PLASTIC, RECONSTRUCTIVE & COSMETIC SURGEON

Rhinoplasty

A rhinoplasty is a surgical operation to reshape the nose. The nose is a complex structure consisting of an inner mucosal lining, cartilage and bony support, and skin coverage. Patients may feel unhappy with the appearance of certain parts of their nose. This includes having a prominent hump on the nose, a nose that is too big, too small, or being dissatisfied with shape of the nasal tip. The operation that is performed needs to be tailored to the specific complaint. Generally this involves lifting up the skin of the nose through an incision between the nostrils (open rhinoplasty) to expose the underlying structure and then modifying this carefully to achieve the desired outcome. It is therefore important to identify the part of the nose that you are unhappy with and communicate this clearly.

What should I expect ?

A rhinoplasty is performed under a general anaesthetic and usually takes 1.5-3 hours depending on the technique used and the extent of the operation. You will be admitted on the day of your surgery and you usually need to stay in hospital overnight. After your operation, you will have a small plaster splint applied over the top of your nose to support it. There will also be a pad covering your nostrils to absorb any excess fluid or bleeding. Very occasionally, a nasal pack like a bolster may be inserted into the nostril to control persistent oozing. On discharge, the gauze pad and/or nasal pack will be removed however the splint needs to remain in place for 10 days. The wound should be kept dry until your follow up. In the first week, you should take things easy and avoid too much physical activity. There will be bruising and swelling in the first week which usually settles by the end of the second week. The nose may also feel blocked initially. You will be thought how to use a nasal douche to cleanse and wash the nostrils. Most patients recover fully after 2 weeks however strenuous exercise should be avoided for at least 6 weeks. It is important to note that it is common for the nose to be mildly swollen after the initial 2 week period. This swelling can be persistent and occasionally last 6-12 months

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What follow up will I have ?

Your wounds will be checked at 7 days, at which time any sutures will be removed. Following that, you will have a further appointment at 3 months to review the outcome. The final outcome is usually evident at 12 months

What are the risks and complications ?

A rhinoplasty is a routine operation with the vast majority of patients being happy with the results however it is important you understand the potential risks and complications that can occur

Scarring : You will have a scar across the columella, the bridge of skin between the nostrils. This scar tends to mature well and over time it will become inconspicuous.

Infection : Although uncommon, wound infections can occur and if they do will require a course of antibiotics

Bleeding : Some minor degrees of bleeding is expected after a rhinoplasty and tends to stop by the next day. If there is heavy bleeding, a return to theatre is required to control it

Asymmetry : Subtle differences between the two sides of the nose, usually due to the underlying structural support, can sometimes be seen

Skin irregularity : If the nasal skin is thin, irregularities can sometimes show through. This is again due to the underlying structural support made up of the cartilage and bone

Swelling : There will be some degree of swelling after the operation that is expected. Occasionally this swelling can persist and last for up to 12 months before finally settling

Loss of smell and taste : This can sometimes occur after a rhinoplasty. It is usually temporary, lasting a few weeks, however in some cases may persist longer than expected

Further information can be downloaded here in this Rhinoplasty guide

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