RHINOPLASTY

The Rhinoplasty or nose job is one of the most frequently performed cosmetic procedures. It is possible to enlarge or reduce a nose, change the shape of its tip, reduce its nostrils all with the aim of the nose looking in harmony with the whole face. However, boundaries exist and your plastic surgeon will help you in assessing what is realistic for you.

There exist both: open rhinoplasty operations and closed rhinoplasty operations. Closed Rhinoplasties involve no visible external scars as the operation is performed within the nose, without making incisions in the external skin. Open Rhinoplasties leave a small scar between the nostrils which is hardly noticeable (these are usually performed when the nose presents particularly difficult problems).

In the consultation with your surgeon, be direct and clear about what you hope to achieve. Your surgeon will analyze the structure of your face and discuss with you what is surgically possible.  The factors that play an important role in the surgery and the outcome are: the facial features/structure, the skin-texture, the structure of the nasal bones and the cartilage.

Tell your surgeons about any prior surgery to the nose. Nowadays secondary and tertiary rhinoplasties can be successful depending on certain factors but the surgeon will be able to advise you about this at your consultation. As with all cosmetic operations it is important that you tell your surgeon your exact and complete medical history, what medication you are taking, whether you are using any nasal sprays (these sprays are recommended to be stopped three months before surgery), whether you have breathing problems, whether you smoke, whether you have abused drugs in the past (especially cocaine), what vitamins/ supplements you are taking and whether you have any allergies.

Anaesthetic

Usually this operation is done under general anaesthetic. However, it can be done under local anaesthetic depending what your surgeon prefers. This operation usually lasts 1-2 hours

Procedure:

The procedure consists of modelling both the bone (present in the upper nose) and the cartilage (present in the lower nose). When reducing the nose, nasal bones are fractured and re-positioned. In order to augment the nose, bone is sometimes taken from another area of your body to build the nose or synthetic materials can be used instead of bone depending what your surgeon thinks is best.

When the procedure is finished, your nostrils will usually be filled with packing (bandages) so you will have to breath out of your mouth. These bandages will be taken out usually between the first and seventh day. During the first 24 hours you will experience swelling around the face, pain around the nose and discomfort. However, these can be minimised by painkillers prescribed by your surgeon. Swelling and bruising around the eyes will gradually appear until the third day. This can be minimised with cold ice packs. Bruising should have disappeared around 10 days later. Swelling takes around 1 month-12 months to see a complete final result. Stitching is usually absorbable. Avoid exercise for around 1 month. Also avoid direct sunlight.

It has been found that even in the most experienced surgical hands the rate of revision (having this operation re-done) is 20% of those who had the first rhinoplasty. Therefore it is important to put yourself in the hands of a very experienced plastic surgeon who is experienced at secondary rhinoplasties as well.