Rhinoplasty

Overview

Some people are unhappy with the size and shape of their nose and feel their nose is not in proportion to the rest of their face. This may simply be the way the nose has developed or it may have altered in shape due to an accident. In addition to the appearance of the nose, patients may find it difficult breathing through one or other of their nostrils due to a deviation in the nasal septum (the cartilage partition between the two nasal passages located in the middle of the inside of the nose).

A rhinoplasty (nose job) is an operation to alter the shape and size of the nose and if necessary, to improve the nasal airway to allow more air to pass through the nose. The operation is performed under a general anaesthetic and takes between 1-2 hours to perform and requires 1 day in hospital. There are a number of ways a rhinoplasty can be performed depending on the specific features of the nose to be corrected. Essentially, the operation can either be done with all the incisions (cuts) hidden on the inside of the nose, called a closed rhinoplasty, or else with most of the incisions on the inside of the nose and an additional small incision on the skin of the nose half way down the columella (the thin piece of skin in the midline between the tip of the nose and the upper lip), called an open rhinoplasty. Through these access incisions, the nose is reshaped by a number of techniques, including reducing any hump on the top of the nose, augmenting any flatness of the nose with bone grafts, straightening the nose, narrowing the bridge of the nose by breaking the bones of the nose and resetting them, straightening the septum to improve the air passages, and altering the tip of the nose by either removing and sculpting the existing cartilage, or adding more cartilage to give better support. Of course, not all these techniques are required in every rhinoplasty, and some operations may be very simple, whilst others may be very complex. The wounds are then closed with dissolving stitches and the nose is covered with a plaster support.

This is one of the most commonly performed cosmetic procedures and has high patient satisfaction and low complication rate.

Frequently asked questions

Am I suitable for a rhinoplasty?

What are the benefits of a rhinoplasty?

Where are the scars?

Is the procedure painful?

How long does it take to recover from the surgery?

When will I notice the results and how long will they last?

Will I be told the risks and complications?

What follow-up appointments will there be?

Am I suitable for an rhinoplasty?

Not everyone is suitable for a rhinoplasty. Suitability is a matter for you and Mr Johnson to discuss in clinic, following a thorough analysis of your medical history and a thorough clinical consultation. If you are suitable, during your consultation Mr Johnson will discuss with you whether you need an open or a closed rhinoplasty.

What are the benefits of an rhinoplasty?

The aims of surgery are to change the shape of your nose to suit your desire. The operation can be very successful at improving the balance and proportion between the nose and the rest of the facial features and thereby increasing patient confidence and improving self esteem.

Where are the scars?

In a closed rhinoplasty all the scars are hidden within the inside of each nostril. In an open rhinoplasty there is an additional scar on the skin of the nose half way down the columella (the thin piece of skin in the midline between the tip of the nose and the upper lip).

Is the procedure painful?

A rhinoplasty is not a particularly painful procedure. During the operation strong painkillers are administered and in addition local anaesthetic is injected into the nose so that when patients wake up from the surgery they will be comfortable. On discharge from hospital, any discomfort can usually be managed with simple tablet type painkillers such as paracetamol etc.

How long does it take to recover from surgery?

It is normal to feel lethargic and tired for the first 2 weeks following surgery. Brusing and swelling can last for several weeks following surgery. The plaster and dressings are removed between 7-10 days after the operation and most people feel able to return to work 3 weeks after the surgery. Patients should refrain from contact sports for 3 months.

When will I notice the results and how long will they last?

The improvement in facial appearance will be immediately apparent following a rhinoplasty. However, there will be some bruising and swelling which may last several weeks. There will be some residual swelling and firmness lasting several months. The final result can usually be judged at around 9 months following surgery.

Will I be told the risks and complications?

Any operation carries with it the risk of complication. Major complications, however, are uncommon following a rhinoplasty. During your initial consultation Mr Johnson will have a full discussion with you about the risks and complications of surgery. If you decide to go ahead with surgery, these risks will again be discussed as part of the consenting process. Fortunately, with correct patient selection and appropriate procedure selection, the risks are kept to an absolute minimum. It is important that you should be reassured that Mr Johnson will not agree to perform any cosmetic procedure on you unless he feels the benefits significantly outweigh the risks.

What follow-up appointments will there be?

Mr Johnson will come and see you on the ward after your surgery and will review you everyday throughout your hospital stay. After you have been discharged Mr Johnson will arrange to see you in clinic after 7-10 days to take off the plaster and review the nose. He will then make arrangements to see you in clinic for longer term follow-up appointments. You will be given contact details for the hospital and Mr Johnson's secretary should you wish at any time to discuss further aspects of your care or make additional arrangements for review.


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