A rhinoplasty procedure can reduce or increase the size of the nose, change the shape of the nose tip, narrow the width of the nostrils or change the angle between the nose and the upper lip.
Preparing for a rhinoplasty surgery
Every patient wishing to have a rhinoplasty in Bristol will have undergone a full consultation with Paul so that patients are made fully informed and comfortable before undergoing rhinoplasty surgery.
The hospital in Bristol where your rhinoplasty surgery is taking place will provide patients with full detailed written instructions on preparing for rhinoplasty surgery.
Unless a very minor rhinoplasty is needed, surgery will be performed under general anaesthetic, so you must not eat or drink 6 hours before the rhinoplasty operation.
You will need to stay in hospital overnight after your rhinoplasty.
Recovering from a rhinoplasty surgery
When you wake up after your rhinoplasty there will be small packs in each nostril so you will have to breathe through your mouth until the next morning when they will be removed. If the bones in your nose have been moved you will also have a plaster of Paris cast on your nose, which will stay on for a week.
Recovery from rhinoplasty is quite quick but the nose will feel fragile for a month or so and you will need to take things easy. Nasal bones only take 2 to 3 weeks to heal up but the swelling is the main effect of rhinoplasty surgery that you will notice. The amount of swelling and black eyes a patient gets varies considerably. It starts to go down very quickly at first but the rate slows down and the last little bit of swelling may take up to a year to settle. You should, however, notice an improvement straight away and you should be presentable after 10 days or so.
Watch the Treatment
I am incredibly pleased with the result of my rhinoplasty. The care I have received from Mr Wilson and his team has been and continues to be fantastic.
Frequently Asked Questions
The best candidates for rhinoplasty are healthy individuals who are looking for improvements – not perfection – in the appearance of their nose, or who have breathing problems within their nose. In addition to realistic expectations, good health and psychological stability are important qualities for a patient considering rhinoplasty. Age may also be a consideration. Many doctors prefer not to operate on teenagers until after they have completed their growth spurt – usually at about 14 or 15 for girls, a bit later for boys. It is important to consider a teenager’s social and emotional adjustments and to make sure the surgery is what they, not their parents, really want.
The way rhinoplasty surgery works depends on which type of operation is needed:
- Augmentation rhinoplasty – this type of rhinoplasty surgery bulks out the nose and raises the bridge. It is most often used in cases of ‘saddle nose’. Through a cut either inside or between the nostrils, a framework formed of the patient’s own bone and cartilage or artificial implantable materials is inserted to create the desired shape.
- Reduction rhinoplasty – this technique is the more common type of rhinoplasty surgery. It does exactly as it says: reduces the size of the nose. This can be the overall size or a specific part, such as the tip or a bump in the bridge. The surgeon removes cartilage and/or bone through cuts made inside the nostrils. Sometimes the nostrils may also need to be reduced to keep facial features in proportion, leaving a fine scar on each.
Both forms of rhinoplasty take 1-2 hours, with the patient under either general anaesthetic or local anaesthetic with sedation.
During surgery the skin of the nose is separated from its supporting framework of bone and cartilage which is then sculpted to the desired shape. The nature of the sculpting will depend on the nature of your problem and your surgeon’s preferred technique. To remove a nasal hump a special file is used. A refined nasal bridge is formed by bringing together the nasal bones on either side of the face. In patients found to have the side of the nasal tip too large, some cartilage is removed. The angle between the nose and upper lip can be improved by elevating and trimming the septum, the dividing wall between the two chambers of the nose. In some cases, it is necessary to narrow the base of the nose. This procedure involves removal of skin from both sides of the nostrils at the centre. In order to improve the nasal contour, it is sometimes necessary to add tissue. Finally, the skin is re-draped over the new framework.
There are two types of rhinoplasty. The open rhinoplasty approach, which is preferred by Mr Wilson, involves making a small incision across the columella, the vertical strip of tissue separating the nostrils, allowing the surgeon to see the entire structure of the nose. When the surgery is complete a splint is applied to help your nose maintain its new shape. Soft plastic splints may also be placed in your nostrils to stabilise the septum, the dividing wall between the air passages.
