Rhinoplasty in Brazil for patients from the Netherlands.

Why patients living in the Netherlands look to Brazil

Brazil has a long surgical tradition in facial and plastic surgery, shaped by the school of Ivo Pitanguy, and appears consistently among the countries with the highest volume of aesthetic procedures in the world in ISAPS surveys. Volume alone proves nothing. What matters for a patient in Amsterdam, Rotterdam or Utrecht is whether the surgeon's training can be verified and whether the structure around the operation is safe.

Medicine in Brazil is regulated by the Conselho Federal de Medicina. Every specialist title corresponds to an RQE number that can be checked on the state medical council website. Dr. Sella holds CRM-PR 33.018 and RQE 17.984 in Otorhinolaryngology, completed his residency at HCFMRP-USP, a direct doctorate in Morphophysiology of Facial Structures at the same institution, a rhinoplasty fellowship in Melbourne and Sydney, and certification by the European Board in Facial Plastic and Reconstructive Surgery. He has published on dorsal preservation in peer-reviewed journals indexed on PubMed and teaches the technique as an invited faculty member in more than ten countries. You can review the full background on the page about Dr. Guilherme Sella.

There is also a practical reason. Surgeon fees, hospital costs and the exchange rate make surgery in Brazil generally less expensive for someone earning in euros than the equivalent procedure in Western Europe. No figures are published online. The budget is given only after the consultation, because it depends on the technique, operating time and whether grafts are needed, and it already includes the surgical team, hospital, anesthesia and follow-up visits.

The first step is a video consultation

The Netherlands is four to five hours ahead of Maringá depending on daylight saving time. Appointments are usually scheduled for late afternoon in Brazil, which falls in the evening in the Netherlands, so you do not have to take time off work.

The teleconsultation lasts about one hour. It covers your medical history, breathing complaints, previous nasal surgery or trauma, standardized photographs taken according to instructions sent in advance, digital simulation and a clear explanation of the technique being considered. The simulation is a communication tool and usually reaches around 60 to 70 percent of similarity with the final result. Nobody should be promised more than that.

Two parts of the assessment can only be done in person: the internal nasal examination and the high-frequency dermatologic ultrasound used to measure skin thickness, map previous fillers or grafts and check columellar vascularization. Both are performed in Maringá on arrival, before surgery, and the plan can still be adjusted at that point.

Tests you can do at home in the Netherlands

Preoperative tests are done where you live, usually through your huisarts or a private laboratory, and sent by email or WhatsApp for review before you buy tickets.

• Routine blood work and coagulation tests
• Cardiology clearance when age or medical history indicates it
• CT scan of the nose and sinuses when there is a functional complaint, prior surgery or suspected deviation
• List of current medications, supplements and allergies
• Previous operative reports, if you had rhinoplasty or septoplasty before

For anyone considering revision rhinoplasty, those old reports and images matter a great deal. They change the surgical plan and the amount of graft material required.

Flights, route and how long to stay

Amsterdam Schiphol has nonstop service to São Paulo Guarulhos, roughly 12 hours. From Guarulhos or Congonhas there are domestic flights to Maringá airport, code MGF, with a flight time of about one hour and twenty minutes. Curitiba is an alternative connection. Many patients arrive in São Paulo in the morning and reach Maringá the same day.

Plan 7 to 10 days in Brazil. A companion is recommended for the first week, and the team can suggest accommodation close to the clinic.

Day	What happens
Day 0 or 1	Arrival in Maringá, rest, in-person consultation, internal nasal exam and nasal ultrasound
Day 2	Surgery under general anesthesia, 3 to 5 hours, 12 to 24 hours in hospital
Day 3	Discharge, first dressing check, instructions for ice, head elevation and saline rinses
Days 4 to 6	Rest, short walks, swelling and periorbital bruising peak and start to fade
Day 7	Cast removal, taping applied, clearance to fly
Days 8 to 10	Optional buffer days before the return flight

Surgery and hospital structure

Rhinoplasty is performed under general anesthesia, or sedation in selected cases, and takes 3 to 5 hours. Revision cases take longer. The approach may be open or closed depending on the anatomy and the plan.

Surgery takes place at Saine Health Complex, a boutique hospital in Maringá with 7,500 square meters, 11 operating rooms, adult and neonatal ICU, intensivists on site 24 hours and hyperbaric medicine. Overnight stay is 12 to 24 hours.

The techniques used include dorsal preservation with push down and let down, described in detail on the page about preservation rhinoplasty, ultrasonic rhinoplasty with a piezoelectric instrument, and structural grafting with septal, conchal or costal cartilage when needed. Because the surgeon is an ENT specialist, functional work on the septum, turbinates and nasal valves is addressed in the same operation when indicated.

Recovery, the flight home and remote follow-up

The external cast stays about 7 days, followed by one week of taping that you can manage yourself. Most patients do not need nasal packing. Light bleeding in the first 48 to 72 hours is expected. Periorbital bruising can last up to 15 days. Numbness of the upper lip and front teeth may persist for up to three months.

Flying is released after the cast is removed. Practical rules for the return trip and the weeks that follow: keep the head elevated around 30 degrees for at least 10 days, no glasses resting on the nose for 4 weeks, exercise after 15 days, no sun, beach or pool for a month, SPF 30 for three months, and never blow your nose.

Follow-up appointments at 1, 3, 6 and 12 months can be done online from the Netherlands or in person if you travel again. Photographs are reviewed at each one. The definitive result appears between 6 and 12 months, and up to 18 months in thick skin or revision cases. Revision rates reported in the rhinoplasty literature range from about 5 to 15 percent, and any reassessment is only considered after 12 months.

Language, documents and insurance

The team works in Portuguese, English and Spanish, and medical documentation can be issued in English on request. Practice is private only, with no Brazilian health insurance contracts.

Dutch health insurance generally does not reimburse aesthetic surgery, and rules for treatment abroad vary by policy. Where there is a functional component such as septoplasty, turbinoplasty or sinus surgery, the clinic provides the reports and invoices you need to submit a claim. Whether your zorgverzekeraar accepts it depends on your contract, so check with them before traveling. More logistics details are on the international patients page.

When to contact Dr. Sella

If you live in the Netherlands and are considering nasal surgery, the sensible first step is a video consultation, not a flight. Indication, technique, risks and timeline are individual and are defined only after a proper assessment. You can read more about the procedure on the rhinoplasty page or reach the team through contact to discuss dates and documentation.