Rhinoplasty ("Nose Job") - Cosmetic Surgery Guide

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Rhinoplasty is a cosmetic procedure which can reshape your nose. It's amongst the most widely used cosmetic surgeries and can help to increase nose size, narrow the span of nostrils, change the angle between your nose and upper lip and alter the shape of the bridge or tip. Rhinoplasty can also help with structural problems like hooks or bumps, improve the appearance or correct problems such as difficulty breathing caused by a deviated septum (the wall between the two nostrils). Rhinoplasty achieves these alterations by reshaping the bone, cartilage and other soft tissues in the nose.

The Procedure

Before you undergo surgery your surgeon will consult with you on the operation itself and any instructions you will need to follow before undergoing surgery. It's usually recommended that you stop smoking before having rhinoplasty. This is because smoking can constrict blood vessels, comprimising blood flow to the skin. This can lead to poor healing and in some cases the death of skin (necrosis) in the treated area. Similarly drinking alcohol can also hamper your body's ability to heal and should be stopped around a week before undergoing surgery. If you are taking certain medications including certain anti-inflammatory drugs or ibuprofen these will need to be stopped as they can add to the risk of bleeding.

There's two main types of rhinolpasty operations; the closed and open techniques. The closed technique will be performed inside the nostrils via a few very small incisions. The open technique uses an incision across the strip of skin between the nostrils, this allows the surgeon to get a better view of the nasal structures. Your anatomy and any personal preferences will be taken into account when deciding which technique will be best for you.

Rhinoplasty differs from person to person, so the exact surgery required will depend on what needs correcting. During the procedure you will be given a general anaesthetic, which means you will be unconscious throughout the operation. If you are looking to modify your profile then your surgeon can reduce the height of your nasal bridge by shaving the septum and upper cartilage. If you are unhappy with the length of your nose then your surgeon will resect the terminal part of the septum and correct the upper lateral cartilage. For reducing the rounded appearance of your nose your surgeon can cut a portion of the alar cartilage and, if needed, the septum can be trimmed to produce a shorter nose. If the bridge of the nose requires narrowing then your surgeon can use a technique called an infracture to cut the nasal bone and carefully push the other bones back together. Excessively wide nostrils can be narrowed through use of a wedge which is inserted and removed through a small incision. Following surgery, a splint is usually applied in order to maintain and support the noses' new shape and is typically removed after about two weeks. Depending on what is being done, rhinoplasty can take between two and three hours to perform.

Aftercare and Recovery

Immediately following surgery its usual for your face to feel swollen and your nose to feel sore. If the pain becomes excessive then your surgeon will prescribe you some painkillers to help. There's usually bruising and swelling around the eyes for about three weeks following surgery. It's usual to experience bleeding in the first few days and it's recommended you avoid any activities which will involve hard contact with your nose, such as blowing it, for about a week after surgery. After about a week your splint and any dressings will be removed, it's recommended you avoid any strenuous activity for about three weeks and refrain from any contact sports for around a month afterwards. It's usual to have follow-up visits with your surgeon to monitor your progress and make sure you are healing properly. Although recovery differs from person to person most rhinoplasty patients are able to return to work within a week after surgery.

The Risks

Although most rhinoplasty procedures are performed without complication, as with all surgery there are some risks. In rare cases infection can develop, but it's usual to be given antibiotics to help prevent this. Blood clots can form under the skin and may require additional surgery to correct. Meningitis or infections in the cranial cavity can occur due to the nasal injuries which occur during rhinoplasty. Scarring is normally inconspicuous however in some cases more aggressive scarring may occur. Fortunately, this is highly treatable with creams and steroid injections. Temporary skin problems can occur as the tape applied to the nose under the splint may irritate the skin. Other possible, but rare risks include nasal obstructions, a retracted columella and bone irregularities caused by the shaping of the nasal bone.

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