Nose and septum reshaping
The Procedure
Nose reshaping (rhinoplasty / nose job) is a procedure designed to improve both the appearance of the nose and/or the nasal airway. It addresses the bony and soft tissue structures of the nose to leave them looking symmetrical and natural. This procedure is carried out under a general anaesthetic and most last between 1 and 2 hours.
Depending on what is required, the nose can either be reduced or built up in size using your own cartilage and tissue. No artificial substances will ever be used in this process. The tip of the nose is a particularly challenging area to deal with and small cartilage grafts plus dissolvable stitches can be used to reshape and position the framework in order to give a subtle but defined improvement.
This operation can be performed either through an open or closed approach. The open approach necessitates a small scar camouflaged by the base of the nose and is useful for a slightly more complex reshaping of the nose whereas the closed approach is carried out within the nose leaving no external scar. With the open approach, very small stitches are inserted at the base of the nose. Both approaches have internal stitches inserted which dissolve away over 2-3 weeks.
Septal surgery (Septoplasty) can be carried out whilst performing nose reshaping or as a separate, stand alone procedure. This usually takes 30 – 40 minutes and is performed within the nose leaving no external scars. It is designed to improve the airway by re-aligning the cartilaginous and bony components of the nasal septum. It has no effect on the external nasal contour and, when performed as a single procedure, is well tolerated as a day case procedure with no external changes seen at all.
A splint will be placed over the bridge of the nose after rhinoplasty and this, along with any outer stitches, will be removed between 5 and 7 days.
Although an overnight stay is usually advised for complex rhinoplasty, less advanced rhinoplasty procedures and septoplasty can be performed as a day case.
Revision surgery is unusual but occasionally necessary, but it is sensible to let the initial surgery settle for at least 6-12 months before acting.
Post-operative care
In order for you to achieve the best result from your surgery, it is important to have post operative follow up. Nose blowing and direct trauma should be avoided for 2–3 weeks afterwards.
Bleeding There is some bleeding after the operation but this is usually minimal. If there is slightly more than expected, small spongy packs can be inserted at the end of the operation and removed before you go home.
Bruising and Swelling
This lasts 7-14 days but can be vary depending on skin type. Internal swelling may cause nasal blockage that can last up to 3 weeks. It is relieved using mild nasal steroid drops (Betnesol) which will be prescribed for you. There may be some subtle swelling of the nasal tip for up to 6 months.
Infection
Post operative infection is rare but to reduce the risk, an antibiotic cream is applied for a week.
Pain
Pain can be mild to moderate but responds well to paracetamol, anti-inflammatories and codeine.
Numbness
Numbness of the nasal tip will resolve but may last as long as 6 months. This also applies to subtle swelling of the tip.
Scarring
The scar at the base of the nose from the open approach is very small and well camouflaged. The same applies to the tiny single incisions on either side of the nose used as an access point to narrow the nasal bones.
The perfect nose is unattainable but my team and I will do everything possible to improve your nasal contour and airway as much as possible. To this end, it is important to have reasonable expectations as to what can be achieved with surgery based upon your consultation and the complexity of the surgery envisaged.