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16Jul
Vascular

What Are Vascular Malformations?

Vascular malformations are abnormal clusters of blood vessels that form during development in the
womb, rather than growing later in life. Unlike tumours, they don’t grow by rapid cell division — instead,
they grow in proportion to the child’s body, though they can also enlarge due to trauma, hormonal
changes (such as puberty or pregnancy), or infection.
Vascular malformations are broadly classified based on the type of vessel involved:
• Capillary malformations — commonly seen as flat, pink-to-red birthmarks (often called “port-wine
stains”) that persist and darken with age.
• Venous malformations — soft, compressible, bluish swellings that tend to enlarge with
dependency (hanging the limb down) and can cause pain, especially after exertion.
• Arteriovenous malformations (AVMs) — high-flow lesions where arteries connect directly to veins
without a normal capillary bed in between. These are often warm to touch, can pulsate, and are more
prone to bleeding and rapid progression.
• Lymphatic malformations — discussed in detail below, as they involve the lymphatic rather than
blood vascular system.
• Combined/complex malformations — involving more than one vessel type together.

What Is a Lymphatic Malformation?

A lymphatic malformation (LM) is an abnormal collection of lymphatic channels or cysts that fails to
connect properly with the rest of the lymphatic system during development. Rather than draining fluid
normally, these channels pool lymph fluid, forming soft, often painless swellings.
Lymphatic malformations are generally categorised as:
• Macrocystic — made up of larger, fluid-filled cysts, often more amenable to procedures like
sclerotherapy.
• Microcystic — composed of numerous tiny channels and cysts, often infiltrating surrounding tissue
more diffusely, which can make treatment more challenging.
• Mixed — a combination of both macrocystic and microcystic components.
Lymphatic malformations most commonly affect the head and neck region, but can occur anywhere in
the body, including the limbs, trunk, and internal organs.

How Are These Different From Hemangiomas?

A common point of confusion is between vascular malformations and infantile hemangiomas.
Hemangiomas are true tumours — they are usually absent or barely visible at birth, grow rapidly in the
first few months of life, and then slowly shrink (involute) over several years. Vascular malformations, by
contrast, are present at birth (even if not immediately visible), never spontaneously resolve, and grow proportionally with the child rather than through rapid proliferation. This distinction matters greatly, since the two conditions are managed very differently.

Why Do These Malformations Need Specialist Attention?

Beyond their appearance, vascular and lymphatic malformations can cause:
• Pain, swelling, or heaviness in the affected area
• Functional limitations, especially when a limb or joint is involved
• Recurrent infections, particularly with lymphatic malformations
• Bleeding or clotting complications, especially with high-flow AVMs
• Psychological and social impact due to visible disfigurement
Because these lesions can involve skin, deeper soft tissue, muscle, and sometimes bone, management is best guided by a specialist experienced in vascular anomalies rather than treated as a purely cosmetic
concern.

Treatment Approaches

Management is tailored to the type, location, size, and symptoms of the malformation, and often involves
a combination of approaches:
• Sclerotherapy — injecting an agent into the abnormal vessels or cysts to cause them to shrink and
scar down, particularly effective for venous and macrocystic lymphatic malformations.
• Laser therapy — useful for superficial capillary malformations to reduce redness and improve skin
appearance.
• Surgical excision — removal of the malformation, sometimes combined with reconstructive
techniques when the lesion is well-localised or causing significant functional or cosmetic concern.
• Embolization — particularly relevant for high-flow arteriovenous malformations, often used before
surgery to reduce blood flow and bleeding risk.
• Combined/staged treatment — many cases, especially larger or mixed malformations, benefit
from a staged plan combining several of the above techniques over time, similar in principle to other
complex reconstructive problems.

The Importance of Early and Accurate Diagnosis

Because vascular and lymphatic malformations can mimic other conditions, and because early
intervention can prevent progression and complications, timely referral to a specialist familiar with
vascular anomalies is important. Imaging — typically ultrasound with Doppler and MRI — plays a key
role in correctly classifying the malformation and planning the right treatment strategy.
Vascular and lymphatic malformations are congenital conditions that, while present from birth, often
become more apparent or symptomatic over time. With accurate classification and a tailored, sometimes
staged treatment plan, patients can achieve significant improvement in both function and appearance.
As with many complex reconstructive problems, the best outcomes come from careful assessment and
an individualised approach rather than a one-size-fits-all solution.

Frequently Asked Questions (FAQ)

1. Are vascular malformations the same as birthmarks?

Some vascular malformations, like capillary malformations (“port-wine stains”), do appear as birthmarks.
But not all birthmarks are vascular malformations, and not all vascular malformations are visible at birth
— some become apparent only as the child grows.

2. Are these conditions cancerous?

No. Vascular and lymphatic malformations are not tumours and are not cancerous. They are structural
abnormalities of blood or lymphatic vessels that form during development.

3. Will a vascular malformation go away on its own?

No. Unlike infantile hemangiomas, which typically shrink over time, vascular and lymphatic
malformations do not resolve spontaneously. They tend to persist and can grow proportionally with the
body, or enlarge due to trauma, hormonal changes, or infection.

4. What's the difference between macrocystic and microcystic lymphatic malformations?

Macrocystic lesions consist of larger fluid-filled cysts and generally respond well to sclerotherapy.
Microcystic lesions are made up of many tiny channels infiltrating the surrounding tissue, which can make them more difficult to treat completely.

 

5. Is surgery always required?

Not always. Treatment depends on the type, size, and location of the malformation. Options include
sclerotherapy, laser therapy, embolization, and surgical excision — used alone or in combination,
sometimes over several staged sessions.

6. Can vascular malformations cause pain?

Yes, particularly venous malformations, which can ache or throb, especially after activity or when the
limb is in a dependent position for a long time.

7. Are lymphatic malformations prone to infection?

Yes, lymphatic malformations can be more susceptible to recurrent infections (cellulitis) in the affected
area, which is one reason timely diagnosis and management matter.

8. What imaging is used to diagnose these conditions?

Ultrasound with Doppler is typically the first-line imaging study, often followed by MRI to map the extent
of the malformation and guide treatment planning.

9. Can adults develop symptoms from a malformation present since birth?

Yes. Because these malformations are present from birth but grow slowly over time, many patients first
notice symptoms or seek treatment in adolescence or adulthood, when the lesion has become larger or
more troublesome

10. Is treatment purely for cosmetic reasons?

No. While appearance is often a concern, treatment also addresses pain, functional limitation, bleeding
risk, and recurrent infection — making management a medical necessity in many cases, not just a cosmetic choice.

How can i book appointment

If you or a loved one is dealing with a vascular or lymphatic malformation, early evaluation by a specialist
can make a significant difference in outcomes. To schedule a consultation with Dr. Jyoshid R Balan,
please reach out through the clinic contact details below.
Phone: 8113005557
Email: drjosh4u@gmail.com
Clinic/Hospital: Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala
This article is authored by Dr. Jyoshid R Balan.

post-burn hand contracture treatment
10Jul

When Burns Steal the Hand’s Function

The hand is one of the most functionally vital — and most vulnerable — parts of the body after a burn injury. Deep burns to the hand often heal with dense scar tissue that pulls the fingers into fixed positions, most commonly a flexion contracture, where the fingers curl inward and can no longer straighten. Left untreated, this doesn’t just limit grip and dexterity; it can affect a patient’s ability to work, perform daily tasks, and maintain independence. Well-planned, well-executed contracture release doesn’t just restore movement — it can be life-changing, and in severe cases, life-saving by preventing complications of a permanently disabled limb.

