Rhinoplasty (Surgery of the Nose) 

 Rhinoplasty is a procedure that changes the size and shape of the nose (lots of people refer to it colloquially as a ‘nose job’), either by increasing or decreasing the bridge, changing the angle, narrowing the nostrils or reshaping the tip. Although many seek a rhinoplasty simply to change the shape of their nose, others may choose nose surgery after a facial injury or to help relieve nasal obstructions.  

Most rhinoplasties are performed on an outpatient basis and usually take an hour or two depending on the extent of the correction. The procedure is commonly performed under a local or general anaesthetic, depending on the patient and surgeon preferences.

Different surgeons prefer different surgical techniques. Some surgeons will use a “closed” technique, where the incisions are made inside the rim of the nostrils. Others make their incision across the base of the nostrils and nose (the “open” technique). This technique may be used in more complicated cases, because the surgeon can more easily see the surgical area.

In either case, the soft tissues of the nose are then separated from the underlying structures allowing access to the cartilage and bone. The cartilage and bone are then altered and sculpted into shape. At the same time, internal problems, such as breathing obstructions can be improved by removing the obstruction or changing the shape of the obstructing matter. Also, if the nostrils are too wide, the surgeon can remove a small wedge of skin from the base for a more harmonized look. 

Best Candidates
Although there is no upper age limit for nose reshaping and nasal reconstruction, most surgeons prefer to not operate on younger patients until they have completed their growth spurts – usually in the mid teens for girls and the mid to late teens for boys.  

Before and after the operation

During the consultation, you and your surgeon will discuss what you hope to change about your nose and how you would like your nose to look. Your surgeon will thoroughly assess your nose and facial structure and discuss your options, given the description of your desired nose. Your general health and medical history may also be reviewed.

Your surgeon can discuss the expected outcome, as well as timing and type of anaesthesia recommended. You will also talk about where the procedure will be performed; the risks and costs involved and answer any questions you may have. Your surgeon will also discuss factors that can influence your surgery and results such as what medication, if any, you should avoid. You may also be asked to stop smoking at least one to two weeks before and after any procedure. Be sure to express any concerns or ask any questions you may have.

Although you will be mobile immediately following your rhinoplasty, you will want to arrange for someone to drive you home after surgery and to help around the house for a day or two. 

A lightweight splint may be placed on the nose for several days after to help maintain its new shape and for protection. Your surgeon may also use nasal picks inside the nose to stabilize the septum – the dividing wall between the air passages. These will be removed in about two days.
After surgery, you’re likely to have swelling and bruising around your nose and eyes. This will peak and begin to subside after the second or third day. Using cold compresses and keeping your head elevated will help reduce this swelling and it should almost be unnoticeable after two weeks or so. A little bleeding is also common during the first few days. Any bruising will fade after a week or so and discoloration will usually disappear in two or three weeks. Camouflage cosmetics can be used to cover the discoloration after the first day or two.

All splints, packing and stitches – if they’re not dissolved – will be removed usually by the end of one week, but they can be removed in up to three weeks, depending on your condition.

It is common to experience some nasal stuffiness, particularly if you’ve had surgery on the septum. It may be a week or two before your surgeon will allow you to gently blow your nose.

You’ll need to be careful not to hit or jar your nose, or allow it to sunburn for at least eight weeks while your nose continues to heal. Although for two to three weeks you should avoid any strenuous activity that raises your blood pressure, your surgeon will determine when you can resume this type of activity given your particular case. You’ll also need to avoid wearing glasses for a few weeks until your nose is completely healed. In your follow-up visits over the months following your rhinoplasty, your surgeon will check your healing process.