If you’re considering rhinoplasty…
If you’re considering a ‘nose job’ or rhinoplasty, this information will give you a basic understanding
of the procedure-when it can help, how it’s performed, and what results you can
expect. It can’t answer all of , since a lot depends on the individual patient
and the surgeon. Please ask your surgeon about anything you don’t understand.
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The best candidates for rhinoplasty
Rhinoplasty or nose reshaping can enhance your appearance and your self-confidence, but it won’t
necessarily change your looks to match your ideal, or cause other people to treat
you differently. Before you decide to have surgery, think carefully about your
expectations and discuss them with your surgeon.
The best candidates for rhinoplasty are people who are looking for improvement,
not perfection, in the way they look. If you’re physically healthy, psychologically
stable, and realistic in your expectations, you may be a good candidate.
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Rhinoplasty for aesthetics
Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes-to
correct birth defects or breathing problems.
Usually it is thought to be better not to have this operation
before the age of 16, although these are some exceptions.
It is important to consider teenagers’ social and emotional adjustment,
too, and to make sure it’s what they, and not their parents,
really want.
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All surgery carries some uncertainty and risk
When rhinoplasty is performed by a qualified plastic surgeon,
complications are infrequent and usually minor. Nevertheless, there is
always a possibility of complications, including infection, nosebleed,
or a reaction to the anaesthesia. You can reduce your risks by closely
following your surgeon’s instructions both before and after surgery.
After surgery, small burst blood vessels may appear as tiny red
spots on the skin’s surface; these are usually minor but may be permanent.
As for scarring, 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, there
are small scars on the base of the nose but these usually fade well.
In about one case out of twenty, 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.
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Planning your surgery
Good communication between you and your surgeon is essential.
In your initial consultation, Mr Murphy will ask what you’d like your
nose to look like, evaluate the structure of your nose and face, and discuss
the possibilities with you. He will also explain the factors that can
influence the procedure and the results. These factors include the structure
of your nasal bones and cartilage, the shape of your face, the thickness
of your skin, your age, and your expectations.
Mr Murphy will also explain the techniques he will use, the risks
involved and any options you may have. Insurance policies don’t cover
purely cosmetic surgery, but, if the procedure is performed for reconstructive
purposes, to correct a breathing problem or a marked deformity, the procedure
may be covered. Check with your insurer, and obtain pre-authorisation
for your surgery.
Be sure to tell Mr Murphy if you’ve had any previous nasal surgery
or an injury to your nose, even if it was many years ago. You should also
inform your surgeon if you have any allergies or breathing difficulties,
if you’re taking any medication, vitamins or recreational drugs and if
you smoke.
Usually clinical photographs are taken before surgery so that
you can discuss them with your surgeon.
Don’t hesitate to ask any questions you may have, especially
those regarding your expectations and concerns about the results.
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Preparing for your surgery
It may be useful to take Arnica tablets for a few days prior
to surgery to try to reduce the bruising.
Please be sure to arrange for someone to drive you home after
your surgery and to help you out for a few days if needed.
Rhinoplasty is performed under general anaesthetic as an in-patient.
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The surgery
Rhinoplasty usually takes an hour or two, though complicated
procedures may take longer. 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 your
problem and your surgeon’s preferred technique. Finally, the skin is redraped
over the new framework.
If your nostrils are too wide, the surgeon
can remove small wedges of skin from
their base, bringing them closer together.
Many plastic surgeons perform rhinoplasty from within the nose,
making their incision inside the nostrils. Others prefer an "open" procedure,
especially in more complicated cases; they make a small incision
across the columella, the vertical strip of tissue separating
the nostrils.
Mr Murphy is experienced in both these techniques and can discuss
the pros and cons of each with you during your consultation.
Incisions are made inside the nostrils
or at the base of the nose, providing
access to the cartilage and bone, which
can then be sculpted into shape.
When the surgery is complete, a splint will be applied to help
your nose maintain its new shape. Nasal packs or soft plastic splints
also may be placed in your nostrils to stabilise the septum, the dividing
wall between the air passages.
The surgeon removes the hump using a
chisel or a rasp, then brings the nasal
bones together to form a narrower
bridge. Cartilage is trimmed to reshape
the tip of the nose.
Trimming the septum improves the angle between the nose and upper lip.
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After your surgery
After surgery-particularly during the first twenty-four hours-your
face will swell, you may develop a lot of bruising around the eyes,
your nose may ache and you may have a dull headache. You can control
any discomfort with the tablets prescribed.
You’ll notice that the swelling and bruising around your eyes
will increase at first, reaching a peak after two or three days. Applying
cold compresses and ice packs will reduce this swelling and make you feel
better. In any case, you’ll feel a lot better than you look. The cast
will be removed from your nose after one week and most of the swelling
and bruising should disappear within two weeks.
A little bleeding is common during the first few days following
surgery, and you may continue to feel some stuffiness for several weeks.
You will be advised not to blow your nose for a week or so, while the
tissues heal.
If you have nasal packing, it will be removed on the morning
after your operation and you’ll feel much more comfortable. By the end
of one or, occasionally, two weeks, all dressings, splints, and stitches
should be removed.
A splint made of tape and an overlay
of plastic, metal, or plaster is applied
to help the bone and cartilage of the
nose maintain their new shape.
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Getting back to normal
Most rhinoplasty patients are up and about the following day,
and able to return to school or sedentary work two weeks following
surgery. It will be several weeks, however, before your nose has settled
completely.
You will be given more specific guidelines for gradually resuming
your normal activities. They’re likely to include these suggestions:
Avoid strenuous activity (jogging, swimming, bending, sexual relations-any
activity that increases your blood pressure) for two to three weeks. Avoid
hitting or rubbing your nose, or getting it sunburned, for eight weeks.
Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it.
Mr Murphy will schedule follow-up visits in the months after
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 can’t do, don’t hesitate to call.
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Your new look
In the days following surgery, when your face is bruised and
swollen, it’s easy to forget that you will be looking better.
In fact, many patients feel depressed for a while after plastic surgery-it’s
quite normal and understandable.
Day by day, your nose will begin to look better and your spirits
will improve. Within two weeks you’ll no longer look as if you’ve
just had surgery.
Still, healing is a slow and gradual process. Some subtle swelling
may be present for months, especially in the tip. The final results
of rhinoplasty may not be apparent for as long as a year.
After surgery, the patient has a smaller
nose, a straighter bridge, a well defined
nasal tip, and an improved angle
between the nose and upper lip.
In the meantime, you might experience some unexpected reactions from family and
friends. They may say they don’t see a major difference in your nose. Or they
may act resentful, especially if you’ve changed something they view as a family
or ethnic trait. If that happens, try to keep in mind why you decided to have
this surgery in the first place. If you’ve met your goals, then your surgery
is a success.
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