Abstract: 

Background: Rhinoplasty can be either reconstructive or aesthetic. The history of rhinoplasty dates back to 2500 years. It was first documented in the Indian subcontinent by Sushruta, a case of reconstructive rhinoplasty on 600 BC, whereas John Orlando Roe performed the first cosmetic rhinoplasty in 1887 in New York. In the West, rhinoplasty is a very commonly performed operation, but it has not gained popularity in Bangladesh yet. This study was carried out to assess the outcome in our cases of rhinoplasty, specially with regard to complication and their management. 

Methods: The period of study was from January 2000 to November 2018. 457 cases of rhinoplasty were done. The desires and expectation of the patients were noted; and probable results were discussed before surgery. The procedure for augmentation rhinoplasty consisted of reconstruction of dorsum of the nose by conchal cartilage graft taken from external ear, ulnar bone graft, or silicone (nasal) implant. Other cosmetic rhinoplasty procedures included dorsal hump reduction, tip plasty for bifid or broad tip and Alar Base Reduction for wide nose with alar prominence. Combination procedures were done frequently. Reconstructive rhinoplasty was performed with median/paramedian forehead flap or composite auriclar graft. 

Results: Excellent results were found in 409 cases, satisfactory in 39 cases and unsatisfactory in 09 cases. Complications were minimal and insignificant. 

Conclusion: We conclude that if expertise is developed rhinoplasty, whether cosmetic or reconstructive, can be performed more frequently and with more satisfactory results. Hands on training, workshops and initial supervision is very important.