The best candidates for rhinoplasty, or a "nose job" as it is so commonly called, are those people who are looking for improvement, not perfection, in the way they look. If the patient is physically healthy, mentally stable, and has realistic expectations, then chances are they will be very happy with their new look. Rhinoplasty usually takes an hour or two, though more complicated procedures may take longer. The surgery starts with the skin of the nose being separated from its supporting framework of the bone and cartilage, which is then sculpted to the desired shape. The skin is then redraped over the new framework. Many plastic surgeons prefer an "open" procedure, usually in the more complicated cases where the surgeon makes a small incision across the columella, this is the vertical strip of tissue that separates the nostrils. After the surgery is complete, a splint is then applied to help the nose maintain its new shape. Nasal packs or soft splints may be placed in the nostrils to stabilize the septum, this is the dividing wall between the air passages. WHAT TO EXPECT After surgery, especially during the first twenty-four hours, the face will feel puffy, the nose may ache, and the patient may experience a dull headache. The patient should plan on staying in bed with their head elevated for the first day. There will be swelling and bruising around the eyes, reaching a peak after two to three days. If the patient has nasal packing it will be removed after a few days and the patient will feel more comfortable. By the end of one week all packings, dressings, splints and stiches should be removed.