Rhinoplasty in Thailand

Most rhinoplasty done in Thailand is augmentation: a silicone or cartilage implant that raises a low bridge and lengthens the tip, which is what the majority of Thai and East Asian patients ask for. A Western nose usually needs the opposite operation, a reduction: taking down a hump, narrowing the bones, refining a bulbous tip, often straightening a deviated septum at the same time. Both are rhinoplasty, but they are different skills, and the first thing to establish is which one the surgeon you are looking at actually does every week.

Bangkok's large private hospitals and the plastic surgery hospitals of Phuket and Pattaya all treat international patients, quote in Thai baht and sell packages that bundle the surgeon, the theatre, the anaesthetist and the follow-up until the splint comes off. This page explains how to check a surgeon and a hospital, what those packages do and do not include, when you can fly home and what moves the price, so that the quotes in the clinic listing below make sense.

• Ask for Western-nose cases

  A surgeon whose portfolio is implants for Asian noses may not be the one for a hump reduction. Ask to see healed reductions on faces like yours, from several angles.

• Board, licence, accreditation

  Thai Board of Plastic and Reconstructive Surgery for the surgeon, a Ministry of Public Health licence for the facility, and hospital accreditation you can verify.

• Stay until the splint is off

  Plan to remain in Thailand until the surgeon removes the splint and clears you to fly, which is usually about a week after the operation.

• Quotes are in baht

  Hospitals quote in Thai baht, often with a dollar figure beside it. Convert on the day and ask what the figure covers before comparing it with a quote from home.

Rhinoplasty in Thailand grew up around Asian noses. The typical request is a higher bridge and a longer, more defined tip, and the typical answer is an implant, usually silicone, sometimes a synthetic sheet or the patient's own rib or ear cartilage. Thai surgeons do a great deal of this work and many are very good at it.

Reduction rhinoplasty is a different operation. It removes bone and cartilage rather than adding it, it usually needs the nasal bones broken and reset, and it lives or dies on tip work and on how the skin redrapes over a smaller frame. The surgeons who do it well in Thailand tend to be those trained or fellowship-trained abroad, or those at hospitals with a steady flow of Western, Middle Eastern and South Asian patients. Ask directly how many reductions the surgeon does in a year and ask to see their healed results at a year, not at a month.

If your nose needs both, for instance a low bridge with a wide tip, or a previous augmentation that has gone wrong, say so at the first contact. Structural and revision work is the hardest part of the field, and the hospital's international department should be able to name the surgeon who takes those cases rather than assigning whoever is free.

A deviated septum with breathing problems is treated in the same operation as septorhinoplasty. A nose that has already been operated on belongs on the revision rhinoplasty page, and patients of African, Middle Eastern or South Asian heritage should read ethnic rhinoplasty in Thailand before choosing a surgeon.

Bangkok has the deepest bench: large private hospitals with international patient centres, interpreters, hotel arrangements and plastic surgery departments that see every kind of nose. It is also where most of the surgeons with overseas fellowships practise. Phuket has hospitals used to Australian and European patients and a plastic surgery hospital of its own, and it is the natural choice if you are combining surgery with a longer stay. Pattaya and Chiang Mai have fewer options but real ones.

Whichever city you choose, the recovery is not a beach holiday. Sun on a healing nose worsens swelling and can darken scars, heat makes swelling last longer, and salt water, pools and diving are off limits until the surgeon says otherwise. Plan the sightseeing for before the operation and the week after it for rest in air conditioning.

1. 1

   Online consultation with photographs

   Front, both profiles, from below and smiling, plus a description of what bothers you and whether you breathe well. The surgeon should reply with a plan, not a price alone, and should say whether it is a reduction, an augmentation or both.
2. 2

   Arrival and examination

   Most hospitals want you in Thailand at least a day before surgery for the in-person examination, blood tests and an anaesthetic assessment. This is when the plan and the price are confirmed, and it is your last chance to walk away without losing more than the deposit.
3. 3

   The operation

   Under general anaesthetic in most hospitals, through an open approach with a small cut across the columella or a closed approach with incisions inside the nose. A reduction with bone work takes longer than an implant. Many patients stay one night.
4. 4

   The first days

   A splint on the bridge, sometimes soft packing inside the nose for a day or two, swelling and bruising under the eyes that peaks early and then fades. Sleep propped up, no bending, no lifting, no glasses resting on the nose.
5. 5

   Splint removal

   Around the end of the first week. The nose looks swollen and wide at this point, which is normal. The surgeon checks the airway and the wounds and, if all is well, clears you to fly.
6. 6

   Home and the long tail

   Most swelling settles over the first months, the tip settles last, and the final shape is judged at a year. Send the surgeon photographs at the agreed points and see a doctor at home promptly if you get fever, bleeding or a blocked, painful nose.

A cosmetic rhinoplasty is not covered by the NHS, by Medicare in Australia or by a health insurer in the United States, and travel insurance excludes planned surgery and its consequences. If a complication appears after you land, an emergency department will treat fever, bleeding or infection like any other patient's, but the cosmetic correction of a disappointing result is yours to pay for, and many surgeons at home are reluctant to revise work they did not do.

Before you leave, decide who will see you when you are back: an ear, nose and throat surgeon or a plastic surgeon for the nose itself, your family doctor for fever or infection. Ask the hospital in Thailand for a discharge summary in English that names the operation performed, any implant or graft used and the medication list. That one document turns an awkward first appointment into an ordinary one.

• Reduction, augmentation or both. Bone work and tip reconstruction take longer in theatre than placing an implant, and the fee follows the time.
• Implant or your own cartilage. A silicone implant is a product with a price; rib or ear cartilage means a second surgical site, more theatre time and usually a higher fee.
• Primary or revision. Revisions are priced higher everywhere because they are slower, less predictable and often need cartilage from elsewhere.
• Breathing surgery at the same time. Adding a septoplasty or turbinate reduction adds surgical time and sometimes a CT scan.
• Hospital or clinic, and which city. A large Bangkok hospital with an international centre charges more than a clinic, and Phuket prices often sit between the two.
• The surgeon's seniority. Fellowship-trained surgeons who take revision and Western-nose cases charge more, and for those cases that is usually money well spent.
• Anaesthetic and nights. General anaesthetic with a night on the ward costs more than sedation and same-day discharge; for a reduction, the former is the safer default.

If you are weighing Thailand against Turkey, the Turkey rhinoplasty page describes a market built around European patients and reduction work, with shorter flights from Europe. The rhinoplasty abroad page compares the destinations, and the plastic surgery in Thailand hub covers the other procedures people combine with a nose job.