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Rhinoplasty (Nose Reshaping)

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Rhinoplasty is an overall term used to describe a range of surgical procedures, which may be used to re-shape the nose, or correct nasal deformities to relieve blockages in the nose. In common terms, a “nose job”!

The nose consists of two basic components: bone and cartilage. The bone supports the upper part of the nose, while the lower part of the nose is supported by cartilage.

Inside the nose is a hollow cavity, called the nasal cavity that is divided into two sections or passages by the nasal septum (the bit dividing the two nostrils).

In some people, the septum becomes slightly out of line and the cartilage dividing the nose is crooked. The crooked cartilage can interfere with breathing and blowing the nose. In many cases surgery is recommended to straighten the septum, and so improve breathing, and this surgery is called septoplasty.

Aesthetic or cosmetic rhinoplasty usually refers to surgery which reshapes the cartilage, bone and sometimes soft tissues of the nose, to produce an appearance more pleasing to the patient.

Your nose is the second most prominent feature on your face, next to your eyes, and its size and shape may be the most obviously defining characteristic of your face.

However, when considering nasal surgery, doctors and patients must consider both the appearance and function of the nose. This is because the size of the breathing passages is sometimes reduced when the size of the nose is altered.

Rhinoplasty can increase or reduce the size of your nose, straighten a lump on the bridge of the nose, change the shape of the tip or the bridge, narrow the nostrils, or change the angle between your nose and your upper lip.

There are limitations however, and rhinoplasty does not allow you to choose a new nose from a magazine!

What happens during a Rhinoplasty out-patient consultation?

In your first appointment, you should clearly explain your expectations of the surgery and how you would like to look afterwards.

Careful discussions regarding your reasons for wanting nose surgery are very important at this stage. Make sure that you obtain as much information as is necessary to enable you to make a fully informed decision about whether to go ahead with rhinoplasty surgery. There will be a discussion about your medical history, to make sure that there are no reasons why you shouldn’t have a rhinoplasty.

You will then be given time to consider fully all the implications of the proposed surgery and a second out-patient appointment will be only be made if you have elected to proceed with surgery. (If you are still not completely sure a further consultation appointment can be arranged.)  At the next appointment, you would sign a consent form, which means that you have understood the future benefits and possible risks associated with the procedure.  Photographs of your nose will be taken for clinical records and stored securely under data protection laws, also they remain “medical in confidence”.

Anaesthesia

Rhinoplasty proceedures are usually performed under a general anaesthetic. As in any surgical procedure, the use of a general anaesthetic carries a small additional risk that Mr Mellor will discuss with you. Precautions will be taken to reduce the small risk of deep vein thrombosis.

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The operation

The operation normally takes between one to two hours, but depending on the extent of the procedure, it can take longer.

During surgery, the soft tissue of the nose is separated from the bone and cartilage underneath the skin. Then the bone may be broken and repositioned and the cartilage reshaped to achieve the look you require.

A splint is applied and the nostrils are packed lightly with a medicated foam pack. Stitches are used to close internal wounds, they will dissolve automatically and will not require removal . The cut made across the skin separating the nostrils, to allow access, is generally closed with dissolving sutures as well.  You will be seen for review after 0ne week, when the splint will be removed.  The packs are removed either late the same day or the next morning depending upon the time of your operation.

How long will it take to recover the surgery?

Most patients find that they can go back to work one to two weeks after surgery. The bruising may need some camouflage make-up around the eyes. It will take several weeks before normal physical activity can be resumed.

What should you do after a Rhinoplasty operation?

It is very important that you follow the advice given carefully after your treatment.

Post surgery advice may include:

  • Using recommended painkillers as required;
  • Decongestants may also be prescribed to reduce internal swelling;
  • Do not  blow your nose for the first couple of weeks to avoid damaging the internal tissue of the nose;
  • Return to have the splint and any stitches removed  a week after the surgery;
  • It is very important to stay out of the sun for two months after the surgery. In some cases, the skin of the nose is parted from the bone and septum that may cause the nose to peel after the surgery. Care should be taken with the new, sensitive layer of skin. Any exposure to the sun could cause scarring;
  • You should avoid contact sports or any activity that may result in your face being jarred or bumped for six weeks after surgery;
  • Contacting the team immediately if you notice any signs of infection or if you experience increased bleeding or a sudden increase in pain.

 

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