DR. SPENCER COCHRAN: Rhinoplasty is a surgical procedure that involves reshaping the nose. It could be performed as a cosmetic procedure to improve the appearance or a medically necessary procedure to improve the breathing. Sometimes a combination of both is required. Primary rhinoplasty refers to first time nasal surgery, whether it be for cosmetic or functional reasons. This is accomplished by removing excess bone and cartilage from beneath the skin. After the newly shaped framework is completed the skin is re-draped to give the nose its new appearance. Sometimes the changes are dramatic or subtle, depending on the patients’ needs.