Rhinoplasty and septorhinoplasty

The nose is different from many other facial features because it is both highly visible and highly functional. Its shape affects facial harmony, but its internal structure also determines how well you breathe. For this reason, successful rhinoplasty requires careful attention to both appearance and function.

ENT surgeons have specialist training in the anatomy, function, and medical conditions of the nose and nasal airway. This is particularly important because problems inside the nose can often be visible externally. A deviated septum, previous nasal trauma, valve collapse, or asymmetry of the nasal bones may affect both breathing and appearance.

The reverse is also true: changes made to improve the external shape of the nose can affect the internal airway if they are not planned carefully. Narrowing the bridge, refining the tip, reducing a hump, or changing nasal support may unintentionally worsen breathing if the functional structures of the nose are not protected or rebuilt.

At ANDSURGEONS, our ENT and facial plastic approach allows us to assess the nose as a complete structure: externally, internally, aesthetically, and functionally. Our goal is not only to create a natural-looking nose that suits the face, but also to preserve or improve healthy nasal breathing.

For many patients, especially those with nasal obstruction, septal deviation, previous trauma, asymmetry, revision surgery, or concerns about both shape and breathing, this combined functional and aesthetic approach is a major advantage.

Rhinoplasty and septorhinoplasty

Rhinoplasty is surgery to refine the shape, balance, and function of the nose. It may be performed to improve facial harmony, correct a nasal deformity, improve breathing, or address both appearance and function in the same procedure.

At ANDSURGEONS, rhinoplasty is performed by ENT and facial plastic surgeons with specialist expertise in both the external appearance of the nose and the internal nasal airway. This is important because the nose is not only a central facial feature, but also a functional breathing organ.

Our approach is designed to achieve a natural, balanced result that suits the patient’s face while preserving or improving nasal function. For many patients, the most appropriate procedure is a septorhinoplasty, where the external shape of the nose and the internal septum or airway are corrected together.

We offer closed rhinoplasty, open rhinoplasty, and advanced ultrasonic bone-sculpting using the piezotome when appropriate.

Closed rhinoplasty

In a closed, or endonasal, rhinoplasty, all incisions are made inside the nostrils. This means there is no visible external scar.

Closed rhinoplasty may be suitable for selected patients who require more limited changes to the nasal bridge, nasal tip, septum, or internal nasal airway. Because the operation is performed through hidden internal incisions, it can be an elegant option for carefully selected cases.

However, the closed approach offers less direct visibility of the nasal framework. For this reason, it may not be ideal for more complex deformities, significant asymmetry, revision surgery, severe septal deviation, traumatic nasal deformity, or cases requiring major structural support.

Open rhinoplasty

In an open rhinoplasty, small incisions are made inside the nostrils and connected by a short incision across the columella, the small strip of skin between the nostrils. This allows the nasal skin to be gently lifted, giving the surgeon direct access to the cartilage, bone, septum, and supporting structures of the nose.

Although this technique involves a small external incision, it usually heals very discreetly. The open approach is often preferred for more complex or structural rhinoplasty, including deviated noses, traumatic deformities, revision cases, significant tip refinement, and patients who require both aesthetic improvement and functional airway correction.

The advantage of the open approach is precision. It allows the surgeon to see and reshape the nasal framework directly, rebuild support where needed, and correct both external and internal problems in a controlled way.

Piezotome ultrasonic rhinoplasty

When reshaping the nasal bones, we may use a piezotome, an advanced ultrasonic surgical instrument that allows highly precise bone cutting and sculpting.

Traditional rhinoplasty instruments reshape bone mechanically. The piezotome uses ultrasonic energy to target bone with greater control, while helping to preserve surrounding soft tissues. This can be especially useful when refining the nasal bridge, narrowing the nasal bones, correcting asymmetry, or treating a deviated bony nose.

For suitable patients, piezotome rhinoplasty may allow more precise bone work and a gentler approach to the surrounding tissues.

What rhinoplasty can address

Rhinoplasty or septorhinoplasty may be considered for patients who want to improve:

• A dorsal hump or bump on the nasal bridge
• A crooked or deviated nose
• A wide or asymmetric nasal bridge
• A drooping, bulbous, or poorly defined nasal tip
• Nasal imbalance after trauma
• Breathing difficulty caused by septal deviation, nasal valve collapse, or internal obstruction
• Problems following previous nasal surgery

The exact surgical plan is always individualized. Some patients need small refinements, while others require more structural reconstruction to improve both appearance and breathing.

Natural results, not an operated look

Our aim is to create a nose that looks natural, balanced, and appropriate for the patient’s face. A successful rhinoplasty should not look artificial or overdone. It should improve facial harmony while preserving the patient’s identity.

This is especially important in international rhinoplasty patients, who often want a refined result but are understandably concerned about looking “operated.” We focus on proportion, symmetry, breathing, and long-term support rather than a one-size-fits-all aesthetic.

Assessment and surgical planning

Before surgery, we assess the nose externally and internally. This includes the nasal bridge, tip, nostrils, septum, nasal valves, airway, skin thickness, facial proportions, and any history of trauma or previous surgery.

The choice between closed rhinoplasty, open rhinoplasty, piezotome-assisted bone work, septoplasty, nasal valve repair, or cartilage grafting depends on the patient’s anatomy and goals.

For international patients, we provide a clear treatment pathway, including consultation, surgical planning, hospital-based care, and follow-up guidance.

Hospital-based specialist care

Rhinoplasty and septorhinoplasty are performed in leading Spanish hospital facilities by senior consultant surgeons. Patients have direct access to specialist care, with no trainee-led surgery.

Our focus is on safe, precise, consultant-delivered surgery for patients seeking both aesthetic refinement and functional nasal improvement.