Nose reshaping (rhinoplasty)

What is a rhinoplasty?

Rhinoplasty is a surgical procedure to increase or decrease the size of the nose or to change its shape. Development continues until the age of 16 years, when the nose stops growing. It is therefore not advisable to operate before this age.

What does this involve?

Rhinoplasty is carried out under a general anaesthetic and either requires a one night stay in hospital, or in some cases, can be performed on a day case basis.

There are various techniques that surgeons use to perform this operation, and you will be advised which is the most appropriate in your case.

Rhinoplasty is either performed from inside the nostrils - a closed rhinoplasty, or by making a small cut on the nose and elevating the skin - an open rhinoplasty. The nasal bones and cartilage are rearranged or removed to achieve the shape you have agreed with your surgeon. The skin of the nose will shrink to the new nose shape in time.

If you are having surgery to make the nostrils smaller, the surgeon will make small incisions in the skin at the crease on the side of each nostril. Once surgery is complete, any incisions are closed with sutures.

Following the procedure you will be taken from the operating theatre into the recovery suite where you will be looked after until you are fully awake. After this, you will return to your room, where nursing staff will check your dressings and monitor your pulse and blood pressure at regular intervals.

The anaesthetist will prescribe painkillers and you should take these regularly for the first week or so. Pain can slow down your recovery, so it is important to discuss any discomfort with the nursing staff.
There may be a drip in one of your arms - this is to keep you well hydrated. This will be removed when you are able to drink a satisfactory amount.

You will have a nasal splint over your nose to support it and in some cases, packs (gauze dressings) in each nostril. The packs will prevent you from breathing through your nose. They will be removed before your discharge home.

When will I recover?

Following rhinoplasty you are likely to have some pain/discomfort, swelling and bruising. These are temporary and should subside after the first few weeks.

Your surgeon will advise you as to how long you will be required to wear your nasal splint - this is usually 7 days.

Your nose may bleed a little when you return home - do not pack your nostrils to try to stop the bleeding. Simply take some gauze and hold it against your nose until the bleeding stops. To help prevent nosebleeds, keep your head up as much as possible and avoid taking overly hot baths/showers.

You may find that your nose is blocked - if this is the case, you must not blow your nose or use any nasal decongestants. You may find it helpful to sleep with some extra pillows. Breathing through your mouth can lead to dryness of the lips and mouth - drink plenty of water and use a cream to prevent your lips cracking.

You will receive a post-operative telephone call from the specialist nurse one to two days after your discharge home to ascertain your progress and well-being. You will also receive a follow-up appointment at which your surgeon will assess your progress and give advice on when you can resume your normal activities.

You must avoid strenuous exercise, heavy lifting and swimming for approximately six weeks after surgery.

The length of time you will need to take off work will depend on your type of employment, but is usually a minimum of one week.

What risks should I know about?

Rhinoplasty is a commonly performed and generally safe procedure. However, all surgery carries an element of risk.

The possible complications of any surgery can include an unexpected reaction to a general anaesthetic, excessive bleeding, developing a blood clot (usually in a vein in the lower leg, known as a DVT - deep vein thrombosis) and infection.

Swelling may cause some difficulty breathing during the first week. Occasionally this can last longer than a week and in some cases may be a permanent side effect of the procedure.

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