Rhinoplasty includes a range of procedures that aim to improve the appearance or function of the nose. Rhinoplasty can be carried out by two different methods—closed and open rhinoplasty. A closed rhinoplasty uses an incision hidden within the nose, whereas during open rhinoplasty the main incision is across the columella, which is the small piece of tissue connecting the nostrils. Rhinoplasty can be further broken down into specific nose surgeries that aim to modify various portions of the nose:
- Radix Modification Rhinoplasty brings the radix (the area where the nasal bridge meets the forehead) in harmony with the bridge and tip.
- Nasal Dorsum Rhinoplasty is a rhinoplasty procedure that modifies the bridge of the nose.
- Tip Modification Rhinoplasty can adjust the tip’s elevation, reduced it in size or alter its definition and projection.
- Nasal Base Rhinoplasty is a rhinoplasty procedure that alters the size and shape of the nostrils.
- Lateral Osteotomy Rhinoplasty involves the controlled fracturing of nasal bones to either narrow or widen the nose, or to straighten out misalignment.
- Premaxillary Augmentation Rhinoplasty uses implants at the base of the nose to increase the projection of the tip, or to lengthen the upper lip.
When you’ve made the decision to undergo rhinoplasty surgery the last thing you want to do is have to wait, particularly if your body image is causing you considerable discomfort.
There are a number of finance options available for cosmetic surgery. If you choose to have your surgery at Spire Bristol Hospital you may be viable for a 0% loan from First Medical Loans. Spire Healthcare and First Medical Loans offer a 0% APR loan to approved customers of cosmetic surgery.
For more information call First Medical Loans on 0845 618 5375 or visit their website.
The Rhinoplasty should be done at a time when you are emotionally ready for it. It should certainly not be an impulsive decision, but one that has been carefully thought out. Once you decide to have rhinoplasty, plan your surgery for a quiet time, when you have at least 10 days to recover – not within several weeks of any major event in your life.
After the rhinoplasty surgery you will have a splint on the outside of your nose, a small gauze at the bottom of your nose and initially you will not be able to see under the splint, as your nose will be swollen. You will notice the swelling and bruising around your eyes will increase at first, reaching a peak after 2-3 days. But you will feel a lot better than you will look. After 5-7 days, when the splint is removed, you will still have a moderate amount of swelling, but most should disappear within about 2 weeks. Some subtle swelling, unnoticeable to anyone but you and your surgeon, will remain for several months. You will see the final results at the top of the nose at 6-9 months, and at the tip between 9-15 months following surgery. During the days following the rhinoplasty surgery when your face is swollen and may be bruised, it is easy to forget that you will be looking better shortly.
Other than feeling a bit drowsy, you should feel pretty good and be able to go home within a few hours following rhinoplasty surgery. Your face may feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with pain medication prescribed by your surgeon. It is not uncommon to feel down right after cosmetic surgery, especially when you look in the mirror and see a swollen face with a splint on your nose. Rest assured that this stage will pass. Day by day, once the split is removed, your nose will begin to look better and your spirits will improve.
Rhinoplasty recovery times vary depending on a number of factors. These include the extent of the rhinoplasty, your body’s immune strength, the skill of your individual surgeon, and how closely you follow the pre- and post-operative care instructions.
The most difficult part of the recovery is the first 24 hours after the rhinoplasty procedure. During this time you will still be feeling the effects of anaesthesia. You should stay in bed with your head elevated and be accompanied by a friend or relative. During the first 48 hours after rhinoplasty headaches and nosebleeds are common, however you should not blow your nose as this can negatively affect the results of your nose surgery.
For the first day after your rhinoplasty keep your head elevated when in bed. You are encouraged to walk but not exert yourself. After the first few days you will be up and about and able to return to work within a week to 10 days. Applying cold compresses will reduce initial swelling and make you feel a bit better. All dressings, splints, and stitches should be removed at 5-7 days. Mr Wilson will schedule frequent follow-up visits during the months following surgery to check on the progress of your healing. If you have any unusual symptoms between visits or any questions about what you can and cannot do, do not hesitate to call Mr Wilson’s office.
