Rhinoplasty

INTRODUCTION

Rhinoplasty (surgery to replace the nose) is a commonly performed plastic surgical procedure. The operation can do a variety of things, including increasing or decreasing the projection of the nose, changing the shape of the bridge of the nose, the tip of the nose, altering the width of the nostrils, or change the profile of the nose. Suitable patients for rhinoplasty include those who are looking for an improvement in the appearance of the nose, but not necessarily a “perfect” nose. Rhinoplasty may enhance your appearance and self-confidence, but it will not necessarily match your ideal, or change the way other people treat you. It is important to think carefully about your expectations from surgery, and to discuss these with your surgeon before the operation.

PLANNING TREATMENT

At your initial consultation your surgeon will ask you what you would like to change about your nose. He will evaluate the structure of your nose and face, and discuss the surgical possibilities with you. Various factors relating to surgery will also be discussed, including the structure of your nasal bones and cartilage, the overall shape of your face, your skin, your age, any medical history and equally importantly, your expectations of surgery. It is extremely important that you let your surgeon know about any medication you are taking, including vitamins, recreational drugs and drugs which affect the blood, such as aspirin or warfarin. You should also tell your surgeon if you smoke. You should also let your surgeon know if you have had any previous nasal injuries or previous surgery to your nose, even if this was many years ago.

Clinical photographs are usually taken before surgery and these will be discussed with you.

You will be given instructions about your admission and the need for fasting six hours before surgery.

Rhinoplasty is carried out under general anaesthetic, usually with an overnight stay post-operatively. The approach to the nose is from within the nostril, or through an incision placed on the columella (the vertical strip of skin between the nostrils). The surgical approach will be discussed with you. The surgery typically takes between one or two hours.

During the surgery the skin of the nose is separated from its underlying bone and cartilage framework, which is then remodeled to the desired shape. The exact nature of the remodeling will depend on your problem and the surgical technique selected. At the end of the procedure the skin is re-draped over the new framework.

At the end of the operation your surgeon will usually apply a splint to your nose, which is kept in place for approximately seven days. You may well have small packs inside the nostrils, placed at the time of surgery and these are usually removed the morning after surgery, prior to discharge home.

AFTERCARE

After your operation you will notice swelling of the face and often bruising around the eyes. You will be advised to sleep propped up on three to four pillows for the first few days after your surgery, to try yo diminish the facial swelling. Your nose may ache and you may have a dull headache. Any discomfort can be treated with painkillers prescribed by your surgeon. The swelling ad bruising usually peaks after two to three days and then starts to resolve. Applying cold compresses or icepacks will help to reduce this swelling and make you feel more comfortable. The splint and any external stiches will be removed from your nose after approximately one week. Most of the swelling and bruising should disappear within two weeks.

You may experience a small amount of bleeding during the first few days following your operation and you may feel slightly “bunged-up” for several weeks. You should try to avoid blowing your nose or picking at your suture for seven to ten days after surgery, to allow the tissues inside your nose to heal. If you have any dry crusting around the outside of the nostrils, this can be gently cleaned with cotton buds.

Most rhinoplasty patients are able to work approximately two weeks following surgery. It will take several weeks however before your nose has settled completely. You should avoid strenuous activity (jogging, swimming, gym, sexual activity etc.) for four weeks. You should avoid banging or rubbing your nose for six to eight weeks. You should be very gentle when washing your face and hair and you should be able to apply cosmetics after the first seven to ten days. You should be able to wear contact lenses as soon as your eyes are comfortable enough.

Your surgeon will arrange follow-up visits in the weeks or months after surgery, to check on your progress. If you have any unusual or unexpected symptoms before or between outpatient appointments, or if you have any questions at all about what you can or cannot do, you should contact the surgeon or clinic.

COMPLICATIONS

Complications are infrequent and usually minor. These include post-operative infection or bleeding. Occasionally, this will require a return to the operating theatre. The risks can be reduced by following closely your surgeon’s instructions before and after the operation.

After operation, small burst blood vessels may appear as tiny red marks on the skin surface – these are usually minor but may be permanent. When rhinoplasty is performed from inside the nose, there is no external visible scarring; when an “open” technique is used, or if your surgeon has carried out the procedure to narrow the nostrils, you will be left with small scars on the base of the nose, but these usually fade well.

In approximately one case in twenty, a second procedure may be required to correct minor irregularity or deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeon. This corrective surgery is usually minor.

YOUR NEW NOSE

It is quite common to feel a bit down in the first few days following surgery, when you face is bruised and swollen. With the passing days, your nose will begin to look better and you will feel happy about your appearance. After approximately two weeks, you will no longer look as if you have had just had surgery.

Healing is a gradual process however and some subtle swelling may be present for many months, especially in the nasal tip area. The final results of the rhinoplasty procedure may not be apparent for as long as one year.

Finally if you have any problems or concerns at all following your local anaesthetic procedure, you should contact us.

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Frequently Asked Questions

  • What is Plastic Surgery?
  • What do I have to look out for before my surgery, to reduce risks and get the best result?
  • How dangerous is general anesthesia?
  • They say plastic surgery is doing miracles. Is it a form of speech or is its potential big?

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