Rhinoplasty

Rhinoplasty is performed to change the shape or size of the nose and/or to improve breathing. The operation may be performed for purely cosmetic reasons or as part of a reconstruction for birth deformities or following trauma, cancer or other disease.

The best candidates for rhinoplasty are people who are seeking an improvement, but not perfection, in the way they look. If you are physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate.

Rhinoplasty is a commonly performed procedure. The nose is the central feature of the face and many people are self-conscious of the size or shape of the nose. The nose may be seen as too big, too small or have some other features which they dislike. Once the nose stops growing – at about 15 or 16 in females and about a year or two later in males – surgery can be performed to alter nasal shape.

Rhinoplasties are individualized to meet the patient’s needs and expectations. Rhinoplasties usually include an improvement of the nasal tip, straightening of the dorsum and adjustment of the bony nasal skeleton. These procedures may be performed as an open procedure with a small externally visible incision through the columella (base of nose) or may be performed as a closed procedure where all of the incisions are hidden. Different advantages exist in either approach. The choice is usually left to the discretion of the surgeon.

Rhinoplasty can correct a variety of conditions including an over-sized nose, a hump on the bridge, an undesirable shape of the nasal tip or a narrow or wide span of the nostrils. Both frontal and profile views of the nose are corrected to complement other facial features, and to provide a balance of proportions. Rhinoplasty can also be used to correct for breathing problems caused by narrow or partially obstructed nostrils.

  • It is important, to accurately define exactly what it is that bothers you about your nose. You may see your nose differently from the way the surgeon does. At the initial consultation, be specific about size and shape of the various parts of your nose, what bothers you and what does not and which features you would like altered. Try to make a list of priorities for yourself.
  • If you are a smoker you will be asked to stop smoking prior to surgery in order to prevent unnecessary complications.
  • Arnica tablets, Vitamin E in large doses, analgesics like Aspirin and even some anti-inflammatory drugs should not be taken prior to surgery as they can promote bleeding during the procedure.
  • No special preparation is required before surgery. You should be fit and healthy on the day of surgery and not suffering from any respiratory tract infection. Wash you face well on the morning of surgery. Prior to surgery, the anaesthetist will see you and prescribe a sedating pre-med.

Rhinoplasty usually takes two to three hours, though complicated procedures may take longer and simpler procedures may be shorter. Rhinoplasty may be performed as a closed procedure through incisions inside the nose. Usually, however, I make a small cut between the nostrils to open the nose. Better visualisation with an open approach allows me to be more accurate in shaping structures inside the nose. With time this incision should be barely visible.

General anaesthesia is used for most operations, although for tip work local anaesthesia and sedation is recommended. Cuts are made inside the nostrils and usually also a small cut is made between the nostrils (open rhinoplasty approach). The skin of the nose is lifted away to expose the skeleton. This skeleton of cartilage and bone is then modified to give the nose its new form. Tissue may be removed, reshaped or added to. Once reshaping is completed, the wounds are closed and a nasal shield may be applied to be worn for about 2 weeks after surgery. Depending on the extent, the duration of surgery may be between 1 and 4 hours.

 
Information 
AnesthesiaGeneral.
Surgery Length2-4 hours or more.
Side EffectsTemporary swelling, bruising around eyes, nose and headaches. Some bleeding and stiffness.
Recovery PeriodBack to work: 1 to 2 weeks. More strenuous activities: 2 to 3 weeks. Avoid hitting nose or sunburn: 8 weeks. Final appearance: 1 year or more.
Stay in Hospital2 days
Stay in Thailand15 days

Once the skin of the nose is lifted from its supporting framework of bone and cartilage, this framework is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and a number of techniques may be used. Finally, the skin is redraped over the new framework, the wounds closed and a dressing applied. A splint or packs in the nostrils may be used.

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 stabilize the septum, the dividing wall between the air passages.

Potential Surgery Risks and Complications vary from patient to patient depending on a range of factors and the extent of surgical work required. Regardless of how remote, the potential risks are listed below are possible. Your own research is essential especially if you are considering surgery. Following pre and post surgical care and instructions will also reduce your risks. See the following potential risks and complications include and not limited to:

Medical:

  • Swelling, bruising “panda eyes”, abscess (from infection – rare), Adhesions (scars internally), numbness, reaction to anaesthesia and other medications
  • Perforated Septum

Aesthetic:

  • Asymmetry (Symmetry never guaranteed)
  • Weakness or sinking
  • Over rotated tip, Pinched tip