For the first 3-5 days following rhinoplasty surgery relax and take it easy. You should be able to return to work within a week or 10 days following surgery. It will be several weeks, however, before you are entirely up to speed. Mr Wilson will probably advise you to avoid strenuous activity (jogging, swimming, bending, sexual relations, any activity that increases your blood pressure) for about 3 weeks.
A little bleeding is common during the first few days following rhinoplasty surgery and you may continue to feel some stuffiness for several weeks. Your surgeon will probably ask you not to blow your nose for a week or so while the tissues heal. You should also avoid hitting or rubbing your nose or getting it sunburned for 8 weeks. Also, be gentle when washing your face and hair or using cosmetics. If you wear glasses they will have to be taped to your forehead or propped on your cheeks for about 4 weeks until your nose is completely healed.
The goal of rhinoplasty is to create a natural looking nose that matches your face. Chances are that if you had a huge bump on your nose and made a radical change, people will notice that you have had surgery. If, however, the changes were more subtle, others may not know that you had surgery, but notice that you look great, even if they are not sure why! That is the sign of a great rhinoplasty.
The best way to minimise bruising after rhinoplasty is not to use any products containing aspirin for at least 2 weeks pre-operatively and 2 weeks post-operatively. There are some suggested post-operative homeopathic remedies for patients undergoing cosmetic surgery. Mr. Wilson recommends the following: Arnica gel which helps minimise swelling after cosmetic surgery and promotes healing; Vitamin C, daily for 2-3 weeks following surgery which helps promote healing; and Zinc, once a day, for 2-3 weeks following cosmetic surgery, which helps with bruising and promotes tissue repair. Non-steroidal anti-inflammatory tablets such as Ibuprofen 200mg three times a day will also help reduce the inflammation. A cooled topical gel shield can also be applied with care not to displace the nasal splint.
With the method of rhinoplasty performed from within the nose there are no visible scars. Using the open rhinoplasty procedure the scars are often imperceptible.
The best news if you are pleased with the results of your new nose, is that your nose will age as gracefully as you do, as the procedure lasts a very long time.
You should follow all pre- and post-operative care instructions given to you by your cosmetic surgeon, these are specifically designed to reduce your recovery time and maximise the results of your rhinoplasty. Before a rhinoplasty procedure, your cosmetic surgeon will give you personalised instructions in preparation, this is known as pre-operative care. These instructions will include reducing your alcohol consumption and stopping smoking two weeks before nose surgery. Drinking alcohol and smoking can decrease your body’s ability to heal, therefore by stopping drinking and smoking your body is better able to recover after your rhinoplasty. If you smoke you must stop or Mr Wilson will not operate on you.
The most important first step is to discuss your procedure with an accredited plastic surgeon who has a true expertise in rhinoplasty; as rhinoplasty is the most difficult operation to obtain consistently good results in cosmetic plastic surgery. Gather as much information as possible about rhinoplasty– including the recovery, any potential risks and complications, the costs, type of facility where the cosmetic surgery will be done and what type of anaesthesia will be used. It is good to use computer imagery which allows you to see what you will look like following your rhinoplasty. Good communication between you and your surgeon is essential. Make sure you are comfortable and confident with the surgeon who will be performing the procedure. Being an informed and educated patient is critical.
During the two-week period before your rhinoplasty, you should not take any medications which contain aspirin because aspirin has an effect on your blood’s ability to clot and could increase your tendency to bleed during the Rhinoplasty and during the postoperative period. If you need minor pain medication you can take regular Paracetamol and Ibuprofen. If you are taking any vitamins, herbal medications or supplements notify your surgeon, as these can also cause problems during the rhinoplasty. Mr Wilson may ask you to stop taking your medications or supplements for the two-week period prior to your surgery. Some homoeopathic remedies taken prior to surgery can result in less pain and bruising, less scar tissue and better overall healing.
