Rhinoplasty: Rhinoplasty is a surgical procedure to reshape or reconstruct a person's nose. It can be required after an injury, in order to aid breathing difficulties, because of a birth defect or undertaken for personal reasons. The two main types of rhinoplasty surgeries are reconstructive and cosmetic. It is the most common of all facial plastic surgeries and post surgery it can help improve breathing and create the effect of balancing a facial appearance.
Reconstructive Rhinoplasty
In reconstructive rhinoplasty the aim is to treat problems with breathing from natural causes or from external injuries. A person suffering from sleep apnoea or who has difficulty in breathing under exercise may have a nasal obstruction as the underlying problem. This can be caused by a number of reasons and a doctor's examination is required to determine the cause.
Septal deviation, when the midline wall of the nose (the septum) is crooked or pushed to one side, is a major contributing factor in many cases. Surgery (known as septorhinoplasty) can help to realign the septum and address any other underlying issues that may be present. This may include inserting cartilage grafts in key internal areas of the nasal passage to strengthen the shape of the nose and septum.
Reconstructive rhinoplasty and septorhinoplasty is normally performed under a general anaesthetic by a qualified surgeon and most people can expect to return home after surgery the same day. If your surgery is not complex or difficult the surgeon may suggest a local anaesthetic, but this will be discussed with you during the consultation phase. The surgery process involves an incision being made at the base of the nose to allow access to the internal areas. In many cases the bones of the nose are not required to be broken but are reshaped and adjusted to allow for easier breathing and alignment of the septum. At this stage cartilage may be removed and/or adjusted to strengthen the nose and provide a more uniform shape. Splints or casts may be applied to help keep the nose in shape, reduce swelling and aid recovery.
The points where the incisions at the base of the nose are placed are carefully chosen to reduce noticeable scarring and many patients will not see any visible scars once the wounds have healed. Recovery periods are broadly similar for all patients of reconstructive rhinoplasty and they will be advised to rest for one or two weeks. This means avoiding any exertion or heavy breathing for at least one week. Ice should also be applied to the affected area to aid recovery along with a directed program of nasal cleaning.
A follow up appointment will be made to remove any splints or cast from the nose and at this point you should be able to return to work and normal daily life. It is advised to avoid any contact sports or sports that involve an accidental risk of your nose being struck (i.e. racquet sports, ball sports etc) for six to eight weeks after your operation. After this time the nose should have healed sufficiently for you to continue life as before.
Cosmetic Rhinoplasty
Reshaping a nose for personal reasons is known as cosmetic rhinoplasty surgery and is considered an elective surgery. This means that health insurance companies may not cover the cost of the procedure or any subsequent follow-up consultations and procedures. It may be possible to have cosmetic rhinoplasty at the same time as a reconstructive operation which is being performed under an insurance scheme or through the National Health Service via a recommendation from your GP.
There are many reasons for wishing to undergo cosmetic rhinoplasty:
- Correction of a bulbous nasal tip.
- Reduction in width of the nasal bones.
- Removal of humps or protrusions.
- Reduce or widen nostril size.
- Removal of scars or blemishes.
- Reshape a curve or twisted nose.
All of these reasons and more can be treated with cosmetic rhinoplasty but any surgery decision should be discussed with your GP in the first instance, before a consult by an expert plastic surgeon. A tailored plan should then be constructed for you as an individual alongside a realistic expectation about the outcome of any surgery. It must be considered that not all people may be suitable candidates for cosmetic rhinoplasty. This may be due to an individual's skin and bone structure, medical history, possibilities of adverse reactions or risk of making the matter worse.
A physical examination will be undertaken by your surgeon to assess what areas can be changed. This will determine the thickness of your skin, bone and cartilage, and may also be used to predict any changes in your breathing that could occur post-surgery. You will be asked about your expectations of surgery and why you want any rhinoplasty to be performed. It is normal to feel self conscious at this point; no-one likes to discuss what they see as imperfections in themselves, but it is vitally important that the surgeon sees you have thought through the process and fully understand the possible risks and potential outcomes of surgery.
As with reconstructive rhinoplasty the surgery will take place either under a general or local anaesthetic. After the procedure you will be moved to a recovery room for observation and to allow you to return to being fully awake and aware. Dependant on your circumstances you may be have an overnight stay before being discharged, or you could be allowed to leave after tests and observations are completed.
What to Expect Following Rhinoplasty Surgery
It is normal for bruising to appear around the eyes and while this may look worrying, it will reduce over the recovery period. You will be advised to rest for at least seven days after surgery with your head in a raised position to reduce swelling and bleeding. Due to the nature of the surgery there may be a feeling of congestion and of your nose being blocked. It is essential you do not blow your nose or try and forcibly remove any blockage as you may cause damage to the healing process.
There is likely to be some leakage of blood and mucus, and your surgeon will provide a drip-pad to absorb any fluids draining from your nose. This affixed in place with tape and will need to replaced as directed by the post surgery instructions. You may also be asked to follow extra precautions such as:
- Try not to laugh or use extreme facial expressions.
- Avoid jogging and other strenuous activities, especially contact sports.
- To be careful when brushing your teeth to avoid movement and bumping of the top lip.
- Eat a high fibre diet until the recovery period has ended. This may seem a bit strange but the theory is a high fibre diet will avoid constipation and thus avoid any straining and subsequent pressure to the surgery area.
- Do not wear spectacles or contact lenses.
In some cases of rhinoplasty surgery there may be localised swelling that can last up to a year. This is completely normal, but if there are any concerns about the results of surgery and recovery then do not hesitate to contact your surgeon for advice.
If you require further surgery it will not normally be arranged until at least 12 months after any previous rhinoplasty procedures. This is due to the changes the nose can make during this time as it adapts to the initial surgery.
UK Rhinoplasty Questions
The other week I was reading through the questions people in the UK ask about rhinoplasty. Many of our web visitors have emailed some interesting enquiries that I thought might be applicable to this blog post. The ones I singled out are, When is rhinoplasty necessary? How much does rhinoplasty cost in the UK? What is rhinoplasty surgery of the nose? How is rhinoplasty surgery performed? When can you shower after rhinoplasty? How should you sleep after rhinoplasty? Can rhinoplasty reduce nostril size? I hope that nearly all of these questions have been covered somewhere on this page, and if some remain unanswered a rhinoplasty "Questions and Answers" feature is a feature we will be introducing very soon. My thanks go out to the following folks in the UK for taking the time to pose their excellent questions; Xavier Thomas, Francis Mcdonald, Maddox Mccarthy and Avery Gould. We also got queries from Sadie Manning in Edinburgh, Landon Eaton in Greater Manchester and Sophie Lister in Belfast.
UK Rhinoplasty Procedures
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