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Rhinoplasty (Nose Re-shaping)
Rhinoplasty, or surgery to reshape
the nose, is a common plastic surgical procedure. It can be used to increase or decrease the size of the nose.
When combined with surgery to the septum (septoplasty) it can also help to
correct breathing problems. The commonest operation is a reduction rhinoplasty,
to reduce the size of one or more components of the nose: the bridge, the tip or
the nostrils.
The nose is a central part of the face, and its shape has a profound effect
on the appearance of the whole face. It can be changed, but it is important
to change it in a way that fits the rest of the face. This is particularly
the case with people with strong ethnic features. Conversely, sometimes the
proportions of other parts of the face influence the appearance of the nose;
for instance a receding chin may make the nose look larger, and the problem
may be best solved by augmenting the chin.
The operation of reduction rhinoplasty.
The operation is carried out under general anaesthetic and usually involves
one night stay in hospital. You will have a splint which will remain for
about a week to ten days. When the splint is removed, you fill find some
swelling and bruising around the nose and eyes and this will last up to
three weeks. Others will not notice this as much as you. It takes a good
three months for all the tissues to settle down into their final shape and
for the feeling to come back completely, particularly at the tip.
The operation reduces the size of the bones and cartilages of the nose.
Cuts are made inside the nostrils and do not usually show on the outside,
and the whole operation is carried out from the inside of the nose. The
bones of the nose are broken to narrow the nose, a hump can be removed,
and the nose shortened. Where the tip needs refining, this is sometimes
best done by an external rhinoplasty, which leaves a small scar on the underside
of the nose.
When you go home, you may notice some minor bleeding from your nose for a
day or two, and if this occurs just dab it gently. Sneeze with your mouth
open to reduce the pressure on your nose, keep your head up as much as
possible to reduce swelling, and do not blow your nose.
Risks of the operation
You should be aware that any operation carries risks. There is the risk of
the general anaesthetic, of chest infection, particularly among smokers.
Bleeding - There are very
occasionally problems with bleeding during or after surgery. Do not take any aspirin or anti-inflammatory medications for
ten days before surgery, as this contributes to a greater risk of bleeding.
High blood pressure that is not under good medical control may cause
bleeding during or after surgery.
Infection - This is unusual
after surgery. Should an infection occur, additional treatment including antibiotics may be necessary. Cartilage
grafts, if used, may require removal should an infection occur.
Scarring - Although good
healing is expected after an operation, abnormal scars may occur within the skin and deeper tissues. Sometimes the sutures
leave visible marks
Difficulty with breathing - There is commonly some difficulty with
breathing through the nose in the first week after the operation. It usually
disappears as the swelling settles down. Occasionally it persists and may
be permanent.
Numbness - There is the potential for diminished sensation or even
permanent
numbness within the nasal skin after tip rhinoplasty. This is
unpredictable.
Unsatisfactory result - In about 10% of patients the nose does not look
right for the patient even after all the swelling has settled. Sometimes
there are visible or tactile deformities. It is usually possible to carry
out another operation to rectify the problems, but one must wait at least a
year for all the swelling to settle down and the scarring to mature. The
secondary surgery is more difficult and may entail additional expense.
Cartilage grafts - These may be needed if the goal of surgery is to
change the projection of the nasal tip. These grafts are obtained either from
within the nose or other parts of the body.
Asymmetry - The human face is normally asymmetrical. Variation from one
side to the other may result from a tip rhinoplasty procedure.
Elaine Sassoon,
AB Hons (Harvard
University),
FRCS(Ed & Eng),
MB BS (University College Hospital Medical School),
FRCS(Plast)
Diploma in Aesthetic and
Oculoplastic Surgery
GASPAR ANASTASI Award,
Aesthetic Society (USA) 2000
Appointments available at:
BUPA Hospital, Hill House Consulting Rooms,
Old Watton Road,
Norwich, NR4 7TD
&
Norfolk & Norwich University Hospital,
Colney Lane,
Norwich, NR4 7UY
Contact Information
- Telephone / Appointments
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- Pauline Osborne (+44)
01603 279805
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- FAX
- (+44) 01603 279805
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- Postal address
-
-
Hill House Consulting Rooms BUPA Hospital, Old Watton Road, Norwich, Norfolk, NR4 7TD
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- Electronic mail
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- pauline@the-coach-house.fsnet.co.uk
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