Mr Omar Tillo
Consultant Plastic Surgeon
Rhinoplasty is one of the most popular surgeries in the country. There are several common reasons why patients choose to have a rhinoplasty. These include:
Traumatic injuries of the nose: slips, trips and falls are common causes of injuries to the nose. To correct deformities to the nose, rhinoplasty will be required to restore the structure of the nose.
Aesthetic: the nose plays a major role in balanced facial aesthetics. For patients who are unhappy with their nasal structure, this can be corrected with a rhinoplasty procedure.
Airflow through the nose: many patients experience problems with breathing through their nose and depend heavily on mouth breathing. Both plastic surgeons and ENT surgeons have specialist expertise in correcting the airflow pathways of the nose. A rhinoplasty procedure can be performed with surgery of the partition of the nose (septoplasty) to address airflow problems.
Whether you choose to have a rhinoplasty because of aesthetic reasons, previous trauma or airflow problems – there are some fundamental prerequisites to make sure you get the best possible outcome from your rhinoplasty procedure:
You will initially be reviewed by a plastic surgeon or head and neck surgeon experienced in rhinoplasty surgery. This way you have the opportunity to discuss directly with the surgeon who will perform your operation (if you go ahead) your ideas, concerns and expectations about the rhinoplasty procedure.
As part of the consultation, the surgeon will:
All rhinoplasty procedures at Centre for Surgery are conducted under our specialist general anaesthesia technique – known as ClearSleep™. In our experience, patients experience fewer side effects under ClearSleep™ technique than under traditional general anaesthesia. It also means that patients usually wake up quickly and are not required to stay overnight. They can recover in the comfort of their own home, which we believe leads to faster recovery and better outcomes.
Rhinoplasty surgery can be performed in a number of different ways: the base of the nose can be narrowed, humps on the bridge can be removed, correcting flared nostrils or even refining the tip of the nose.
The rhinoplasty procedure will in all cases be either closed or open. The surgeon will decide in consultation with you which is the best procedure for your case.
Closed rhinoplasty vs open rhinoplasty:
Closed rhinoplasty – cuts will be concealed inside the nose
Open rhinoplasty – a small incision is performed on the area at the inferior aspect of the nose between the nostrils. This area is called the columella
After you are asleep, the bones of the nose and the cartilaginous areas will be exposed. This allows the rhinoplasty surgeon to use specialised instruments to shape the nose. Some procedures may require the use of cartilage taken from other areas of the body such as the back of the ear or even from a very small area of the ribcage. This is required for the extra support to maintain the structure of the nose. Airflow issues are corrected by ensuring the septum of the nose is straightened up. Tiny stitches will be used to close up any incisions that were made. A special packing material will be placed to minimise the risk of bleeding, and a splint is worn for one week to facilitate proper healing.
After your rhinoplasty procedure, there will be bruising and swelling. In particular, the lower eyelids may look particularly bruised. This is normal and will subside with time.
To minimise the impact of the bruising and swelling, you should lie with head up in bed on a few pillows. We also highly recommend our patients to apply ice packs for the first 48 hours following the surgery.
You will be discharged the same day and you can rest in the comfort of your own home providing you have a responsible adult with you for at least 24 hours. Our medical team will phone you the next morning and you will see the surgeon one week later for removal of the splint. There will then be subsequent follow-up appointments to monitor your healing and progress.
Top tips for recovery
Smoking impairs healing and so you should aim to stop smoking at least one month prior to rhinoplasty. Medicines which thin the blood should also be stopped – you should consult your GP if you have any concerns about your health. You will be required to wash with a special antiseptic solution prior to surgery to minimise the risk of infection.
You must have realistic expectations of what can be achieved with rhinoplasty surgery. Your health should be optimal and you must be at least 18 years of age. Performing rhinoplasty on the still growing facial skeleton can impair the results.
A closed rhinoplasty or open rhinoplasty can be performed. An open rhinoplasty is better for correcting tip deformities and revision rhinoplasty surgery. The closed rhinoplasty technique is better for correcting hump deformities and the healing is generally quicker. Rhinoplasty surgery is one of the most commonly performed procedures at Centre for Surgery.
The procedure can take up three to four hours, with a revision rhinoplasty taking longer.
You will be discharged on the same day after the effect of anesthesia wears off and you can rest at either one of our partner hotels or in the comfort of your own home providing you have a responsible adult with you for at least 24 hours.
A nasal splint similar to a plaster cast will be applied to your nose and this must be worn for one week before being removed in the clinic. This ensures healing can proceed in an optimal manner and also to protect your nose from any potential knock and further injury. Bruising should start to resolve after two weeks but swelling can last for up to four weeks. The definitive appearance should start to become apparent between six months to one year after the rhinoplasty procedure.
Surgeons at Centre for Surgery can prescribe pain medications and antibiotics to prevent infection, but other medications may complicate your aftercare. We advise our patients to consult with their surgeon before taking any medications. As for herbal remedies, it is best to avoid herbal supplements before as well as after surgery as they their safety and purity are unregulated by the FDA.
Initial swelling will subdue within a few weeks and you will start seeing gradual changes in the appearance of your nose, however, it could take up to a year to see the final results of the nose-reshaping surgery.
Rhinoplasty complications are uncommon. Potential complications with rhinoplasty include bleeding, wound breakdown, dorsal bridge depression, nasal airflow problems and surgical site infection. Our day surgery units are specially equipped for the performance of rhinoplasty surgery that is both safe and effective. Rhinoplasty complications are minimised through meticulous preparation and pre-operative planning by the surgical team.
As you will experience a certain degree of swelling and bruising you should avoid excessive physical activities for at least two weeks. If you wear glasses, we recommend not to wear them for six weeks following your surgery to gain the best outcome. Also, avoid smoking and high exposure to the sun as it will slow down the healing process.
After your first nose-reshaping surgery, it is ideally recommended not to have any further work done for 12-18 months so that favourable outcome can be achieved after a revision surgery. However, seldom waiting for a whole year could worsen the nasal framework and make the correction harder. Hence, the waiting period between your first and revision surgery must be carefully decided by you and your surgeon by looking at the result that was achieved and your expectation.
Yes, certain breathing problems caused by crooked or pinched nose can be cured with nose-reshaping surgery and it can help improve both appearance and functionality of the nose.
Thin-skinned patients are regarded as the most challenging type of people for the nose-reshaping procedure as imperfections can be very visible. Nevertheless, you can still achieve satisfactory results with meticulousness and precision when contouring the nasal framework.