Rhinoplasty (Nose) Surgery

Rhinoplasty involves reshaping the cartilage, bone and soft tissues of the nose. This may be to address cosmetic concerns or for reconstructive purposes.

COMMON REASONS WHY PEOPLE CONSIDER HAVING RHINOPLASTY SURGERY

Functional problems

• Particularly breathing issues.

Cosmetic concerns

• A bent nose, a prominent bump, issues with the tip of the nose or a desire to achieve a more pleasing aesthetic shape and balance with the rest of your facial features may be addressed with rhinoplasty surgery.

Both functional and cosmetic reasons may be naturally occurring or as a result of trauma. Often there is a combination of several of these aspects to consider.

WHAT IS INVOLVED WITH RHINOPLASTY SURGERY?

• General anaesthetic
• Surgery Duration: Approximately two to three hours of operating time.

RECOVERY AFTER SURGERY

• Patients most commonly require a hospital stay of one night.
• Nose and facial area may be a little bit bruised for a few days. You may develop “black eyes” in some cases.
• A plastic splint and tape will be on the outside of your nose for one week. There may be packs up your nose for a few days.
• Social interaction in public can often occur by about two weeks.
• Gentle increasing mobilisation and activity and generally back to most normal day to day activities within a week.
• Able to drive when feel comfortable to do so.
• No heavy lifting/exercise for two weeks e.g. Avoid the gym, aerobics, running.

POST OPERATIVE CARE & REVIEW

Mr White will see you in hospital after your surgery and/or prior to your discharge from hospital.

Post operative visits with Mr White:

• Approximately three - four days after surgery if you have packs in or one week if not
  - At this stage Mr White will make sure that you are well and the wounds are healing nicely.
• Six weeks post surgery review
  – At this time you will have a better idea of what the final result from surgery will be like.
• Four - Six months post surgery.
• 12 months.
  
  If there are any concerns you will be seen more frequently.

SURGICAL GOALS

1. YOUR SAFETY
2. Correct the issues that are identified by you and Mr White
3. Minimise dramatic changes so that you don’t have an “operated on” look; in general it is better to under-do nose surgery than over-do it.

BEFORE DECIDING TO HAVE RHINOPLASTY SURGERY YOU SHOULD CONSIDER THE FOLLOWING

• If you are a smoker: STOP Smoking
• You should have a generally good level of fitness and health
• Define the exact reasons that you are undergoing this surgery
• Have realistic expectations of a reasonable surgical result.

ALTERNATIVES TO SURGERY

• No surgery or delaying surgery
• Medical treatment (e.g. nasal sprays or splints) for breathing issues
• Use of soft tissue fillers.

RISKS TO CONSIDER

Anaesthetic - In otherwise well people, general anaesthesia is very safe with modern techniques. Mr White’s rooms will give you the details of your anaesthetist prior to surgery to discuss any specific concerns.

Bleeding/Haematoma – This may need a return to the operating theatre. This can impact on wound healing or skin survival. Infection in the wound – If this does occur, it is usually cleared up with antibiotic tablets. Wound infection is rare in nasal surgery.

DVT/PE (Deep venous thrombosis/pulmonary embolus) - Blood clots that are potentially very serious and even life threatening which can form in the legs and travel to the lungs. Multiple strategies are employed to minimise the risk of these occurring.

Scars - Typically are at their thickest and reddest at 6-10 weeks after surgery. Scars continue to mature and improve for up to 18 months after surgery. Scar management advice will be discussed in your follow up visit with Mr White to assist in achieving the goal of a thin, barely noticeable scar. Note: the external scar is located on the columella (area between the two nostrils).

Asymmetry - The scars may be slightly different on your right compared to left side or the result can slightly differ between the two sides. Wound separation/delayed healing - This is much more common in smokers or if there is an infection. Final results take 12-18 months to arrive at. There is a degree of swelling that doesn’t settle for this period of time. Often there are palpable lumps that can be felt even at the final stage but the important aspect is the look and functional aspects rather than what you can feel.

Rhinorrheoa - Ongoing clear fluid running from the nose.

Numbness can be present for several months on the skin of the nose.

Septal perforation - a hole in the septum that can lead to crusting, whistling or nasal collapse Cartilage warping - over time even excellent results can sometimes be lost if the cartilage warps (bends). Revisional surgery may be required in this setting.

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NO SURGERY IS RISK FREE.

All surgery is a balance between realistic surgical goals and knowledge of possible risks and complications. Risks are minimised by careful patient selection and planning, high standards of surgical training, meticulous surgical technique and vigilant post operative care. Small, less serious issues are common and every effort is made to resolve them quickly. These very rarely have any long-term effect on an excellent final result.

• For further information please either email or make an appointment with Mr White