The operation may be called "primary", if it is done for the first time, and "secondary"
if a previous nose-job requires a corrective step, or a hole in the septum needs repair.
The closed technique refers to the incision being made within the nostril
The open technique refers to the incision made in the columella or the portion that separates the two nostrils.
The surgeon then inserts his instrument through the incision and reshapes the nose by elevating or working on the cartilage or bone. He may at times use a cartilage graft taken from the ear or the ribs to achieve the desired shape or elevation. Sometimes he may resort to osteotomies or chiseling of the bones of the nose in pursuit of the perfect shape. The tissues are then draped back into position and stitches are applied to close the opening.
Splints may be applied within the nose or outside to stabilize the grafts and prevent movement.
Thus any part of the nose can be changed including its size, its slope, its tip, the width of the bridge, the nostrils as well as the septum within.
Excellent cosmetic results ensure that the incisions are not visible on the face and are usually concealed. There may be a bandage on the nose. Post-op care must be taken so as to not stress the suture lines, and the doctor’s instructions must be followed very carefully.
If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.