Rhinoplasty is an operation designed to re-shape the nose and / or improve the function of nasal respiration. The need for surgery may be as a result of trauma (and hence covered by ACC). Surgery may focus on the tip of the nose which is cartilagenous or the dorsum (back) of the nose which is bony. Often both these areas are refined together to give an overall aesthetic and functional improvement which is in harmony.
The surgery is most often performed through an ‘open approach'. I find this technique to give by far the best exposure for performing both cosmetic and reconstructive rhinoplasty, which range in difficulty from simple alterations to major total nasal reconstruction in certain congenital condition. There is a small incision on the columella (the strip of skin that joins the tip of the nose to the upper lip), with the rest of the incisions being placed inside the nose itself. The scars are usually extremently difficult to see and this approach provides the exposure which is required for precise and accurate surgical alterations to the nasal framework (bone and cartilage).
If alterations to the inner workings of the nose are required to improve breathing, then this can be performed through the same surgical approach.
During the consultation we will spend a significant amount of time discussing the exact requirements of surgery and what you nasal shape you hope to achieve. It is essential for me to understand precisely what you wish to alter and in what way so we can achieve the best surgical result.
What to expect from Surgery
The surgery can be performed as a daycase procedure or you may prefer an overnight stay. It will usually be performed under a general anaesthetic. There will be a splint placed on the nose at the end of the operation which will be in place for one week. The sutures at the columella will also be removed after one week, with the rest of sutures inside the nose being dissolving.
Rhinoplasty is not a painful operation and most patients are surprised at how little actual pain there is. You will however feel quite ‘stuffy' and may get some swelling and bruising around the eyes. Most of this will settle in seven to ten days.
You may anticipate returning to work in 10 to 14 days. The nose however will be delicate for 3 months and will take this time to reach maximum strength. For this reason contact sport should be avoided. Exercise may be commenced at about 2 weeks at a gentle pace, gradually building up to full activity in 6 weeks.
Rhinoplasty is a common aesthetic and reconstructive procedure and has a very high patient satisfaction rate. However it is also one of the most difficult to perform well and even amongst plastic surgeon, only a subset would routinely do this procedure. For this reason, it is essential that you do your research as to who you would like to have perform the surgery for you. The most important part of the procedure is the preoperative consultation so a precise understanding of the patient's wishes and limitations of surgery can be communicated.