The Case: All Digits Involved

In this case, the patient presented with flexion contractures affecting all fingers of the hand following a burn injury. This is a more complex presentation than an isolated finger contracture, since every digit needed release, coverage, and a coordinated plan to avoid creating new problems — such as webbing between fingers — while solving the old one.

post-burn hand contracture treatment

A Staged Surgical Approach

Severe multi-digit contractures are rarely fixed in a single operation. This case followed a carefully staged reconstructive plan: Stage 1 — Release and Provisional Fixation The contracted bands were completely released to bring the fingers back to a corrected, extended position. Temporary Kirschner wires (K-wires) were used to hold the joints in this corrected alignment while healing progressed, preventing the contracture from recurring during the early recovery period.
Stage 1 — Soft Tissue Cover Releasing a contracture always leaves a raw area that needs healthy, well-vascularised tissue for cover — skin grafts alone are often insufficient for a mobile, functional hand. In this case, a syndactylised groin and hypogastric flap was used, joining the fingers together temporarily within a single flap of tissue transferred from the groin/lower abdominal region. This approach provides robust, reliable coverage for multiple digits simultaneously.
Stage 2 — Syndactyly Release and Flap Thinning Once the flap has taken and matured, the fingers — temporarily joined together under the flap — are surgically separated (syndactyly release) to restore individual finger mobility. The flap tissue is also thinned at this stage, since flap tissue transferred from the groin tends to be bulky and needs refinement to allow better finger movement and a more natural hand contour.

Why This Staged Strategy Works

• Complete release first ensures the deforming force of the contracture is fully addressed, not just partially corrected.
• K-wire fixation protects the correction during early healing, when the tissues are most prone to re-contracting.
• Flap cover (rather than skin grafting alone) provides durable, supple tissue that can withstand the mechanical demands of hand use.
• Staged separation and thinning allows the reconstruction to mature before fine-tuning, ultimately yielding a hand that is not only released but genuinely functional — with fingers that move independently and a contour that supports grip, pinch, and daily activity.

Post-burn hand contractures are a reminder that burn care doesn’t end when the wound closes. Reconstructive surgery, done in the right stages with the right techniques, can return meaningful function to a hand that might otherwise remain permanently disabled. This case illustrates how a systematic, staged plan — release, provisional fixation, flap cover, then refinement — can achieve excellent outcomes even in severe, multi-digit involvement.

post-burn hand contracture treatment

Frequently Asked Questions (FAQ)

What is a post-burn flexion contracture?

It’s a condition where scar tissue formed after a deep burn tightens and pulls a joint — in this case, the finger joints — into a bent position, restricting the ability to straighten the fingers.

Why can't the contracture be released and closed in one surgery?

Releasing a contracture leaves a raw area that needs stable, well-vascularized tissue for cover. In multi-digit cases, achieving reliable correction, adequate coverage, and eventual individual finger mobility usually requires a staged plan rather than a single procedure.

What is a K-wire, and why is it used here?

A Kirschner wire (K-wire) is a thin metal pin used to temporarily hold a joint in a corrected position while the surrounding soft tissue heals, reducing the risk of the contracture recurring.

What is a syndactylised groin and hypogastric flap?

It’s a flap of skin and tissue taken from the groin/lower abdominal region and used to cover multiple released fingers at once, with the fingers temporarily joined together under the flap for reliable healing.

 

Why are the fingers joined together temporarily?

Joining the fingers under a single flap (syndactylisation) allows robust blood supply and coverage for all digits simultaneously, which is more reliable than trying to cover each finger separately at this stage.

What happens in the second stage of surgery?

Once the flap has matured, the fingers are surgically separated (syndactyly release) and the flap tissue is thinned, restoring individual finger movement and improving the hand’s contour and function.

How long does the full treatment take?

Staged hand reconstruction typically spans several weeks to a few months between stages, allowing the flap to mature and heal properly before the next step, though exact timelines vary by case.

What results can patients expect?

With proper staged management, patients can regain meaningful finger movement, grip, and pinch function — outcomes that significantly improve independence and quality of life compared to an untreated contracture.

Can this approach be used when all fingers are affected, not just one?

Yes — this case specifically demonstrates the technique in a patient with all fingers affected, showing that even complex, multi-digit contractures can be systematically addressed with a staged flap-based approach.

Is this type of surgery only cosmetic?

No. While the hand’s appearance does improve, the primary goal is restoring function — the ability to grip, hold, and use the hand for daily activities and work, which can be essential to a patient’s independence and livelihood.

How can i book appointment

A consultation with Dr. Jyoshid is completely confidential. You will receive a clinical assessment, grade classification, a recommended treatment plan, and a transparent quote — with no pressure and no obligation.
Sushrutha Institute of Plastic Surgery Elite Mission Hospital, Thrissur, Kerala
📞 +91 8113005557 ✉️ drjosh4u@gmail.com 🌐 www.drjosh.in

26Jun

Gynecomastia — the development of enlarged breast tissue in men — is far more common than most people realise. Studies suggest it affects up to 40–60% of men at some point in their lives, yet it remains one of the least talked-about conditions in men’s health.
For many men, gynecomastia is not just a physical issue. The embarrassment of a visible chest deformity — at the gym, at the beach, in a fitted shirt — can quietly affect confidence, social life, and mental wellbeing for years. Many men live with it for a decade or more before seeking help, often because they don’t know that a safe, effective surgical solution exists close to home.
This guide covers everything you need to know about gynecomastia surgery in Kerala — what causes it, which grade you have, what the surgery involves, the full cost breakdown, what recovery looks like, and why choosing the right type of surgeon matters more than most men realise.

What Is Gynecomastia and Who Needs Surgery?

Gynecomastia is the benign (non-cancerous) enlargement of glandular breast tissue in males. It is caused by an imbalance between oestrogen and testosterone — either too much oestrogen, too little testosterone, or increased sensitivity to oestrogen at the breast tissue level.
It is important to distinguish true gynecomastia from pseudogynecomastia (also called lipomastia), which is fatty tissue accumulation in the chest area without glandular enlargement. This distinction matters because the two conditions require different surgical approaches.
Common causes of gynecomastia include:
• Hormonal changes during puberty (the most common cause in teenagers)
• Age-related hormonal shifts in men over 50
• Anabolic steroid use (a significant and growing cause in young men)
• Certain medications — including some antihypertensives, antidepressants, and proton pump inhibitors
• Conditions affecting the liver, kidneys, or thyroid
• Idiopathic (no identifiable cause — accounts for approximately 25% of adult cases)
Who needs surgery?
Not every man with gynecomastia needs an operation. Mild pubertal gynecomastia in teenagers often resolves on its own within one to two years. However, surgery is appropriate when:
• The enlargement has persisted for more than two years with no sign of spontaneous resolution
• The underlying hormonal cause has been identified and treated, but the breast tissue has not regressed
• The condition is causing significant psychological distress or social avoidance
• The enlargement is large enough to cause physical discomfort or postural changes
• The patient is an adult with stable weight and realistic expectations

Grades of Gynecomastia: Which Stage Are You?

  • Gynecomastia is classified into grades based on the degree of breast enlargement and the amount of excess skin. Understanding your grade helps determine which surgical technique is most appropriate.
    Grade I — Minor enlargement, no excess skin A small mound of glandular tissue around the nipple-areola complex. Often not visible under a T-shirt but noticeable when shirtless. Treatment: glandular excision alone or combined with minimal liposuction.
    Grade IIa — Moderate enlargement, no excess skin More visible breast mound extending beyond the areola. The chest has a female breast appearance when examined but there is no skin laxity. Treatment: liposuction and/or glandular excision through a small periareolar incision.
    Grade IIb — Moderate enlargement with minor excess skin Similar to Grade IIa but with some degree of skin redundancy. The skin may appear slightly loose after tissue removal if this grade is not addressed surgically. Treatment: liposuction plus glandular excision; occasionally a small skin adjustment.
    Grade III — Marked enlargement with excess skin Significant breast enlargement with considerable skin excess and ptosis (sagging). Often resembles female breast morphology. Treatment: more extensive surgery including skin excision in addition to glandular and fatty tissue removal. This grade may leave more visible scarring.
    The importance of correct grading
    Grade directly determines technique. A surgeon who performs only liposuction on a Grade I patient with a firm glandular disc will leave behind a hard residual lump — one of the most common causes of patient dissatisfaction after gynecomastia surgery. Correct clinical assessment before surgery is non-negotiable.
    Dr. Jyoshid R. Balan performs a thorough clinical examination at consultation, including assessment of glandular tissue consistency, skin quality, nipple position, and fat distribution, before recommending any surgical approach.

