Rhinoplasty (nose surgery) is a surgical procedure to improve the function (reconstructive surgery) and/or the appearance (cosmetic surgery) of your nose. Rhinoplasty is also commonly called a "nose reshaping" or "nose job".
Reconstructive nose surgery is performed to correct trauma, birth defects or breathing problems.
Cosmetic nose surgery enhances facial harmony and self confidence. It can also make you look younger. It can be be combined with other surgical procedures such as chin augmentation to enhance aesthetic results.
Before rhinoplasty
After rhinoplasty
Before rhinoplasty
After rhinoplasty
Procedure rhinoplasty
Normally a rhinoplasty should be performed under general anaesthesia. If only small corrections are necessary local anaesthesia could do.
Rhinoplasty normally requires one to two hours in surgery, depending on the amount of nose reshaping to be done.
Incisions are made inside
the nostrils. Mostly, a tiny, inconspicuous incision is also made across the columella, the bit of skin that separates the nostrils. The surgeon first separates soft tissues of the nose from the underlying structures, then reshapes the cartilage and bone.
Most patients remain at home for a week. If tampons have been left inside your nose they will be removed 3 to 4 days after surgery. If there are external sutures, they are usually removed 7 days after surgery. The external cast is removed at the same time.
The periorbital bruising usually lasts two weeks. Due to wound healing, there are minor and subtle shifting and settling of the nose over the first year.
In some cases, the surgeon may shape a small piece of the patient's own cartilage or bone to strengthen or change the structure of the nose. Usually the cartilage is harvested from the septum although if there isn't enough which can often occur in revision rhinoplasty, cartilage can be taken from the concha of the ear or rarely the ribs.
In the rare case, again usually revision rhinoplasty, where bone is required, it is harvested from the cranium or ribs. We never use synthetic implants as they cause a lot of problems, chief of which isinfection.
To improve nasal breathing function, a septoplasty may also be performed. If there is turbinate hypertrophy, an inferior turbinectomy can be done.
Complications rhinoplasty
There are several complications that can arise in rhinoplasty, although it is usually considered to be safe and successful. Postoperative bleeding is uncommon and often resolves without needing treatment. Infection is rare and can occasionally progress to an abscess that requires surgical drainage under general anesthetic.
Sometimes you end up with a slightly asymmetrical nose, which can be surgically corrected. Adhesions, which are scars that form to bridge across the nasal cavity from the septum to the turbinates, are also rare but cause nasal obstruction to breathing and usually need to be cut away. A hole can be inadvertently made at the time of surgery in the septum, called a septal perforation. This can cause chronic nose bleeding, crusting, difficult breathing and whistling with breathing.
If too much of the underlying structure of the nose (cartilage and/or bone) is removed, this can cause the overlying nasal skin to have little shape resulting in a 'polly beak' deformity. Likewise if the septum is not supported, the bridge of the nose can sink resulting in a "saddle nose" deformity. The tip of the nose can be over-rotated causing the nostrils to be too visible and creating a "Miss piggy" look. If the cartilages of the tip of the nose are over-resected, this can cause a pinched look to the tip.
If an incision is made across the collumella (open approach rhinoplasty) there can be variable degree of numbness to the nose that may take months to resolve.
Secondary rhinoplasty is performed to correct problems that persist or develop after a previous rhinoplasty. Although the problems may be minor and easily corrected, often the problems are major, which makes the secondary rhinoplasty more difficult, requiring more expertise than the primary surgery.
