Rhinoplasty is an operation designed to change the appearance and/or improve the function of your nose. There are several components to your nasal shape that you may wish altered in some way. These include the profile from the side view, the length or width, or the shape of the tip and the nostril openings. The most common concerns include a “bump” of the nose, a crooked nose or a bulbous nose tip. Breathing difficulties may be a concern, particularly following previous fracture of the nose (broken nose).BEFORE AND AFTER PHOTOS
The changes you wish to achieve may require altering the bones and cartilages that make up the skeleton of the nose. The lining of the nasal passageways or even the skin covering may also be changed. It is important to be clear about the changes you want and to agree with your surgeon on realistic goals before surgery.
When assessing your nose, the balance of your facial features will also be assessed and discussed with you. It is not uncommon for the chin projection to be mentioned when discussing the nose. In this situation, chin augmentation (genioplasty) may be discussed with you. The profile of the nose can be altered. These options will be discussed and clarified with you at the time of consultation.
There are two main approaches to rhinoplasty. Firstly a closed approach is done through the nostrils with no external stitches. Secondly, an “open” approach is done via a small incision under the base of the nose. This gives better access to work on the skeleton of the nose and may be preferred when more complicated work is required.
How long does it take?
Do I have to stay in hospital?
What happens after surgery?
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.
When can I return to normal activities?
Are there any risks?
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 and infection are generally uncommon with nasal surgery. This is due to the superior blood supply of the nasal tissues.
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.
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.
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.
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.
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.
What about costs
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.
**Individual results may vary. All surgery carries risks.
You should get a second opinion from an equally qualified Specialist Plastic Surgeon before proceeding with surgery.