What the Surgery Involves: Liposuction, Gland Excision, or Both?

Gynecomastia surgery is not a single, standardised operation. The correct technique depends entirely on what is driving the chest enlargement in your specific case.
Liposuction alone
Suitable for pseudogynecomastia (pure fatty enlargement) or Grade I–IIa cases where the glandular component is minimal. A thin cannula is inserted through two tiny incisions (usually 3–4mm) in the chest. Fat is removed by suction, contouring the chest to a flat, masculine profile. Scarring is minimal and inconspicuous.
Liposuction alone is not sufficient for true gynecomastia with a firm glandular disc. If you can feel a hard or rubbery lump directly beneath the nipple, that is glandular tissue — it cannot be suctioned out and must be excised.
Glandular excision alone
For Grade I cases with primarily glandular enlargement and little excess fat, the glandular disc is removed through a small incision along the lower border of the areola (the periareolar approach). This incision heals well and becomes almost invisible within 6–12 months as it follows the natural colour transition of the areola.
Combined liposuction and glandular excision
The most commonly performed technique for Grade IIa and IIb gynecomastia. Liposuction addresses the fatty component and chest contouring, while direct excision removes the firm glandular disc. The result is a flat, well-contoured, masculine chest. This is the approach Dr. Jyoshid uses for the majority of his gynecomastia patients.
Skin excision (Grade III)
For patients with significant skin excess — most commonly seen after massive weight loss or in older men with Grade III gynecomastia — skin removal is required in addition to tissue excision. This leaves more visible scarring (typically a scar around the areola and sometimes a vertical scar below it), which fades considerably over time but is a necessary trade-off for a flat, lifted chest contour.
A note on technique selection: Dr. Jyoshid will recommend the technique most appropriate for your grade and chest anatomy at your consultation. Beware of clinics that offer a single one-size-fits-all approach — the correct operation varies from patient to patient.

Gynecomastia Surgery Cost in Kerala: Full Breakdown

 
 

At Dr. Jyoshid’s centre — Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur — gynecomastia surgery costs are as follows:
Procedure Type
What It Involves
Approximate Cost
Liposuction only (pseudogynecomastia)
Fat removal via cannula, no gland excision
₹60,000 – ₹85,000
Glandular excision only (Grade I)
Periareolar incision, gland removal
₹75,000 – ₹1,00,000
Combined liposuction + excision (Grade IIa/IIb)
Most common approach
₹95,000 – ₹1,30,000
Grade III with skin excision
Tissue + skin removal
₹1,30,000 – ₹1,80,000
All prices are approximate and include surgeon’s fee, anaesthesia, operation theatre charges, one night of hospital stay (if required), compression garment, and follow-up appointments. A personalised quote is given at consultation.
What is included in the cost:
• Surgeon’s fee (Dr. Jyoshid R. Balan, MCh Plastic Surgery)
• Anaesthesiologist’s fee
• Operation theatre charges at Elite Mission Hospital
•Day-care or overnight hospital stay as clinically required
• Compression vest/garment for the recovery period
•Dressings and post-operative review appointments
What is billed separately:
• Pre-operative blood tests and investigations (typically ₹2,000–₹5,000)
• Post-operative medications (approximately ₹500–₹1,200)

Recovery: What to Expect in the First 4 Weeks

Gynecomastia surgery has a manageable recovery for most patients. Here is a realistic week-by-week picture.
Day of surgery and day 1 The procedure is performed under general anaesthesia and typically takes 1–2 hours. Most patients go home the same day or after one night of observation. Expect moderate swelling, bruising, and chest tightness. A compression garment is applied before you leave the OT — you will wear this continuously for the first 3–4 weeks.
Days 2–7 (Week 1) Soreness and tightness in the chest are normal and well managed with prescribed pain relief. Most patients are mobile and comfortable by day 3. Avoid lifting your arms above shoulder height. You can shower after 48 hours, being careful around the dressings. Swelling will look worse before it improves — this is normal.
Weeks 2–3 Bruising fades. Swelling begins to subside, though it will not be fully gone. Many patients return to sedentary desk work at 7–10 days and light office work by 2 weeks. Strenuous activity, gym, and upper body exercise are off-limits. The chest will still look swollen — do not judge your results at this stage.
Week 4 The compression garment is typically worn for 4 weeks, then transitioned to a firm compression undershirt for another 2–4 weeks. Most patients are back to normal daily activity. Light lower-body exercise (walking, cycling on a static bike) is usually permitted. Upper body exercise and chest workouts should wait until 6 weeks minimum.
Months 1–3 Residual swelling gradually resolves. The chest contour continues to refine. Scars begin to fade — they go through a reddish phase before lightening to skin tone. By month 3, the improvement is dramatic and clearly visible.
Months 3–6: Final results The final chest contour is typically visible by 3–6 months. Scars continue to mature and lighten for up to 12–18 months. The results are permanent, provided weight remains stable and anabolic steroid use (if applicable) is discontinued.

Why You Need a Plastic Surgeon — Not a General Surgeon — for This Procedure

 
 

This is one of the most important points in this entire guide, and one that is frequently overlooked.
Gynecomastia surgery is offered by a wide range of practitioners in India — general surgeons, cosmetic surgeons without plastic surgery qualifications, and even dermatologists running laser clinics. The procedure sounds straightforward. In reality, it demands a sophisticated combination of surgical skills that only a trained plastic surgeon reliably possesses.
Aesthetic judgment, not just technical removal. Removing tissue is only half the job. The surgeon must sculpt a natural, masculine chest contour — taking enough tissue to flatten the chest, but not so much that the nipple becomes inverted or the chest looks hollowed. This requires the aesthetic eye and experience of a plastic surgeon.
Liposuction technique for chest contouring. Chest liposuction for gynecomastia is different from standard body liposuction. The skin of the chest must retract smoothly over the new contour. Aggressive or technically poor liposuction leads to surface irregularities, waviness, and visible dimpling. Plastic surgeons who routinely perform body contouring procedures have the skills to avoid these outcomes.
Management of complications. Haematoma (blood collection), seroma (fluid accumulation), nipple retraction, asymmetry, and contour irregularities are known complications of gynecomastia surgery. A qualified plastic surgeon has the training to prevent and manage all of them. A general surgeon operating outside their specialist area may not.
Revision capability. If a result is not ideal, revision gynecomastia surgery is even more technically demanding than the primary procedure — because of fibrosis, altered anatomy, and the need to correct the previous surgeon’s work. Dr. Jyoshid performs revision gynecomastia cases and is qualified to do so precisely because of his plastic surgery training and experience.
Dr. Jyoshid R. Balan holds an MCh in Plastic Surgery and is a member of the Association of Plastic Surgeons of India (APSI). His practice at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur covers the full spectrum of body contouring procedures — giving him the breadth of experience that gynecomastia surgery demands.

Is Gynecomastia Surgery Covered by Insurance?

In most cases, no. Because gynecomastia surgery is primarily a cosmetic procedure addressing appearance and quality of life, it is classified as elective and excluded from standard Indian health insurance plans.
However, if gynecomastia is causing documented physical symptoms — chronic pain, tenderness, or skin irritation — some insurers may consider partial coverage. Your surgeon can provide clinical documentation if applicable. Check your policy terms and speak to your insurer before assuming it is not covered.

Frequently Asked Questions (FAQ)

Is gynecomastia surgery permanent?

