Nose reshaping (Rhinoplasty)

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Procedure: The nose is reshaped by correcting its size, eliminating hump, altering shape of tip or bridge, narrowing of flared nostrils, or changing angle between nose and upper lip. May improve breathing. (May be covered by insurance.)

Duration: 1 - 2 hours or more.

Anaesthesia: General or local with sedation.

In/Outpatient: Normally outpatient.

Side Effects: Headaches, temporary swelling and bruising around eyes and nose. Some bleeding and stiffness.

Risks: Infection. Small blood vessel burst resulting in tiny, permanent red spots; insufficient improvement, requiring another operation.

Recovery: Back to work: 1 - 2 weeks. Strenuous physical activity: 2 to 3 weeks. Avoid sunburn or getting hit in nose: 8 weeks. Final results: 1 year or more.

Duration of Results: Permanent.

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₤ 1200 per person

If You're Considering Nose Surgery...
Rhinoplasty, or surgery to improve the appearance or function of the nose, is one of the most widespread plastic surgery procedures. Rhinoplasty embraces nose reduction or enlargement procedures, reshaping of the tip or the bridge, narrowing the nostrils, or changing the angle between the nose and the upper lip. It may also include the correction of a congenital defect or injury or procedures to alleviate breathing difficulty.
If you’re thinking of undergoing rhinoplasty, this information will give you general understanding of the procedure – when it can improve your health and appearance, how it’s done, and what outcomes may be expected. However, it can’t cover all questions you may have because many answers depend on the individual patient and the surgeon.

The Best Candidates for Rhinoplasty
Rhinoplasty can improve your looks and enhance your self-esteem, but it won’t necessarily alter your appearance to equal your ideal, or make other people treat you in a different way. Before you make your mind up to undergo the surgery, think about your expectations and discuss them with your surgeon.
The best candidates for rhinoplasty are those who are seeking for enhancement, not perfection, in their look. If you are in a good physical and emotional state, and have realistic expectations, you may be a good candidate for the surgery.
Rhinoplasty may be done for aesthetic or reconstructive purposes – to eliminate congenital defects or relieve breathing problems.
Age is an important factor. Many surgeons will not operate on teenagers until after their growth spurt – around 14 or 15 for girls, and a little later for boys. It’s also important to take into consideration teenagers’ social and psychological adaptation, and to make certain it’s what they, and not their parents, really wish for.

All Surgery Carries Some Uncertainty and Risk
When rhinoplasty is executed by a qualified plastic surgery specialist, complications are rare and usually insignificant. Yet, the possibility of complications remains, including infection, nose bleeding or negative body’s reaction to the anaesthesia. You can lessen the risks by carefully following your surgeon’s instructions both before and after the surgery.
Following the surgery, small red spots may appear on the surface of the skin; they are usually minor but may remain for ever. As for scars, when rhinoplasty is performed from inside the nose, scars are invisible at all; if an ‘open’ approach is used, or when the procedure requires the narrowing of the span of the nostrils, the small scars on the nose base are usually indistinguishable.
In about one case out of ten, an additional procedure may be required – for instance, correction of a minor deformity. Such cases are unpredictable and occur even to patients operated on by the most skilled surgeons. Usually, the corrective surgery is minor.

Planning Your Surgery
Good communication between you and your physician is important. During your first consultation, the surgeon will ask what improvements you want, evaluate the structure of your nose and face, and discuss surgery possibilities with you. He or she will also describe the factors that may influence the procedure and the results. The surgery depends on the structure of your nasal bones and cartilage, the thickness of your skin, the shape of your face, your age, and your expectations.
Your surgeon will also tell what techniques and anaesthesia he or she will use, the type of facility where the operation will be carried out, the costs and risks involved, and any options there may be. Most insurance policies don’t cover entirely cosmetic surgery; but if the procedure is done for reconstructive purposes, to alleviate breathing difficulties or correct an obvious disfigurement, the procedure may be covered. Check with your insurer, and get pre-authorization for your surgery.
Inform your surgeon if you’ve had any nose surgery before, or any injury, even if it was long ago. You should also tell your surgeon if you suffer from any allergies or have breathing problems, if you smoke and if you’re taking any medications, vitamins or recreational drugs.
If you have any questions regarding your expectations and concerns about the results, ask without hesitation.

Preparing For Your Surgery
You will be given detailed instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Closely following these instructions, you may expect a more smoothly-going surgery.
While preparing for the surgery, make sure that someone will be able to drive you home after your surgery and be near for a few days if any help will be needed.

The Surgery
Rhinoplasty normally takes 1 to 3 hours, although complex procedures may last longer. During the surgery, the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to create the desired shape and size of the nose. The sculpting will depend on your problem and your surgeon’s chosen technique. As a final procedure, the skin is re-draped over the new framework.
Rhinoplasty is often performed from within the nose, making the incision inside the nostrils. Open rhinoplasty is used in more difficult procedures or for large noses; the surgeon makes a small incision across the columella, the fleshy column between the nostrils.
After the surgery, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be put in your nostrils to steady the septum, the vertical plane of tissue that separates the nostrils.

After Your Surgery
After surgery – especially during the first twenty-four hours – your face will feel swollen, your nose may ache, and you may have a headache. Any discomfort can be minimized with the pain medication prescribed by the surgeon. At home, the patient should stay in bed with the head elevated (except for going to the bathroom) for the first day.
Initial swelling and bruising around the eyes is a normal occurrence, reaching a peak after two or three days. Cold compresses on the face, bridge of the nose and eyes as long as bearable will reduce these problems. In any case, you’ll feel a lot better than you look. Most of the swelling and bruising should fade away within around two weeks. (Some slight swelling – noticeable only to you and your surgeon – will disappear after several months.)
Moderate bleeding is normal during the first few days after surgery, and the feeling of some stuffiness may continue for several weeks. You will probably be asked to avoid blowing your nose for a week or so, to let the tissues heal.
If you have nasal packing, it will be removed after several days and you’ll feel much better. By the end of one or, rarely, two weeks, all splints, dressings and stitches should be taken away.

Getting Back to Normal
Most rhinoplasty patients are up and about within two days, and can come back to school or sedentary work a week following surgery. However, it will take several weeks before you feel as well as usual.
Your surgeon will give more particular guidelines for getting back to your normal activities. They may include the following suggestions: Avoid any activity that elevates your blood pressure for two to three weeks; Avoid sunburn, hitting or rubbing your nose for eight weeks; Be careful when washing your face and hair or using cosmetics.
If you don’t know what you can and can’t do or any unusual symptoms, you should call your doctor.

Your New Look
After the operation, with their face bruised and swollen, patients often feel depressed, but such a reaction is quite normal and understandable.
Remember that this stage will pass. Day by day, your nose will start to look better, and in one or two weeks’ time, your look will markedly improve.
However, the process of healing is gradual. Some puffiness (especially in the tip) may remain for months. The final results may appear only after a year or more.
For the time being, your family and friends may react in an unexpected way. They may tell you they don’t distinguish any big difference in your nose. They may feel indignant, especially if the surgery has changed something they see as a family or ethnic feature. In such cases, remember what made you come to the decision to have rhinoplasty in the first place. If your aims are achieved, then the operation is a success.

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