What is rhinoplasty?
Rhinoplasty reshapes the framework of the nose: the bone of the upper third, the cartilage of the middle and the tip, and the septum that divides the airway. The skin is not cut away; it is lifted, the structure beneath it is changed, and it shrinks onto the new shape over the months that follow. Dr. Cat performs primary rhinoplasty, with or without a septoplasty, for patients who want a bump taken down, a wide bridge or tip narrowed, a drooping tip lifted or a low bridge built up, and for patients who cannot breathe through one side. Our page on nose shape concerns explains what sets each shape and why tape, exercises and creams cannot move bone or cartilage.
What rhinoplasty can change
- A dorsal hump, the bump of bone and cartilage along the bridge, taken down and the bridge narrowed
- A bulbous, drooping or upturned tip, reshaped by suturing and trimming the tip cartilages
- A wide nose, narrowed where the width lives: the bones, the tip cartilages or the nostrils
- A crooked nose, straightened together with the septum behind it
- A low or flat bridge, built up with your own cartilage
- A deviated septum or a narrowed airway, corrected in the same operation
Who is a good candidate for rhinoplasty?
Most of Dr. Cat's rhinoplasty patients have disliked the same feature in every photograph for years: a hump in profile, a tip that is round or drops when they smile, a nose that reads too wide from the front. Some also breathe poorly through one side. If the feature is bone or cartilage, only surgery changes it, and the decision is about proportion, because a nose is designed for the face around it.
You may be a good candidate if
- A hump, a wide bridge, a bulbous or drooping tip, flared nostrils or a crooked nose has bothered you for years
- Your breathing is blocked on one side by a deviated septum, which can be corrected in the same surgery
- You are at least 16 years old, with facial growth complete
- You are in good physical health, a non-smoker, with realistic expectations of a refined nose rather than a different face
- This is your first rhinoplasty: Dr. Cat performs primary rhinoplasty, with or without septoplasty
Not yet, or a different plan, if
- You are under 16 or still growing: the framework has to finish developing before it is reshaped
- You use nicotine and cannot stop: it starves the lifted skin and the grafts of the blood supply they need to heal
- You want a copy of a celebrity's nose: inspiration photos are welcome, but a nose is planned for your face, not someone else's
- A small hump or a slight asymmetry that filler can disguise: non-surgical rhinoplasty is the lighter step, described below
- You want a previous rhinoplasty corrected: at our practice revision rhinoplasty is performed by our board-certified facial plastic surgeon
Types of rhinoplasty
Closed rhinoplasty
In a closed rhinoplasty every incision is inside the nostrils, so there is no visible scar and the recovery is a little shorter. Dr. Cat uses it for smaller refinements: a hump reduction, modest narrowing of the bridge and simpler tip work.
Open rhinoplasty
An open rhinoplasty adds a short incision across the columella, the strip of skin between the nostrils, so the whole framework can be seen directly. Dr. Cat uses it when the tip needs reshaping, when grafts have to be placed, and for a crooked nose; the incision fades to a fine line. Our post on open vs closed rhinoplasty compares the two; the choice follows your anatomy, not the scar.
Rhinoplasty with septoplasty
When a deviated septum or a narrowed airway is part of the picture, Dr. Cat corrects it in the same operation: the septum is straightened, enlarged turbinates are reduced when they block the airway, and spreader grafts support the middle of the bridge so that taking down a hump does not narrow the airway later. Septoplasty or turbinate reduction added to the plan is quoted at the consultation.
Ethnic rhinoplasty
Ethnic rhinoplasty refines a nose while keeping it in character with the face and its heritage, and it often builds rather than reduces: cartilage grafts raise a low bridge or support a soft tip, and nostrils are narrowed where they flare. Because grafting adds operating time, it usually sits at the upper part of Dr. Cat's price range.
Revision rhinoplasty
Correcting a previous rhinoplasty means operating through scar tissue, often with cartilage from the ear or the rib to replace what was removed. At our practice revision rhinoplasty is performed by our board-certified facial plastic surgeon; his surgeon's fee is $40,000 to $50,500, with the operating room and anesthesia quoted at the consultation. Most surgeons advise waiting about a year after the first surgery, once the swelling has settled.
Non-surgical rhinoplasty
Filler placed above and below a small hump makes the profile read as a straight line for months to a year or more; it adds volume, so it cannot make a nose smaller or fix breathing. At our practice it is performed by our facial plastic surgeon at a set price of $4,500, including two visits.