Yes, in the vast majority of cases. Once the glandular tissue is surgically removed, it does not grow back under normal circumstances. The fatty
component can return if you gain significant weight. Men who used anabolic steroids must permanently discontinue them to maintain results — ongoing steroid use can cause recurrence.

Will there be visible scars?

For Grade I and IIa cases, incisions are placed along the lower edge of the areola (periareolar incision) and/or as 3–4mm liposuction ports in inconspicuous locations. Scars are minimal and typically invisible in most lighting within 6–12 months. Grade III cases involve more extensive incisions; scarring is more noticeable but continues to fade over 1–2 years.

Can I see before and after photos of real patients?

Yes. Dr. Jyoshid maintains a portfolio of before-and-after photographs from actual patients. These are shown during your consultation (not published online for patient privacy reasons). Ask to see results from patients with a similar grade and chest type to your own.

How long do I need to take off work?

For desk-based or sedentary work, most patients return at 7–10 days. Jobs involving physical exertion, heavy lifting, or upper body work require 3–4 weeks off. Discuss your specific occupation at your consultation.

 

Will I need to wear a compression garment?

Yes. A compression vest is worn continuously for the first 3–4 weeks after surgery, then as a firm undershirt for a further 2–4 weeks. This controls swelling, supports skin retraction, and helps the chest contour set correctly. It is an important part of recovery, not optional.

At what age can I have gynecomastia surgery?

Surgery is generally recommended only once breast development has stabilised — typically after age 18 for most patients, though cases are assessed individually. Pubertal gynecomastia in teenagers is usually observed for 1–2 years before surgery is considered, as spontaneous resolution is common.

What if I have had gynecomastia surgery elsewhere with poor results?

Dr. Jyoshid performs revision gynecomastia surgery for patients who have had unsatisfactory results elsewhere — including cases of residual glandular tissue, contour irregularities, asymmetry, and nipple retraction. A detailed consultation is required to assess what revision is possible and what the realistic outcome would be.

How can i book appointment

Gynecomastia is a sensitive issue and every patient’s situation is different. A consultation with Dr. Jyoshid is completely confidential. You will receive a clinical assessment, grade classification, a recommended treatment plan, and a transparent quote — with no pressure and no obligation.
Sushrutha Institute of Plastic Surgery Elite Mission Hospital, Thrissur, Kerala
📞 +91 8113005557 ✉️ drjosh4u@gmail.com 🌐 www.drjosh.in

20Jun

Before You Start: What Shapes Your Recovery

No two rhinoplasty recoveries are identical. Several factors influence how quickly you heal, how much swelling you experience, and when your final result becomes visible.
Skin thickness. Patients with thicker nasal skin — common in South Indian nasal anatomy — tend to retain swelling for longer than patients with thin skin. This is because the extra layers of soft tissue above the reshaped framework take more time to shrink down and conform to the new structure. Thick-skinned patients often find that their final result continues to refine for 12–18 months post-surgery.
Scope of surgery. A tip rhinoplasty involves less disruption than a full rhinoplasty combining hump reduction, tip reshaping, and septoplasty. More extensive surgery means more post-operative swelling and a longer timeline to the final result.
Primary vs revision rhinoplasty. Revision rhinoplasty recovery is typically longer and more variable than primary surgery recovery due to existing scar tissue and the more extensive nature of the procedure.
Individual healing biology. Genetics, immune response, nutritional status, and lifestyle factors all influence healing speed. Patients who follow post-operative instructions carefully — particularly around avoiding pressure on the nose, sleeping position, and sun exposure — consistently have smoother recoveries.
With that context established, here is what to expect at each stage.

rhinoplasty

One of the most common questions patients ask before booking rhinoplasty is not about the surgery itself — it is about what comes after.
How long will I be swollen? When can I go back to work? When will I actually see the result? What happens at the one-week mark when the splint comes off?
These are exactly the right questions to ask. Rhinoplasty recovery is a process that unfolds over months, not days. Understanding that process in advance — what is normal, what is a warning sign, what to expect at each stage — makes an enormous difference to how comfortably and confidently you move through it.
This is the complete rhinoplasty recovery guide from Dr. Jyoshid R. Balan, Senior Consultant Plastic Surgeon at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala. It covers every stage from the day of surgery to the point at which your final result has fully settled.This page is different. As one of the most experienced rhinoplasty surgeons in Kerala, Dr. Jyoshid R. Balan believes patients deserve complete transparency about what they will pay before they even book a consultation. Below you will find a full breakdown of rhinoplasty costs in Kerala in 2025–26 — what is included, what drives prices up or down, and why patients from across India and the Middle East choose Thrissur for nose surgery.

Day of Surgery and Day 1–3: Immediately After Rhinoplasty

You will wake from general anaesthesia with a nasal splint or cast on the outside of your nose, internal dissolvable sutures or soft nasal packs, and moderate swelling across the nose and cheeks. Some patients also have bruising around the eyes, ranging from mild discolouration to more visible black-eye bruising — this varies widely between individuals and is not predictive of the final result.
Pain level: Most patients describe the discomfort after rhinoplasty as moderate rather than severe — more of a tight, pressured sensation than sharp pain. It is well managed with prescribed oral pain relief. The nose feels blocked, similar to a heavy cold, because of internal swelling. This is normal and expected.
Bleeding: A small amount of blood-tinged fluid draining from the nostrils in the first 24–48 hours is normal. You will have a small gauze drip pad taped beneath the nostrils to catch this. Heavy or continuous bleeding beyond the first few hours should be reported to the clinic immediately.

What you should do in the first 3 days:

  • Sleep with your head elevated on two or three pillows at a 30–45 degree angle. This is the single most effective thing you can do to reduce swelling — gravity works for you or against you depending on your sleeping position.
     Apply cold compresses gently to your cheeks (not the nose directly) to reduce periorbital bruising.
     Take all prescribed medications as directed — antibiotics, pain relief, and anti-inflammatory.
    Eat soft foods that require minimal chewing. Avoid anything that requires you to open your mouth very wide.
     Do not blow your nose under any circumstances for the first two weeks.
     Rest at home. No physical activity, no bending, no lifting, no straining.
    What you will feel: It is common to feel congested, slightly anxious about the splinted appearance, and uncertain about whether the swelling is normal. It is. The nose looks dramatically different under a splint than it will when the splint is removed and swelling reduces. Try not to assess results at this stage.

Week 1: Splint, Swelling, and the Hard Part

The first week is the most challenging part of rhinoplasty recovery — not because it is severely painful, but because you look and feel quite different from normal, you cannot breathe well through your nose, and you have to be careful about almost everything.
Swelling peaks at around days 3–5 before beginning to slowly reduce. The nose and surrounding area will look their most swollen and bruised at this point. This is entirely normal and no indication of the eventual result.
Bruising around the eyes is at its worst in the first week and will typically progress through yellow-green shading before fading. Arnica gel applied gently to the cheeks (away from incision sites) and arnica supplements may help speed this process. Most bruising is well concealed with makeup (if applicable) by the 10-day mark.
Breathing: You will be breathing through your mouth for most of this week because internal swelling reduces nasal airflow significantly. This improves noticeably after the splint comes off and continues to improve over the following weeks as internal swelling subsides.
Activity: You are largely resting at home during week one. Short gentle walks around the house or garden are fine — and actually helpful for circulation — but nothing more strenuous. Avoid bending down at the waist, lifting anything heavier than a light bag, or any activity that raises your blood pressure and heart rate significantly.
Work: Most patients take 7–10 days off work entirely. If you have a fully desk-based job with no video calls and no need to be presentable, some patients return at day 7. For roles involving face-to-face interaction or video presence, the 10–14 day mark is more realistic.
Social media and photographs: Most patients choose to wait until at least the 3-week mark before appearing on camera. The 1-week stage is not representative of your result — swelling and bruising are at or near peak.