Be sure to arrange for someone to drive you home after the rhinoplasty and to help you out for a few days if needed.
The major contraindication is serious health problems, such as a cardiac or pulmonary condition. Since rhinoplasty is elective surgery involving the use of anaesthesia the benefits should be carefully weighed against the risks. For a healthy individual risks are minimal, but for someone with a significant medical condition, a more careful evaluation is vital. If, after a consultation with Mr. Wilson and medical clearance by your own doctor, you choose to proceed with the rhinoplasty, it will be done in a controlled setting in a hospital under general anaesthesia.
Important questions include: How much experience do you have in rhinoplasty? How many of these surgeries do you do every year? Are you an accredited plastic surgeon? Do you have access to photo imaging so I can see on a computer how I will look after the rhinoplasty? Do you do more primary or secondary (corrective) rhinoplasty? What is your revision ratio? Can I see before-and-after photos of some of your patients? Where do you perform the rhinoplasty? What kind of anesthesia do you use?
If you have realistic expectations, a clear vision of the results and good communication with your cosmetic surgeon, the satisfaction rate is over 90% – creating a natural looking nose that fits the shape of your face and makes you smile when you look in the mirror.
Benefits are both physical and psychological. When you feel that you look better, it’s only natural that you will have a better self-image and more self -confidence.
You can expect to feel better about the face that stares back at you in the mirror. If you discussed your expectations thoroughly with your cosmetic surgeon, there should be no surprises. You should have a nose that has been reshaped to look natural and fit your face. Remember, however, that healing after a rhinoplasty is a slow and gradual process. Some swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for up to 12-15 months.
With any type of cosmetic surgery, there are risks. Your choice to undergo cosmetic surgery is based on the comparison of the risks with the potential benefits. When rhinoplasty is performed by a qualified accredited plastic surgeon with expertise in rhinoplasty, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, nosebleed, or a reaction to the anaesthesia. While unusual, one of the possible risks of the rhinoplasty is bleeding. Should significant post-operative bleeding occur, it may require emergency treatment to stop the bleeding, or even require a blood transfusion in rare situations. If an infection occurs, which is also highly unusual, additional treatment including antibiotics may be necessary. After rhinoplasty, small blood vessels may burst and appear as tiny red spots on the skin’s surface. These are usually minor but may be permanent.
When rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an “open” technique is used or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible but abnormal scars may occur, both within the skin and the deeper tissues. Scars may be unattractive and of a different colour than the surrounding skin. There is also the possibility of visible marks from sutures. While very rare, additional treatments, including surgery, may be needed to treat scarring.
Deeper structures such as nerves, tear ducts, blood vessels, and muscles may be damaged during the course of surgery and this may be temporary or permanent. The potential for this to occur varies with the type of rhinoplasty procedure performed. Other possible risks of rhinoplasty include: numbness or loss of skin sensation in the nasal skin; asymmetry – a variation from one side to the other side of the nose; an allergic reaction to tape, suture material or topical preparation (only reported in rare cases); delayed healing or wound disruption which may require frequent dressing changes (more common among smokers); nasal septal perforation that may require further surgery (also a rare occurrence); nasal airway alterations which may require further surgery (also a rare occurrence); and nasal airway alterations which may interfere with the passage of air through the nose. You may also have complications from surgical anaesthesia. While rare, there is the possibility of complications, injury and even death from all forms of surgical anaesthesia or sedation. Although the majority of patients do not experience these complications, you should discuss each of them with your doctor to make sure you understand any risks, potential complications and consequences of rhinoplasty.
In about one case out of 20, a second procedure may be required – for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons. The corrective surgery is usually minor.
There is really no alternative to rhinoplasty that will produce the same results of reshaping your nose. The alternative is the choice not to undergo the surgery. Certain internal nasal airway disorders may not require surgery on the exterior of the nose. Risks and potential complications are associated with alternative forms of treatment that involve surgery, such as septoplasty; to correct nasal airway disorders.