How Dr. Cat does it
Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained. Rhinoplasty is where the two trainings meet, because the operation has to produce a nose that looks right and a nose that breathes.
Planned on your proportions, not on a template
The plan starts with the face, not the nose: how the tip relates to the upper lip, how the bridge sits between the eyes, how the chin projects beneath it. A copy of someone else's nose is never the plan, because the relationship between the tip and the lip decides whether a nose looks operated on. The goal is a nose that stops drawing attention, so the eyes and the lips do.
The framework: bone, cartilage and your own grafts
A hump is taken down in its two materials separately: the bone is rasped or cut, the cartilage is trimmed. That leaves an open roof where the bones no longer meet, so the nasal bones are moved inward with controlled cuts called osteotomies, which closes the roof and narrows the bridge, and spreader grafts hold the middle of the bridge open so the airway is preserved. A bulbous tip is reshaped by suturing and trimming the tip cartilages, not by removing skin; a drooping tip is rotated upward and held with a cartilage strut; a low bridge is built up with cartilage. The grafts come from your own septum or, when more is needed, from the ear through a small incision hidden behind it: living tissue, without the lifetime risk of shifting, extrusion and infection that a silicone implant carries.
Surgery day
Rhinoplasty takes about three to four and a half hours under general anesthesia, with a board-certified physician anesthesiologist for the whole case, in Dr. Cat's QUAD A accredited surgery center on Rodeo Drive. She performs every step herself and schedules one major surgery per surgical day, so nothing is rushed. You wake with a small splint over the bridge, and after a few hours in recovery you go home with someone to drive you; if the septum was worked on, soft internal splints support it for the first week.
Combining rhinoplasty with other procedures
Rhinoplasty with chin augmentation
A prominent nose over a short chin looks larger than it is, and bringing the chin forward can do as much for a profile as reducing the nose. When the chin is part of the plan, a chin implant is placed by our facial plastic surgeon, who works alongside Dr. Cat; our page on chin augmentation covers it.
Rhinoplasty with a facelift, eyelid lift or fat transfer
Patients who are also treating the signs of aging often plan an eyelid lift with Dr. Cat, or a facelift with our facial plastic surgeon, and fat transfer to the face restores volume to hollow cheeks with your own fat; whether a combination fits one surgical day or is better staged is decided at the consultation.
Rhinoplasty recovery timeline
Here is what recovery looks like for most of Dr. Cat's rhinoplasty patients. The congestion of the first week surprises patients more than the discomfort does, and it clears as the swelling does.
- The night of surgeryYou go home a few hours after waking, with someone to drive you and stay the night. Expect congestion and a heavy feeling under the splint rather than pain; most patients manage with Tylenol. Sleep on your back with your head raised, and use a cold compress on the eyes, not the nose.
- Days two to threeSwelling and any bruising around the eyes peak at about 48 hours and then improve; with Dr. Cat's gentle technique most patients bruise little. Keep the splint dry and skip decongestant sprays, which interfere with healing.
- One weekThe splint and any internal dressing come out at your visit with Dr. Cat, and you see the new shape for the first time, still swollen. Out-of-town patients can usually fly home once cleared at this visit.
- Two weeksMost patients are back at a desk and in public. Light exercise such as walking or an easy stationary bike can start. Glasses must not rest on the bridge: tape the frames to your forehead or wear contacts.
- Six weeksThe nasal bones have set: running and lifting resume, and glasses can sit on the bridge again. Anything that could hit the nose waits longer, with Dr. Cat's clearance.
- Three monthsAbout 80 percent of the swelling is gone and the bridge has settled. The tip, where the skin is thickest, is still refining, and the nose looks more swollen in the mornings and in heat.
- Six to twelve monthsThe tip settles and the last swelling leaves; thick skin takes the longest. The result is judged at a year, when Dr. Cat takes the photographs for her gallery.
Rhinoplasty before and after photos
Profiles show a hump best and front views show width, so look at both. The six cases below are Dr. Cat's. RHY-0704 and RHY-0593 had the nose refined and a bulbous tip narrowed; RHY-0419 is a young woman whose nasal bump was taken down and bulbous tip reduced; RHY-0477 is a 31-year-old who wanted her dorsal bump gone and her tip slightly lifted, with subtle results. Open each case for every angle, and find the starting nose closest to yours in the full rhinoplasty before and after photos.