Week 2: Splint Removal and Your First Reveal

 
 

The splint or external cast is typically removed at your one-week or ten-day post-operative appointment. For many patients, this is the moment they have been most looking forward to — and it is important to set expectations correctly.
What you will see at splint removal: Your nose will be visibly reshaped. The hump that was there before will be gone (if that was the goal). The tip will look more refined. The overall proportions will be different. However — and this is important — the nose will still be very swollen. It will look wider, blunter, and less defined than it will ultimately appear. The skin has been lifted off the underlying framework and is in the process of re-draping. What you are seeing at week two is not your result.
The week-two “reality check” is one of the most common sources of patient anxiety in rhinoplasty recovery. Many patients worry at this stage that their nose looks too wide, that the
tip is too big, or that they can’t see the changes they wanted. This is almost universally a function of swelling, not of the surgical outcome. Trust the process and give it time.
What changes in week two:
 Bruising fades significantly and is largely gone by the end of the week for most patients
 Swelling begins a slow but steady decline
 Nasal breathing improves noticeably as internal swelling reduces
 The tight, pressured feeling in the nose begins to ease
 Most patients feel much more like themselves by the end of week two
Activity in week two: Light, gentle daily activities are fine. Continue sleeping with your head elevated. No exercise, no heavy lifting, no activities with a risk of impact to the nose.
Glasses: If you wear glasses, this is an important point. Glasses must not rest on the nose for at least 6–8 weeks after rhinoplasty (and up to 3 months if bones were fractured and repositioned). The weight of the frames can indent and reshape healing bone and cartilage. Contact lenses are the solution during this period. If you cannot wear contacts, glasses can be taped to the forehead or supported by a headband — your surgeon will advise you.

Weeks 3–4: Returning to Daily Life

By weeks three and four, most patients feel largely normal in terms of daily function. The dramatic swelling and bruising of the first two weeks has resolved. The nose still has residual swelling — particularly at the tip — but the overall shape is beginning to give a clearer picture of what the result will look like.
Work: Virtually all patients are back to full desk and office work by the end of week three. If your job involves physically demanding tasks, heavy lifting, or contact sports, week four is the earliest most surgeons would consider clearing you to return — and only after a review appointment.
Social life: Most patients feel comfortable going out socially by weeks 3–4. Residual swelling is noticeable to the patient but not always to others — friends and family often describe the nose as looking “slightly swollen” or “a little different” rather than obviously post-operative.
Makeup and sun exposure: Foundation and concealer can typically be applied around (not on) the nose from week two, and more broadly from week three. Sun exposure is an important consideration — UV radiation can darken healing scars and prolong swelling. A high SPF sunscreen over and around the nose should be worn every day when outdoors for the first six months. Avoid direct sun to the nose as much as possible in the early months.
Nasal massage: Some surgeons recommend gentle nasal massage during this period to help manage swelling, soften scar tissue, and improve skin retraction over the reshaped framework.
Dr. Jyoshid will advise you specifically on whether massage is appropriate for your procedure, the correct technique, and when to start — do not begin massage without specific instruction, as incorrect massage can shift healing structures.
Sleeping: You can transition to sleeping on your back without strict elevation by weeks 3–4, but sleeping face-down or on your side should be avoided for at least 6 weeks to protect the healing nose from pressure and asymmetric force.

Months 1–3: Subtle Changes You Will Notice

After the dramatic changes of the first few weeks, the month 1–3 period is one of gradual, ongoing refinement. Changes are subtle month-to-month but significant when compared over the full three-month period.
Swelling timeline: Roughly 70–80% of the initial post-operative swelling resolves within the first 4–6 weeks. The remaining 20–30% — concentrated particularly at the nasal tip — reduces very slowly over the following months. Patients are often surprised to find that their nose still looks slightly different at month 2 than it did at month 1. This is the healing process working as it should.
The tip is always last. The nasal tip is the area of the nose that retains swelling the longest after rhinoplasty. This is because the tip has the highest concentration of soft tissue and the thickest skin. Tip swelling can persist as a subtle puffiness, a slight ball-like appearance, or reduced definition for 6–12 months — and even longer in thick-skinned patients. Understanding this prevents unnecessary anxiety at the 2–3 month mark when the tip still looks different from the bridges and sides of the nose that have already settled.
Activity resumption: Light cardiovascular exercise (walking, light jogging) is typically permitted at 3–4 weeks, with clearance from your surgeon. Full gym use, weight training, and upper body exercise can usually resume at 6 weeks. Contact sports — anything with a risk of a blow to the nose — should be avoided for a minimum of 3 months, and ideally 6 months.
Scar maturation: For patients who had open rhinoplasty, the columellar scar (the small incision across the strip of tissue between the nostrils) will be pink, slightly raised, and noticeable during this period. This is normal scar maturation. Silicone gel or sheeting applied to the scar from week 3–4 can accelerate fading. By month 3, the scar is typically flat and beginning to blend. By month 6–12, it is virtually invisible in most patients.
Psychological adjustment: The 1–3 month period is when most patients begin to genuinely appreciate their result. The drama of the early weeks has passed, the nose looks clearly different and better, and the changes are settling into something that looks natural. Some patients go through a brief period of continued anxiety in months 1–2 when swelling has not fully resolved — this is normal and almost always resolves as final results emerge.

Months 6–12: Final Results Settling

 
 

This is the stage most patients find hardest to be patient about — and the stage that is most worth waiting for.
Month 6 marks the point at which most patients have a clear, stable picture of their rhinoplasty result. The majority of swelling has resolved. The skin has re-draped over the reshaped framework. The nose looks like the nose you will have for life.
For patients with thinner skin, final results may be fully visible even earlier — by months 4–5. For patients with thick nasal skin — particularly common in South Asian and Middle Eastern nasal anatomy — the full result may continue to refine until month 12 or beyond. This is not a sign that something went wrong. It is simply the biological reality of how thicker skin responds to the underlying structural changes.

What “final result” actually means:
 Swelling has completely resolved
 The nasal framework (bone and cartilage) is fully healed and stable
 The skin has fully conformed to the reshaped underlying structure
Scarring (if open rhinoplasty) has fully matured and is at its lightest
 Nasal breathing, if improved by the surgery, is at its optimal state
At month 12, Dr. Jyoshid schedules a final review appointment to assess the settled result and discuss any further observations or questions the patient may have.
Long-term care:
 Continue applying SPF to the nose and surrounding skin daily — UV exposure affects skin quality and aging regardless of surgery
 Avoid nose piercings through healing tissue for at least 12 months
 If you play contact sports, continue wearing appropriate nose protection
 Maintain a stable weight — significant weight changes affect facial fat distribution and can subtly change how the nose relates to the rest of the face

Rhinoplasty Recovery Do’s and Don’ts

A quick reference for the full recovery period.
Do’s
Do sleep with your head elevated for the first 3–4 weeks — this is the most effective way to reduce swelling.
Do take all prescribed medications exactly as directed, even if you feel well.
Do keep all follow-up appointments — changes that are normal can look alarming to an untrained eye, and check-ups provide important reassurance.
Do wear SPF 50 sunscreen over and around your nose every day from week three onwards for at least six months.
Do use saline nasal spray as directed to keep the nasal passages moist as healing progresses.
Do tell your surgeon if you are a glasses wearer before surgery — planning the post-operative period around this makes a significant difference.
Do be patient. The final result takes months, not weeks. Judge nothing before month 3, and ideally month 6.
Don’ts
Don’t blow your nose for the first two weeks. Sneezing, if unavoidable, should be done with your mouth open to reduce pressure through the nasal passages.
Don’t wear glasses resting on the nose bridge for 6–8 weeks minimum (longer if osteotomies were performed).
Don’t expose your nose to direct sun without protection for at least six months.
Don’t engage in strenuous exercise, heavy lifting, or any activity that significantly raises your heart rate and blood pressure for the first 3–4 weeks.
Don’t touch, press, or manipulate your nose between scheduled massage sessions — even light habitual touching slows healing.
Don’t smoke. Smoking dramatically impairs wound healing, increases infection risk, and reduces the quality of your final result. Patients are asked to stop smoking at least 4 weeks before surgery and maintain this through the full recovery period.
Don’t judge your result before month 3. The rhinoplasty recovery process rewards patience.
When to Call the Clinic
Most symptoms during rhinoplasty recovery are normal and expected. A few are not. Contact Dr. Jyoshid’s clinic immediately if you experience:
 Heavy or uncontrolled bleeding from the nose (beyond the light draining expected in the first 48 hours)
 Fever above 38.5°C
 Severe or worsening pain that is not controlled by prescribed pain relief
 Sudden and significant increase in swelling on one side of the nose
 Discharge that is cloudy, green, or foul-smelling (signs of possible infection)
 Any concerns that feel unusual — when in doubt, call

Frequently Asked Questions (FAQ)

How long does rhinoplasty recovery take?

