Rhinoplasty ‘Nose reshaping’ is a surgical procedure that can define, reshape and restructure the nose. It is one of the most popular facial cosmetic surgeries and is often referred to as a ‘nose job’.
Rhinoplasty can create a more symmetrical and proportional nose to complement the overall facial aesthetics of the patient but can also serve to correct breathing impairments and repair the effects of trauma, such as a broken nose.
FAQs for Nose Reshaping Surgery (Rhinoplasty)
A consultation will determine whether a nose reshaping is suitable for you. This will be based on a variety of factors; you will be asked about your general medical history. Questions will include focus on your general medical history and any previous nasal surgery or injury.
If the nose reshaping you require is corrective surgery as a result of a previous Rhinoplasty it is important to wait at least 1 year before any further surgery is attempted.
Enquiries will also be made as to your breathing patterns and whether you suffer from any nasal obstruction. Normally such issues can be addressed during the rhinoplasty. Mr Karidis will then discuss with you why you are unhappy with the shape of your nose.
A rhinoplasty operation is usually performed through incisions inside the nostrils. Occasionally there are external scars, particularly when reducing nostril size (alar base reduction) or if complicated tip work is required. If alar base reductions have been performed during the nose reshaping then the scars will be found tucked into the base of the nostrils within the natural skin fold.
These are also generally well hidden by the natural shadow cast by the position of the nose. In complex tip surgery, you may require an external incision (open rhinoplasty) carefully placed in the columella (the lower middle segment of skin situated between your nostrils) but you will be informed appropriately.
Through the incisions, once the skin is lifted off the nasal cartilage and bone, any bump on the bridge is removed with a delicate chisel to give a new profile. The nasal bones, depending on the circumstances, are then usually broken and reset in a careful way to allow them to meet in the midline and narrow the bridge line. If any breathing difficulties exist, then the septum (structure separating the two nasal compartments) can be altered accordingly.
Finally, the tip of the nose, comprising of cartilage beneath the skin, is adjusted in size and shape to refine the nose so that it matches the new profile. Sometimes this is done with internal stitches, other times a small segment of your own cartilage is used.
Once you’re back in your room, you will notice that you will be propped up in bed with a couple of pillows in order to elevate your head. This is necessary to reduce the swelling around your nose. You may or may not have some bruising around the eyes. You will also notice that it will be difficult to breathe through your nose.
This is because of the nasal packs. Understandably, most patients report that the packs are the most unpleasant part of the whole operation. This is not because they are painful, but because you are forced to breathe through your mouth until these are removed, the following morning.
Of course, you will automatically be breathing through your mouth- so don’t panic!
The following morning the packs are removed and your breathing will be better, however, there will still be significant congestion/swelling within the nose so do not expect to breathe perfectly from your nose. This, of course, will get better although it will take a number of weeks before it returns to ‘normal’.
Please also note that once the packs are removed you should expect to get some nasal bleeding in a drip like fashion. A small gauze bolster will be placed under the nose to catch these drips. You will find that within the next few days this will steadily become less until it stops.
It is very important to realise that even once the plaster cast is removed from the bridge of the nose there will almost certainly be a significant degree of swelling still present. Therefore the shape of the nose at this stage is not the final one.
Moreover, many times the nasal bridge looks quite narrow and slim immediately once the plaster is removed, but then subsequently swells up again due to normal healing process. This obvious swelling will however rapidly decrease in the ensuing 3-4 weeks and the nose will begin to settle.
However, it is important to remember that even after this time, the shape of the nose is still not the final one. This is partly because of scar tissue which will form underneath the skin of the nose, as a result of the surgery, and which will have a subtle volume effect on the final shape giving rise to some fullness and width to the nose.
These internal scars gradually change their shape (called scar maturation) and resolve in time. The process of scar maturation will take up to one year, sometimes longer, to complete and therefore only after this time is the final ultimate shape of your new nose apparent.
As a simple guide in assessing the progress of your nose, you should gently squeeze the tip of a normal unoperated nose, and then your own to compare the firmness. The firmer it is the more time is required for it to settle.
Remarkably enough, pain after a nose reshaping operation is not usually a problem. It is easily relieved by an injection in the first few hours and a mild painkiller such as paracetamol as necessary afterwards.
Tips from the Top
Senior Nurse Suzi says:
A balanced healthy diet, rich in protein will help you heal from surgery – try drinking a fresh green juice every morning.
Write down any questions and take them into your consultation with Mr Karidis – that way you won’t forget anything.
Prepare your body for surgery by keeping it soft and supple by moisturising skin twice daily (avoid vitamin E containing products).
Always wear sun block (SPF 50+) over surgery scars to stop pigmentation.
Stock up on comfy lounge wear for after your surgery – front opening tops are ideal.