Rhinoplasty / Nose reshaping

The operation is performed under general anaesthetic and generally takes about two hours.

Usually rhinoplasty involves an overnight stay in hospital. It is possible for the surgery to be done on a day surgery basis if you wish. Pain relief will be prescribed as necessary.

Following the operation, you will have a small splint over the nose for protection. This should stay in place for about one week. Usually, small strip bandages are placed into the nostrils to prevent bleeding. These should not cause undue discomfort and will be removed the morning following surgery.

Your nose will feel strange, somewhat tight and swollen for several days and a degree of swelling and bruising, particularly around the eyes and cheeks, will probably be encountered. Although most of the swelling subsides in one to two weeks, there continues to be some swelling that may take six months or longer to subside. Swelling inside the nose can persist for several weeks and cause nasal stuffiness.

Generally speaking you will be able to engage in social contact by the second week following surgery. It is important for you not to over-exert during the healing period or troublesome bleeding may occasionally occur and require repacking of the nose. Return to work at 2 weeks is usual.

As with any surgical procedure, there is a risk of complication. Surgery and anesthesia are safe and it is most unlikely you will experience any difficulty. However, there are areas of potential problems you need to understand before proceeding with your surgery.

Bleeding

Bleeding and infection are generally uncommon with nasal surgery. This is due to the superior blood supply of the nasal tissues.

Scarring

Incisions or cuts used to perform the surgery are designed to be hidden in such a way that nobody should notice that you have had surgery. The incisions can be either completely internal or may involve a small cut through the base of the nose.

Scarring following surgery can take up to 2 years to mature. However, while great care will be taken to give the neatest incision closure possible, the healing process can be unpredictable and it is possible, although unlikely, that you may be unhappy with some aspect of your incision lines or the shape of your nose.

Nasal shape

Swelling of the nose can affect nasal contour for some months and during this period of settling, improvement in nasal shape can be expected.  It is likely that close scrutiny of your new nasal shape may reveal some small irregularity in contour or symmetry.  Having expectations of improvement with a change of shape rather than perfection is the most likely result in post-operative satisfaction.

Breathing

The nose is part of the airway by which air enters the body during breathing.  By manipulating the nose shape it is possible the nasal air passageway can be altered. You may notice nasal congestion and some restriction to airflow through the nose, particularly in the early post-operative months. This can be expected to resolve as swelling settles. You may also temporarily experience a diminished sense of smell.

Sensation

The tip of the nose often feels numb for some months but this is quite normal and usually recovers completely.  In the first few weeks, there may be a feeling of stiffness or numbness in the upper lip.  This is because swelling in the nose can affect the movement of the lip.  As with all other changes due to this swelling process, it is quite transient. The lip or a front tooth may be numb temporarily.

Anaesthetic

You will be receiving a general anaesthetic and your anaesthetist will be discussing with you possible discomforts following anaesthesia.  Any questions you have regarding your anaesthetic would be best answered by your anaesthetist at the time of surgery.

Costs of surgery will always differ from surgeon to surgeon. There is a range from “cheap and nasty” to ridiculously overpriced in the market place.  Do your homework and be happy with the quality of service and experience you are being offered. Beware of the pitfalls of shopping around for the cheapest costs for this operation as this is the wrong way to choose your surgeon and may leads to disappointment with results. Remember surgery is not like purchasing a TV or a computer.  The product is not a commodity and what you get will differ depending on who you choose to perform your surgery.

It is important to remember that healing continues for some time following surgery as the skin shrinks and adjusts to the new framework. Rarely, the final result may not be what you and Dr Drielsma anticipated. Minor irregularities usually can be corrected with a revision procedure.

The quality of skin overlying the nasal cartilage is an important factor in the final appearance of the nose. Thick and oily skin does not conform as well and may compromise the result. Older skin does not possess the elastic properties of younger skin and may preclude an optimal result.

You should avoid smoking for at least three weeks before and after surgery to assist in the healing process. You should also not take aspirin or aspirin-containing medications for two weeks prior to surgery.

Should there be any questions regarding rhinoplasty, be sure they are answered in advance by Dr Drielsma. Well-meaning friends are not a good source of information. Find out everything before proceeding with the operation.

Finally, there can be no absolute guarantee with any surgery.  Remember, the realistic aim of this operation is an improvement, not perfection.