The majority of visible swelling and bruising resolves within 2–3 weeks. Most patients are socially presentable at 2 weeks and back to normal daily activity by week 3–4. However, complete recovery — including the resolution of all residual swelling and full settling of the final result — takes 6–12 months. For thick-skinned patients, refinement continues up to 18 months.

When can I go back to work after rhinoplasty?

For desk-based, non-public-facing roles: 7–10 days. For office and client-facing roles: 10–14 days. For physically demanding or contact-risk roles: 3–4 weeks minimum.

When can I exercise after rhinoplasty?

Light walking is fine from day 3–5. Light cardio (gentle jogging, cycling) at 3–4 weeks with surgical clearance. Full gym and weight training at 6 weeks. Contact sports at 3 months minimum.

When can I fly after rhinoplasty?

Short domestic flights are generally permitted after 2 weeks. Long-haul international flights are best avoided for 4–6 weeks — cabin pressure changes and the risk of congestion can be uncomfortable and potentially affect early healing. NRI patients travelling back to the Gulf or abroad should discuss timing with Dr. Jyoshid directly.

 

When can I wear glasses after rhinoplasty?

Glasses must not rest on the nasal bridge for 6–8 weeks after rhinoplasty, and up to 3 months if osteotomies (bone fractures for repositioning) were performed. Contact lenses are the recommended solution during this period. Glasses can be taped to the forehead or supported with a headband if contacts are not an option.

When will my nose look normal after rhinoplasty?

Most patients look “normal” — not visibly post-operative — by 2–3 weeks. The nose continues to refine and improve from there. The clearest picture of your final result emerges at 3–6 months, with full settling by 12 months.

Is rhinoplasty recovery painful?

Most patients rate the discomfort as moderate — a tight, pressured, congested sensation rather than acute pain. It is well managed with oral medications.
The first 3–5 days are the most uncomfortable; most patients feel significantly better by the end

How can i book appointment

If you are considering rhinoplasty in Kerala, Dr. Jyoshid R. Balan offers detailed pre-operative consultations that walk through the entire process — surgical plan, expected changes, recovery timeline, and realistic outcomes — so you know exactly what to expect before you commit to surgery.
Sushrutha Institute of Plastic Surgery Elite Mission Hospital, Thrissur, Kerala
📞 +91 8113005557 ✉️ drjosh4u@gmail.com 🌐 www.drjosh.in

9Jun

If you have been researching rhinoplasty in Kerala, you have probably noticed that most surgeons and hospitals either don’t publish their prices at all, or give a range so wide it tells you almost nothing — “₹80,000 to ₹3,00,000” is not a useful answer when you are trying to make a considered decision.
This page is different. As one of the most experienced rhinoplasty surgeons in Kerala, Dr. Jyoshid R. Balan believes patients deserve complete transparency about what they will pay before they even book a consultation. Below you will find a full breakdown of rhinoplasty costs in Kerala in 2025–26 — what is included, what drives prices up or down, and why patients from across India and the Middle East choose Thrissur for nose surgery.

What Is the Rhinoplasty Cost in Kerala?

At Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur — rhinoplasty costs between ₹1,20,000 and ₹1,50,000 for a primary (first-time) cosmetic rhinoplasty.
This is an all-inclusive figure that covers:
• Surgeon’s fee
• Anaesthesiologist’s fee
• Operation theatre charges
• Hospital stay (typically 1 night)
• Post-operative dressings and splint
• One-week and two-week follow-up consultations
There are no hidden add-ons sprung on you at discharge. The quoted price is the price you pay.
For more complex procedures — revision rhinoplasty, septorhinoplasty, or cases involving significant cartilage grafting — the cost will be higher. See the breakdown table below.

Rhinoplasty Cost Table: Procedure by Procedure

Procedure
What It Involves
Approximate Cost
Primary cosmetic rhinoplasty
Reshaping bone, cartilage, or soft tissue for the first time
₹1,20,000 – ₹1,50,000
Septorhinoplasty
Cosmetic reshaping combined with septal correction for breathing
₹1,40,000 – ₹1,70,000
Procedure Revision rhinoplasty Tip rhinoplasty
What It Involves Correcting or refining results from a previous nose surgery Reshaping the nasal tip only (limited scope)
Approximate Cost ₹1,60,000 – ₹2,20,000 ₹90,000 – ₹1,20,000

All figures are approximate and subject to individual assessment. A personalised quote is provided at your consultation.

 

Dr. Jyoshid R. Balan, Senior Consultant Plastic Surgeon specializing in rhinoplasty at Elite Mission Hospital, Thrissur, Kerala, India

Dr. Jyoshid R. Balan

Dr. Jyoshid R. Balan, MCh (Plastic Surgery)

Senior Consultant Plastic Surgeon · Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala · Member, Association of Plastic Surgeons of India

Quick answer

Dr. Jyoshid R. Balan (MCh Plastic Surgery), Senior Consultant at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala, is one of India’s most experienced rhinoplasty surgeons. He performs cosmetic, functional, and revision rhinoplasty for patients from India and abroad. Rhinoplasty cost in India . Consultations: +91 8113005557.

What Is Included in the Rhinoplasty Package?

Understanding exactly what your quoted price covers is as important as the number itself. Here is a detailed breakdown of what is included at Dr. Jyoshid’s centre:
Surgical fees The surgeon’s fee covers the entire procedure — pre-operative marking, the surgery itself, and immediate post-operative review. At Elite Mission Hospital, rhinoplasty is performed exclusively by Dr. Jyoshid R. Balan (MCh Plastic Surgery). It is never delegated to a registrar or junior doctor.
Anaesthesia General anaesthesia is administered and monitored by a dedicated, qualified anaesthesiologist. This is included in the package — it is not billed separately as it is in some clinic settings.
Operation theatre and hospital stay The procedure is performed in a full hospital OT with ICU backup, emergency protocols, and nursing support. One night’s hospital admission is included in the package cost for procedures requiring general anaesthesia.
Post-operative care Dressings, the nasal splint, and scheduled follow-up appointments at one week and two weeks post-surgery are included. If you travel from outside Thrissur, follow-up by video call can be arranged.

Why Kerala Is Cheaper Than Mumbai, Delhi, or Bangalore for Rhinoplasty

The same rhinoplasty procedure performed by a similarly qualified plastic surgeon in Mumbai or Delhi typically costs ₹2,00,000 to ₹3,50,000 — sometimes more in premium metro clinics.
Kerala offers a genuine cost advantage for several structural reasons:
Lower overheads. Operating costs for hospitals in Thrissur are significantly lower than in Mumbai or Delhi. Land, staff salaries, and facility costs are all cheaper — and those savings are passed on to patients.
No “brand premium.” Large metropolitan cosmetic surgery chains charge for their name and marketing spend. A highly experienced surgeon at a tertiary care centre in Kerala does not need to build that cost into every patient’s bill.
No hidden consultation fees. In many metro cities, the initial consultation itself costs ₹2,000–₹5,000. At Dr. Jyoshid’s centre, consultation fees are nominal and credited toward your surgery if you proceed.
No compromise on standards. Elite Mission Hospital is a nationally recognised multi-speciality hospital. The anaesthesia team, nursing staff, and OT infrastructure are equivalent to any top-tier facility in India. Lower cost does not mean lower quality — it means lower overheads.

