What is involved in a nose job will greatly depend on your individual needs and the complexity of the surgery that you have requested. For a less complicated cosmetic refinement of the nose the surgery may only last an hour or two, and you may only need to go under a local anesthetic. However, for more complicated surgeries such as reconstructive surgeries a general anesthetic will be used and the surgery may last over eight hours.
The surgery itself will include an incision either inside the nostril or on the underside of the nose, again depending on the type of surgery that is being performed. The skin covering the nose will then be separated from the internal supportive structures so that the surgeon will be able to identify structures and have access to structures that will be modified. Chisels, scissor-like instruments, and scalpels will then be used to shape and refine the internal structures so that the outer skin will have a more attractive base to drape over. If the nose is too thin then harvested cartilage maybe implanted inside the nose to help reinforce the bridge and provide a sturdier support structure for the nose and the person's airways.
After the internal structures have been repaired or refined, the external elements are then addressed including removing excess skin, anchoring skin strata, and finally closing the incision lines. After these processes have been completed the nose is then placed in a split to protect the internal structures from damage. The nostrils are also packed with nasal packs or plastic supports to help reinforce the septum and to help absorb blood seepage from the incision sights.