Nose Surgery | London Facial Surgeons

WHY CONSIDER SURGERY?

The nose has a great impact on how a person looks and in addition all the important functions of breathing. External nasal irregularities may cause concerns, symptoms of blockage and even snoring, all of which can affect quality of life. Nasal surgery can address these issues. A slight alteration in the appearance and or function of the nose can greatly improve one's appearance, self confidence, or health. If you are considering a rhinoplasty, you may want to know how a rhinoplasty is performed and what you can expect. Some aspects of rhinoplasty are discussed in the following section, however any specific questions pertaining to surgery will be discussed during your consultation.

AM I A SUITABLE CANDIDATE FOR RHINOPLASTY SURGERY?

Pre-requisites for rhinoplasty include good health, realistic expectations and an understanding of the surgical outcome. There is no absolute perfection in rhinoplasty, but the aim is to improve the nose functionally and aesthetically, making it harmonise better with other facial features. Also age may be a consideration as we prefer not to operate on teenagers until after they have completed their growth spurt at around 15 for girls and 17 years for boys, though there are exceptions.

THE BENEFITS OF RHINOPLASTY SURGERY

Cosmetic rhinoplasty can reduce the size of a large nose, narrow nose that is too wide, straighten a nose that is crooked, eliminate bumps, reshape the tip and improve the relationship between the nose and other facial features such as the lip and chin. Additionally a rhinoplasty can also provide a stronger bridge, enhance nasal tip definition and narrow the base of the nose for a more defined look. A good rhinoplasty result seeks enhancement of the eyes with nasal harmony. Functionally it can increase airflow in blocked noses and may improve sinus problems.

LIMITATIONS OF RHINOPLASTY SURGERY

A rhinoplasty is perhaps the most complex facial plastic surgical procedure. Various patient related factors, as well as the surgeon's experience, confirms the outcome of surgery. The ultimate outcome depends to a great extent on how the tissue heals. Refinements, particularly in the nasal tip area, take up to 12 months to be fully appreciated due to resolution of the post-operative swelling. Please note that rhinoplasty surgery will not always alter your life to the extent that you may expect.

CONSULTATION FOR RHINOPLASTY SURGERY

When considering rhinoplasty surgery your choice of a qualified, experienced rhinoplasty surgeon is of paramount importance. Many rhinoplasty surgeons are trained in Ear, Nose and Throat as well as Facial Cosmetic Surgery, which means you, can expect a highest level of expertise from your surgeon. During the consultation, a thorough medical history is obtained. The nose is examined in detail, both externally and internally. Occasionally an endoscope may also be used for internal examination. Photographs are taken and digital manipulation is carried out to help you understand the surgical procedure and expected results. You can expect a thorough explanation of the surgeon's expectations and risks involved in surgery.

SPECIAL CONSIDERATIONS

These include a degree of nasal refinement or change desired and its effect on nasal function. How the shape of the nose relates to the overall contour of the face and specific facial features are also considered. The aesthetic benefits of chin reduction or augmentation in relation to the rhinoplasty are also considered. Texture and thickness of the skin, strength of the underlying cartilage and its effect on the eventual outcome are considered. Skin colour and ethnic background also play a major role. Occasionally cartilage from the ear or rib may have to be taken in rhinoplasty to help rebuild the nasal shape.

HOW IS SURGERY PERFORMED?

The procedure is performed under a general or local anaesthesia, which means you, will be asleep throughout the procedure. Depending on the correction required the procedure might be carried out using an internal (endonasal) or external (open) approach. In the endonasal approach, cuts are made only inside the nose where they are not visible. In the external approach or open rhinoplasty, these cuts are joined with a small cut in the area of the skin separating the nostrils. Following this the underlying bone and cartilage are sculptured to create a desired shape. Skin is re-draped over new framework and all incisions are closed with stitches. After this a small cast is placed on the nose. Packs are not generally placed inside the nose, in order to avoid any discomfort involved in removing the packs. The whole procedure takes approximately 2-3 hours depending on the complexity of the nose.

POST-OPERATIVE PERIOD AND TIME OFF

The nose will feel blocked after surgery with some pain and discomfort. There may be swelling and bruising around the eyes, which may peak in the first 1-2 days following surgery. You will be advised to sleep in a "head up" position and use ice pack which help to reduce the swelling and bruising. Routine activities may be resumed within two weeks of surgery, but strenuous exercise is restricted for three weeks and contact sports, diving or weight lifting for six weeks. Air travel may be resumed about a week following surgery and spectacles may be worn on the bridge of the nose after six weeks. Some minor residual swelling can persist for several weeks and the final refinement can take several months to settle depending on the thickness and quality of the skin.

COMPLICATIONS OF RHINOPLASTY SURGERY

Complications are infrequent and usually minor, but include infection, nosebleeds and anaesthetic reactions. You may also notice minor nasal irregularities. In cases of open approach rhinoplasty or nostril narrowing procedures, external scars are visible, but tend to be inconspicuous.

It should be noted that in approximately 1 case out of 20, a second procedure (revision rhinoplasty) might be required. Such cases are unpredictable and can happen to any patient, even in the hands of the most skilled and experienced surgeons.