Risks and safety
Every surgery carries risk, and rhinoplasty is one of the operations plastic surgeons most often revise, usually because too much was taken. Here is what can happen, what Dr. Cat does to prevent it, and when to call us.
What can go wrong
- Bleeding in the first days, or a nosebleed later if the nose is bumped or blown
- Infection at an incision or around a graft
- Swelling that lasts longer than expected, especially at the tip and under thick skin, and numbness of the tip that fades over months
- A visible columella scar after an open rhinoplasty, rare with a fine closure
- Asymmetry, a small irregularity of the bridge, or a result that needs a touch-up once the swelling has settled
- Breathing that is worse rather than better, when the cartilage that held the airway open was removed
- Anesthesia risks, which the board-certified anesthesiologist reviews with you before surgery
How Dr. Cat reduces these risks
- Careful patient selection: age and growth, nicotine, medical history, and a nose examined inside and out before you are scheduled
- Medical clearance and lab work, and a pre-operative appointment covering the medications, supplements and alcohol to avoid for two weeks before surgery
- Surgery in a QUAD A accredited facility with a board-certified physician anesthesiologist for the whole case, and one major surgery that day
- A conservative plan: a hump reduced without scooping the bridge, a tip refined by suturing rather than by removing its support, spreader grafts so the airway stays open, and structure built from your own cartilage
- A splint for the first week, no glasses on the bridge and no impact for six weeks, and follow-up visits through the first year, all included in the quote
Call us right away for a fever over 101°F, chills, or spreading redness, warmth or foul-smelling drainage at an incision or inside the nose; a nosebleed that does not stop with gentle pressure and your head up; swelling or pain that keeps getting worse after the third day; or any blow to the nose.
Call 911 first, then us, for chest pain, shortness of breath, or calf pain or swelling in one leg. And for anything that worries you: Dr. Cat and our staff are available to you throughout your recovery.
How much does rhinoplasty cost in Beverly Hills?
Dr. Cat's surgeon's fee for a primary rhinoplasty is $40,000 to $45,500. The operating room and the board-certified physician anesthesiologist are quoted at your consultation, once Dr. Cat has examined you and set the operating time your surgery needs: operating time varies with your anatomy and with the areas treated together, so it is set by her, not by a price list. Surgeon's fees are typical ranges: a more complex case can cost more, and your fee is set at your consultation and is final only in your written quote. The quote is itemized in writing and includes the splint and dressings and your follow-up visits, with no second invoice after surgery. Where your price lands depends on how much of the framework has to change and whether grafts are needed; septoplasty or turbinate reduction added to the plan is quoted at the consultation. A revision rhinoplasty with our facial plastic surgeon is a surgeon's fee of $40,000 to $50,500, with the operating room and anesthesia quoted at the consultation.
The price reflects what is behind it: one surgeon who performs every step herself, one major surgery per surgical day, a physician anesthesiologist for the whole case and an accredited facility. Please do not fall for cheap or fast surgery: a cheap nose job is the most expensive kind, because a scooped bridge or a pinched tip is rebuilt with rib or ear cartilage at a cost above the original surgery done well. Our rhinoplasty cost guide explains what a quote is made of and the questions to ask any surgeon.
Consultation fee and financing
A consultation with Dr. Cat is $500, or $1,500 for a revision consultation, and the full amount is credited toward your surgery. To pay over time, the practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans. Cosmetic rhinoplasty is not covered by insurance; when a septoplasty is part of the surgery, the functional portion sometimes qualifies. Dr. Cat's office does not bill insurance, but gives you an itemized statement with the codes so you can submit a claim yourself.
Your consultation with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. At the consultation, in person on Rodeo Drive or, for out-of-town patients, by private video consultation through OnPatient, the HIPAA-secure patient portal, Dr. Cat examines the nose inside and out: where the hump is bone and where it is cartilage, how far apart the nasal bones sit, how strong the tip cartilages are, how thick the skin is, and whether the septum is straight and the airway open. She tells you plainly what your bone, cartilage and skin allow, shows you the planned nose with computer imaging, and you leave with an itemized written quote. Many of her rhinoplasty patients travel to Beverly Hills and fly home after the splint comes off at about a week.