Hidden Costs to Watch Out For

 
 

Transparency cuts both ways — it also means being honest about costs that can arise outside the package.
Pre-operative investigations. Blood tests, an ECG, and sometimes a nasal CT scan are required before surgery. These are ordered by Dr. Jyoshid based on your individual health profile and typically cost ₹3,000–₹8,000 depending on which tests are needed.
Additional nights of stay. Most patients are discharged after one night. If your recovery requires an extra night of observation (rare, and only for clinical reasons), this will be charged at the hospital’s standard room rate.
Medications. Post-operative antibiotics, anti-inflammatories, and saline nasal sprays are prescribed on discharge. A typical course costs ₹800–₹1,500 at a pharmacy.
Travel and accommodation. If you are travelling from outside Thrissur or from abroad, budget for this separately. The hospital is located centrally in Thrissur with good connectivity by road, rail, and from Cochin International Airport (approximately 70km away).
No surprise revision charges. If a minor touch-up is needed in the early recovery period — which is rare — this is assessed on a case-by-case basis and not a routine cost.

Does Insurance Cover Rhinoplasty in India?

For most patients, no. Here is the distinction that matters:
Cosmetic rhinoplasty — surgery performed purely to improve the appearance of the nose — is considered an elective cosmetic procedure and is not covered by health insurance in India.
Functional rhinoplasty or septoplasty — surgery to correct a deviated septum or structural problem causing genuine breathing difficulties — may be partially covered by some health insurance policies, depending on your policy terms and the insurer’s assessment.
Septorhinoplasty — which combines cosmetic reshaping with functional correction — is a grey area. Some insurers will cover the functional component (the septal correction) while the patient self-pays for the cosmetic portion. Dr. Jyoshid’s team can provide the necessary clinical documentation to support your insurance claim for the functional element where applicable.
If you have a corporate health insurance plan or a Mediclaim policy, it is worth checking your policy document or calling your insurer directly before your consultation.

Rhinoplasty Cost for NRI and Gulf Patients

 
 

A growing proportion of Dr. Jyoshid’s rhinoplasty patients travel from the Middle East — particularly the UAE, Saudi Arabia, Kuwait, Qatar, and Oman — as well as from the UK, Australia, and Southeast Asia.
The appeal is straightforward: rhinoplasty by a highly experienced specialist in Kerala costs a fraction of what the same procedure costs abroad.
Approximate comparison:
Location
Typical Rhinoplasty Cost
UAE (Dubai / Abu Dhabi)
AED 18,000 – AED 35,000 (approx. ₹4,00,000 – ₹7,80,000)
UK
GBP 5,000 – GBP 9,000 (approx. ₹5,30,000 – ₹9,50,000)
Australia
AUD 8,000 – AUD 15,000 (approx. ₹4,40,000 – ₹8,20,000)
What NRI patients receive:
Pre-operative virtual consultation before travelling, so everything is planned in advance
Airport pickup assistance guidance and accommodation recommendations near thehospital
Video call follow-ups after returning home, so there is no need to stay in India for weeks
Complete medical documentation for insurance or records in your home country
To plan your surgery trip, contact the clinic at +91 8113005557 or email drjosh4u@gmail.com.

Plastic surgeon examining a patient's nasal anatomy before rhinoplasty surgery at a hospital in Kerala

What Determines the Final Cost of Your Rhinoplasty?
Every

Every nose is different, and rhinoplasty is one of the most customised procedures in cosmetic surgery. Several factors influence where your quote falls within the range:
Complexity of the surgery. A straightforward tip refinement is simpler than a full rhinoplasty involving hump reduction, tip reshaping, and base narrowing. More complex procedures require more operative time and skill, which is reflected in the price.
Whether cartilage grafting is required. Some patients — particularly those undergoing revision rhinoplasty or those with weak cartilage — need grafts taken from the ear or rib. This adds surgical time and complexity.
Primary vs revision. Revision rhinoplasty is always more technically demanding than primary surgery. Scar tissue, altered anatomy, and the need to correct previous results mean the surgeon must work harder and take more time. This is reflected in the higher cost range.
Functional component. If you have a deviated septum and want it corrected at the same time as your cosmetic rhinoplasty (septorhinoplasty), the procedure will cost slightly more than cosmetic rhinoplasty alone — but considerably less than having the two procedures done separately.
Skin type and thickness. Patients with very thick nasal skin (common in South Indian nasal anatomy) sometimes require modified techniques to achieve definition. Dr. Jyoshid will assess this at your consultation.
Why

Why the Cheapest Quote Is Rarely the Best Choice

 
 

It is tempting to choose a surgeon based on the lowest quoted price. For rhinoplasty specifically, this logic can be costly in the long run.
Rhinoplasty is the most technically demanding cosmetic surgery procedure. The results are visible, permanent, and difficult to reverse. A poorly executed primary rhinoplasty may require an expensive and far more complex revision procedure to correct. The cost of a revision rhinoplasty — in money, recovery time, and emotional stress — almost always exceeds what was saved by choosing the cheaper surgeon the first time.
When evaluating a rhinoplasty surgeon, the right questions are:

• Is this surgeon a qualified plastic surgeon with an MCh in Plastic Surgery?

• How many rhinoplasty procedures have they performed, and can they show me aportfolio of before-and-after photos?
• Do they perform revision rhinoplasty? (A surgeon confident enough to take on revisionshas advanced skills.)
• Is the surgery performed in a properly equipped hospital OT — not a clinic procedureroom?
Dr. Jyoshid R. Balan answers yes to all of the above. His rhinoplasty portfolio covers primary, revision, functional, and ethnic rhinoplasty across hundreds of patients from across India and abroad.

Frequently Asked Questions (FAQ)

What is the average rhinoplasty cost in India?

Rhinoplasty costs in India vary widely by city and surgeon. In metro cities like Mumbai and Delhi, prices range from ₹1,50,000 to ₹4,00,000 at reputable centres. Rhinoplasty costs in India vary widely by city and surgeon. In metro cities like Mumbai and Delhi, prices range from ₹1,50,000 to ₹4,00,000 at reputable centres. In Kerala, a highly qualified specialist like Dr. Jyoshid performs rhinoplasty at ₹1,20,000–₹1,50,000 without any reduction in surgical quality.

Is rhinoplasty cost negotiable?

The quoted price at Dr. Jyoshid’s centre reflects the actual cost of the procedure — surgeon fees, anaesthesia, hospital stay, and follow-up. It is not inflated for negotiation. What you are quoted is what it costs.

Can I pay in instalments?

Payment plans are not offered directly by the clinic. Some patients arrange medical loans through third-party providers. Speak to the clinic team for current guidance.

Does the cost include post-operative medications?

Post-operative medicines (antibiotics, anti-inflammatories, saline spray) are prescribed on discharge and purchased separately from a pharmacy. A typical course costs ₹800–₹1,500.

 

How much does revision rhinoplasty cost in Kerala?

Revision rhinoplasty at Dr. Jyoshid’s centre costs approximately ₹1,60,000–₹2,20,000 depending on the complexity of the corrections needed. Revision cases require a detailed consultation to assess the previous surgery before a precise quote can be given.

Is the initial consultation free?

Consultation fees at Dr. Jyoshid’s clinic are nominal and credited toward your surgery cost if you proceed with the procedure. Contact the clinic directly for current details.

