Surgery to reshape the nose, or Rhinoplasty, is one of the most commonly performed plastic surgery procedures. It can be used to reduce or increase the size of your nose, change the shape or help relieve some breathing problems.
A detailed consultation is essential. We will discuss what you would like your nose to look like, evaluate the structure of your nose and face and discuss the possibilities. We will also discuss the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin and your age. Previous nose surgery or an injury to your nose, even if it was many years ago may affect your surgery. The planning of your surgery may be affected if you have any allergies or breathing difficulties, if you’re taking any medicines and if you smoke.
Frequently Asked Questions
You should not take aspirin or non-steroidal anti-inflammatory drugs such as Aspirin or Ibuprofen for two weeks before your surgery. These medicines increase the risk of post-operative bleeding and have an adverse effect on bruising. If you smoke, you will need to stop smoking for two weeks before surgery and a week afterwards. Smoking reduces the blood flow to the skin and can prevent healing. You will need someone to drive you home after your surgery and to help you out for a few days at home.
All surgery is associated with some risk. Complications following rhinoplasty are infrequent and usually minor. It is quite common to notice a little bleeding for a couple of days after surgery. More severe bleeding is uncommon and can generally be treated by sitting up and applying a cool gauze lightly against the nostrils. Rarely, an open rhinoplasty may result in adverse scarring on the columella. Very occasionally, corrective surgery may be needed to correct a minor deformity. The surgery is generally minor. Most scientific papers on rhinoplasty quote the need for minor corrections at about 5-10%.
A general anaesthetic is usually needed for rhinoplasty. The surgery takes between one and two hours. Depending on the type of rhinoplasty, the surgery can also be undertaken under local anaesthetic and sedation. Many cosmetic rhinoplasties are undertaken entirely through incisions inside the nose leaving no visible scars. Where more complex surgery is required, for example to correct an asymmetry or perform a revision rhinoplasty, an open rhinoplasty approach may be needed. This involves making an incision on the columella (The part of the nose between the nostrils).
During surgery, the skin of the nose is separated from its supporting framework of bone and cartilage. Adjustments to the bone and cartilage of the nose are made to correct the shape. Sometimes cartilage grafts are required. At the end of surgery, the incisions are repaired with fine sutures (stitches). A light plastic splint is place over the nose to protect it for the first week. Nasal packs may be needed for the first 12 hours after surgery.
After your procedure you will need to rest on the ward until the effects of the anaesthesia have passed Many people prefer to stay in hospital overnight. You might have some discomfort as the anaesthetic wears off and your nose will feel blocked (as if you have a cold). You will be offered pain relief by the nursing staff as you need it. They will care for you until you are discharged.
You may have dressing packs in each nostril overnight. These will stop you breathing through your nose.
Most people are able to return to work about 14 days after surgery. The nose will be delicate for some time and will take 2-3 months to reach its maximum strength. For this reason, contact sports should be avoided for the first 6-8 weeks. Although most of the swelling settles relatively quickly, complete resolution of the swelling within the skin takes approximately 6 to 9 months. This is particularly noticeable in the nasal tip, which is the last site to settle. For this reason, a final contour cannot be judged until 6 to 9 months following surgery. There may be some numbness over the nose, which will gradually disappear over a few weeks or months.
Following your procedure, your surgeon will ask you to book an appointment one week post-operatively for removal of your splint and removal of any non-dissolvable sutures. If you need pain relief, you can take over the counter painkillers, such as Paracetamol or Ibuprofen.
It may take 24 hours to recover from your anaesthetic. During this time you should not drive, drink alcohol, operate machinery or sign anything important documents.
To aid recovery we recommend that you;
- Keep your head up as much as possible. Use an extra pillow or two when you sleep for a few days after your operation.
- Keep the splints on your nose dry and don’t have a hot bath until the splint has been removed.
- Do not blow your nose during the first week following your operation, only wipe it gently. If you need to sneeze, try to do it with your mouth open as this will help to protect your nose.
- Don’t remove any crusts in your nostrils until you see your surgeon to have the splints removed.
- Stay away from dusty or smoky places until you’ve recovered.
Your nostrils may be blocked for a week or two after your operation and you will need to breathe through your mouth. You may find moving uncomfortable, but it is important to move normally to reduce the swelling.
Sleeping may be uncomfortable to begin with, but sleeping in a more upright position propped up with pillows will help with both comfort and to reduce swelling. Most people are able to return to work about 14 days after surgery, although most of the bruising should settle in the first week. The nose will be delicate for some time and will take 2-3 months to reach its maximum strength. For this reason, contact sports should be avoided for the first 6-8 weeks after your surgery.
Despite most of the swelling settling relatively quickly, complete resolution of all the swelling within the skin take approximately 6-9 months. This is particularly noticeable in the tip, which is the last site to settle. There may be some numbness over the nose, which will gradually disappear over a few weeks or months.