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Introduction To Primary Rhinoplasty
Primary rhinoplasty is a highly individualized procedure designed to improve both the appearance and function of the nose. At our practice in Louisville, every rhinoplasty consultation begins with a detailed discussion of patient goals, limitations, and realistic outcomes
What Is Primary Rhinoplasty?
Primary rhinoplasty refers to first-time nose surgery performed to correct cosmetic concerns, functional breathing issues, or both. There is no objective definition of a “perfect” nose, as facial harmony and aesthetics are deeply personal.
Our goal is always to create a natural, refined, functional, and durable result tailored to each individual patient
Common Reasons Patients Seek Primary Rhinoplasty
Patients pursue rhinoplasty for a wide range of concerns, including:
- Dorsal hump
- Tip or bridge asymmetry
- Bulbous nasal tip
- Over-projected nose
- Drooping nasal tip
- Wide bridge or tip
- Nasal obstruction or breathing difficulties
Each concern requires a custom surgical plan, not a one-size-fits-all approach
Our Structural Rhinoplasty Philosophy
We perform structural rhinoplasty in every case. This means we do not simply remove cartilage or bone. We reshape, reinforce, and support the nasal framework to ensure long-term stability.
Structural rhinoplasty is critical for:
- Maintaining nasal shape over time
- Preserving or improving breathing
- Preventing collapse or distortion years after surgery
This philosophy is especially important for patients seeking both aesthetic refinement and functional improvement.
How Primary Rhinoplasty Surgery Is Performed
Primary rhinoplasty is performed under general anesthesia for optimal comfort and safety. Surgery takes place at a major hospital in downtown Louisville.
In approximately 98% of cases, we perform an open rhinoplasty, which involves a small 4–6 mm incision beneath the nose. This allows complete visualization of the nasal structures with minimal trauma. In the vast majority of patients, the incision becomes virtually invisible within three months
Key surgical steps may include:
- Septoplasty to straighten the nasal septum
- Dorsal hump reduction when present
- Controlled nasal bone repositioning
- Tip support using septal extension grafts
- Cartilage reshaping rather than removal
Internal nasal splints and an external nasal cast are placed at the conclusion of surgery and removed at the one-week postoperative vis
Primary Rhinoplasty Recovery Timeline
After the cast and internal splints are removed at the 1 week visit, tape is typically applied to the nose. This is most often changed every 3-5 days, and worn for at least the first 6 weeks if not longer.
In the early periods of healing, the nose must be moisturized both at the incision under the nose, and internally. This is accomplished with the generous and frequent application of ointment and gel saline spray. This is especially important during the dry winter months, and is typically performed for the first 3-9 months after surgery.
Swelling after Rhinoplasty is extremely variable, and is dependent on many factors. Some common factors are skin thickness, patient age, patient health, diet and lifestyle, and patient compliance with post-operative instructions. It takes 2-3 years for most patients to have complete resolution of all swelling, however most patients are “studio ready” as early as 2-3 months post-operatively.
Primary Rhinoplasty Results: Before and After
The following before and after photos show real patient results after primary rhinoplasty. Each case reflects an individualized, structural approach focused on achieving natural facial balance, long-term nasal support, and improved function when indicated. Because every nose and facial anatomy is unique, techniques are tailored to the patient’s specific goals, skin characteristics, and underlying nasal structure. Results shown represent typical outcomes following proper healing
General FAQ: Primary Rhinoplasty
Primary rhinoplasty is first-time nose surgery performed on a patient who has never had prior nasal surgery. It is designed to improve the appearance of the nose, nasal function (breathing), or both, using the patient’s original nasal anatomy.
Because no previous surgical changes exist, primary rhinoplasty allows the surgeon to work with intact cartilage, bone, and soft tissue, making structural planning more predictable than revision surgery
The difference between primary and revision rhinoplasty is whether the nose has been operated on before.
Primary rhinoplasty is the first nasal surgery, performed on untouched anatomy.
Revision rhinoplasty is performed after one or more prior rhinoplasty surgeries to correct cosmetic issues, breathing problems, or structural collapse.
Revision rhinoplasty is typically more complex due to scar tissue, altered anatomy, and limited remaining cartilage, often requiring grafting and advanced structural techniques
A primary rhinoplasty is also known as:
First-time rhinoplasty
Initial rhinoplasty
Primary nose surgery
All of these terms refer to the same concept: a rhinoplasty performed on a nose that has never been surgically altered.
Primary rhinoplasty refers to the initial nasal surgery, while secondary rhinoplasty (also called revision rhinoplasty) refers to any subsequent nose surgery performed after the first.
Primary rhinoplasty focuses on reshaping and supporting natural anatomy.
Secondary (revision) rhinoplasty focuses on correcting problems from prior surgery, such as asymmetry, breathing difficulty, or structural weakness.
Secondary rhinoplasty often requires more complex techniques and a higher level of surgical expertise