and closed approaches yield similar patient satisfaction, aesthetic and functional results; there’s no universally superior method—choice depends on anatomy and surgeon preference.
What are typical revision rates and risk factors after septorhinoplasty?
Large retrospective reviews report revision rates in the ballpark of ~5-15%, depending on complexity and follow-up. Risk factors include structural under-correction, postoperative nasal obstruction, poor wound healing, or surgical planning errors.
Are pediatric patients at higher risk of needing revision septoplasty?
Yes. One cohort study found pediatric patients had a higher revision septoplasty (or conversion to rhinoplasty) rate than adults—2.9% pediatric vs 1.1% adult revision in one large database.
Can rhinoplasty / septorhinoplasty influence brain or olfactory function?
Functional septorhinoplasty may lead to structural changes in brain regions involved in olfaction, according to neuroimaging work, highlighting the interplay between nasal airflow and brain networks.
Is the nasal septum essential from an aesthetic standpoint?
Absolutely. The septum provides central support for the nose. Many publications discuss the coupling between septal structure and nasal aesthetic outcomes. Proper septal work is foundational to both stable form and function.
How do I choose whether my surgeon should prioritize structure, skin envelope, or support grafts?
Ask how they plan to support mid-vault, tip, and dorsum. A balanced approach considers integrity of cartilage, minimizing overresection, and using grafts (spreader, columellar, etc.) to maintain both aesthetics and airway. Outcomes literature supports that neglecting support leads to collapse/deformity.
What is the role of 3D imaging or simulation in rhinoplasty planning?
3D simulation tools help communicate changes and improve alignment between patient expectation and surgical plan. Automated assessment systems are emerging: e.g. a recent ML framework quantified nasal aesthetic improvements across many cases.
Dr. Richard Balikian is a renowned facial plastic surgeon known for his dedication to patients throughout Southern California.
With more than two decades of experience and double board certification in Facial Plastic and Reconstructive Surgery and Otolaryngology – Head and Neck Surgery, he brings together surgical precision and an artist’s eye.
Dr. Balikian is among a select group of specialists whose advanced training is devoted entirely to procedures of the face and neck.

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