How can i book appointment

If you are considering rhinoplasty in Kerala and want a transparent, personalised quote from one of India’s most experienced facial plastic surgeons, the next step is a consultation with Dr. Jyoshid R. Balan.
Sushrutha Institute of Plastic Surgery Elite Mission Hospital, Thrissur, Kerala

📍 Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala
📞 +91 8113005557
✉️ drjosh4u@gmail.com
🌐 www.drjosh.in

Book your consultation today and get a clear, honest answer about what your rhinoplasty will cost — and what results you can realistically achieve.

rhinoplasty-in-india
23May

Best Rhinoplasty Surgeon in India: Dr. Jyoshid R. Balan, MCh — Thrissur, Kerala

Dr. Jyoshid R. Balan (MCh Plastic Surgery) is widely regarded as one of the best rhinoplasty surgeons in India. Senior Consultant at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala, he specializes in cosmetic, functional, and revision rhinoplasty and treats patients from across India and the Middle East.

This guide covers everything about rhinoplasty in India — costs, recovery, surgeon selection, and why patients travel to Thrissur, Kerala for nose surgery with Dr. Jyoshid.

Are you considering rhinoplasty in India? Whether you want to reshape your nose for cosmetic reasons, correct a breathing problem, or fix an injury, choosing the right rhinoplasty surgeon in India can make all the difference between a result you love, and one you regret.

 

This guide covers everything — what nose surgery in India involves, what to expect during rhinoplasty recovery, how to choose the best rhinoplasty surgeon in India, and why patients from across India and abroad travel to Thrissur, Kerala for nose reshaping surgery in India with Dr. Jyoshid R. Balan.

What is rhinoplasty?

 

Rhinoplasty — commonly called a “nose job” — is one of the most technically demanding procedures in cosmetic surgery. It involves reshaping the bone, cartilage, or soft tissue of the nose to improve its appearance, function, or both.

Cosmetic rhinoplasty

Focuses on improving the shape, size, or proportions of the nose. Patients may want to reduce a nasal hump, refine a wide or bulbous tip, correct asymmetry, or bring the nose into better balance with the rest of the face.

Functional rhinoplasty

Corrects structural problems inside the nose — such as a deviated septum — that cause breathing difficulties, snoring, or chronic nasal congestion. Many patients combine cosmetic and functional goals in a single surgery.

Revision rhinoplasty

Performed to correct or refine results from a previous nose surgery. It is more complex than primary rhinoplasty and requires a surgeon with advanced skills and deep anatomical knowledge.

Dr. Jyoshid R. Balan, Senior Consultant Plastic Surgeon specializing in rhinoplasty at Elite Mission Hospital, Thrissur, Kerala, India

Dr. Jyoshid R. Balan

Dr. Jyoshid R. Balan, MCh (Plastic Surgery)

Senior Consultant Plastic Surgeon · Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala · Member, Association of Plastic Surgeons of India

Quick answer

Dr. Jyoshid R. Balan (MCh Plastic Surgery), Senior Consultant at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala, is one of India’s most experienced rhinoplasty surgeons. He performs cosmetic, functional, and revision rhinoplasty for patients from India and abroad. Rhinoplasty cost in India . Consultations: +91 8113005557.

Plastic surgeon examining a patient's nasal anatomy before rhinoplasty surgery at a hospital in Kerala

Why rhinoplasty results depend entirely on your surgeon

No two noses are the same. Rhinoplasty is not a copy-paste procedure — it requires the surgeon to understand your individual facial anatomy, your ethnic features, your skin type, and your personal goals. A skilled rhinoplasty surgeon blends surgical precision with an artistic eye to create results that look completely natural.

This is why experience matters enormously. A surgeon who has performed hundreds of rhinoplasty procedures — including complex revisions — will anticipate challenges, avoid complications, and deliver consistent outcomes. A surgeon who dabbles in rhinoplasty occasionally cannot offer the same level of expertise.

Dr. Jyoshid R. Balan has dedicated a significant portion of his plastic surgery career to facial procedures, with rhinoplasty as a primary focus. Practising at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital in Thrissur, Kerala, he has built a reputation for achieving natural-looking nose reshaping results that honour each patient’s unique features.

5 things to look for in a rhinoplasty surgeon in Kerala

Choosing the right surgeon is the single most important decision you will make. Here is what to look for:

  1. Specialisation in plastic and cosmetic surgery. Rhinoplasty should be performed by a qualified plastic surgeon — not a general surgeon or ENT practising cosmetic procedures on the side.
  2. A strong rhinoplasty portfolio. Ask to see before-and-after photos of real patients. Results should look natural, not overdone.
  3. Revision rhinoplasty experience. A surgeon confident enough to take on revision cases has advanced skills. This is a mark of genuine expertise.
  4. Transparent communication. A good surgeon will tell you honestly what is achievable and what is not, rather than simply agreeing with everything you request.
  5. A fully equipped, accredited facility. Surgery should be performed in a proper hospital setting with experienced anaesthesia and nursing teams.

Dr. Jyoshid meets all five criteria. He practises at a tertiary care plastic surgery centre within a reputed multi-speciality hospital, with a dedicated team and full surgical infrastructure.

Patient consultation before rhinoplasty nose surgery at Elite Mission Hospital Thrissur Kerala with Dr Jyoshid R Balan

Who travels to Dr. Jyoshid for rhinoplasty?

 
 

Patients travel from across Kerala — Kochi, Kozhikode, Palakkad, Kottayam — as well as from Tamil Nadu, Karnataka, and Goa. Dr. Jyoshid also welcomes international patients from the Middle East, Europe, and Southeast Asia who seek world-class cosmetic surgery in India at a fraction of the cost they would pay abroad.

For international patients, the team assists with travel planning, accommodation guidance, and follow-up consultations via video call after the patient returns home.

Frequently Asked Questions (FAQ)

Is rhinoplasty painful?

The procedure is performed under anaesthesia, so you will feel nothing during surgery. Post-operative discomfort is manageable with prescribed medication. Most patients are comfortable within a few days and return to desk work within 7–10 days.

 

Will there be visible scars after rhinoplasty?

In open rhinoplasty, a small incision is made across the columella (the strip of tissue between the nostrils). This scar fades to become virtually invisible over time. Closed rhinoplasty leaves no external scars at all.

What is the cost of rhinoplasty in India?

Rhinoplasty in India at Dr. Jyoshid’s centre costs between ₹1,20,000 and ₹1,50,000 depending on the complexity of the procedure, technique used, and individual requirements. This includes surgeon fees, anaesthesia, hospital stay, and post-operative care. Contact us at +91 8113005557 or drjosh4u@gmail.com for a personalised quote.

Can I get rhinoplasty and septoplasty together?

Yes. Combining cosmetic reshaping with septal correction — called septorhinoplasty — allows both goals to be achieved in a single anaesthesia and recovery period. Dr. Jyoshid routinely performs septorhinoplasty at Elite Mission Hospital, Thrissur.

 

Who is the best rhinoplasty surgeon in India?

Dr. Jyoshid R. Balan is widely regarded as one of the best rhinoplasty surgeons in India. A Senior Consultant Plastic Surgeon at Sushrutha Institute of Plastic Surgery, Elite Mission Hospital in Thrissur, Kerala, he specialises in cosmetic, functional, and revision rhinoplasty.

Does Dr. Jyoshid see international patients for rhinoplasty?

Yes. Dr. Jyoshid R. Balan welcomes international patients from the Middle East, Europe, and Southeast Asia. His team assists with travel planning, accommodation, and follow-up via video call. Contact: +91 8113005557 or drjosh4u@gmail.com.

How can i book appointment

If you are considering rhinoplasty in Kerala and want to speak with one of India’s leading facial plastic surgeons, Dr. Jyoshid R. Balan offers consultations at Elite Mission Hospital, Thrissur.

📍 Sushrutha Institute of Plastic Surgery, Elite Mission Hospital, Thrissur, Kerala
📞 +91 8113005557
✉️ drjosh4u@gmail.com
🌐 www.drjosh.in

Book your consultation today and take the first step towards the result you have always wanted.

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