The nose has a great impact on how a person looks in addition to all the important function – breathing. External nasal irregularities may cause concerns, blockage and even snoring, all of which can affect quality of life. Nasal surgery can address these issues. Some aspects of rhinoplasty are discussed in the following section.

Pre-requisites for rhinoplasty include good health and realistic expectations. There is no perfection in rhinoplasty, but the aim is to improve the nose functionally and aesthetically, to blend it with other facial features. Age is a consideration – we prefer not to operate on teenagers until after they have completed their growth spurt at around sixteen for girls and seventeen for boys, though there are exceptions.

Cosmetic rhinoplasty can decrease or increase nasal size, straighten a bent or crooked nose, remove bumps, reshape the tip, a create stronger bridge and improve breating.

A rhinoplasty is perhaps the most complex facial plastic surgical procedure. Various patient related factors, as well as the surgeon’s experience, will determine 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 12 months or longer. Please note that rhinoplasty surgery may not alter your life to the extent that you may expect.

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 outcomes and risks involved in the surgery.

These include the degree of nasal refinement or change desired, and its effect on nasal function. 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.  Other facial features such as the size and shape of the chin etc are considered.

The procedure is performed under a general or local anaesthesia, which means patients 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 two to three hours depending on the complexity of the nose and may even take longer.

The nose will feel blocked after surgery with mouth breathing causing a dry throat. Blood stained mucous discharge through the nostrils and at the back of the throat is to be expected, and lasts for two to three days. There may be swelling and bruising around the eyes, which may peak in the first one to two days following surgery. The pain is minimal. The nose will appear larger and swollen for a few weeks but settles gradually. 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 one week.

Complications are infrequent and are usually minor, these include but not limited to infection, nosebleeds, persistent swelling and bruising, poorly healed scar, minor nasal irregularities, perforation of the nasal septum, persistence of the nasal hump etc. Please note that one patient out of twenty, may require a second procedure (revision rhinoplasty). This is unpredictable and can happen to any patient, even in the hands of the most skilled and experienced surgeons.

Please ask all questions you may have, and ascertain that your questions have been answered satisfactorily before you proceed to surgery.

Understand that this is lifestyle surgery and not an essential operation and should be considered a major intervention.


Procedure time1 - 4 Hours depending on complexity
General/Local anaestheticGeneral
No. of nights in hospitalDay Case
Time off work2 Weeks
Restrict activity3 Weeks
Back to normaility / sports3 Weeks

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PRACTICE MANAGER: Chelsea Fulton 07534 771264 MEDICAL SECRETARY: Karen Harris 07453 881588
CORRESPONDENCE ADDRESS: Enso House Crayfields Business Park, 3 New Mill Road, Orpington BR5 3TW | Tel: 01689 490119 | Fax: 01689 873221