Frequently asked questions regarding rhinoplasty "nose job" surgery
What can be done by rhinoplasty "nose job" surgery?
Will there be scars after a nose job?
What type of anaesthetic is used in a rhinoplasty operation?
What does a rhinoplasty / nose job operation involve?
What happens after a rhinoplasty? What should I expect?
Is rhinoplasty surgery safe?
How do I arrange a consultation about rhinoplasty / nose job surgery with Mr Hamilton in London, UK?
What can be done by rhinoplasty "nose job" surgery?
Nasal re-shaping is a highly individualised treatment, each patient being assessed and treated in a manner best suited to their particular situation. Technically called a rhinoplasty, nasal re-shaping surgery is often termed a "nose job" in the popular press. In general, nasal shape can be altered by adjusting the shape of the nasal bones on the bridge of the nose and by adjusting and re-positioning the cartilages which make up the majority of the tip and lower bridge of the nose.
Will there be scars after a nose job?
In the simplest of rhinoplasties, the incisions are made inside the nose (“closed rhinoplasty”) and are not visible from the outside (indeed they are even sometimes very difficult for surgeons to see on the inside of the nose!) In more complex cases, particularly where a lot of re-shaping of the tip is required, a small incision is made across the columella (the piece of skin between the nostrils) and leaves a small scar in this position in addition to the internal scars (“open rhinoplasty”). Whilst this scar can be visible when viewed from below, in the vast majority of patients it settles to be almost invisible.
What type of anaesthetic is used in a rhinoplasty "nose job" operation?
Nose reshaping is usually carried out under general anaesthetic administered by an experienced consultant anaesthetist. Patients have the opportunity to discuss the anaesthetic with the anaesthetist prior to the surgery.
What does a rhinoplasty / nose job operation involve?
You will be admitted to the hospital on the day of surgery and be seen in the ward by Mr Hamilton and the anaesthetist. The areas intended for correction will be re-discussed and some pen marks placed on your skin to guide the surgery.
In theatre, after the anaesthetic has been given, Mr Hamilton will prepare you for surgery, The skin incision, is any, is marked then a mixture of local anaesthetic and adrenaline is placed in the nose to reduce bleeding and the amount of general anaesthetic required thus improving the safety of the procedure and the speed of recovery. The nose is reshaped as per the pre-operative plan and the incisions are closed using very fine sutures which are designed to be very easy to remove if they are on the outside or to dissolve if they are on the inside. Usually, a small specially moulded plastic splint is placed over the nose to reduce swelling and protect the newly re-shaped nose. Small “packs” may be placed in the nostrils overnight to catch any minor drips of fluid or blood. The anaesthetic is then reversed very gently and you will be returned to the recovery area and then to the ward.
What should I expect after a rhinoplasty / nose job operation?
Usually, after a gentle night in hospital, you will be able to go home the following morning. It is best to take things easy, avoiding bending down too much and exercising for several days. The swelling experienced tends to increase on the first and second postoperative day before setting over the next week or two.
Depending on the exact procedure, you will be seen back at the consultation room 5 to 7 days after surgery when the sutures will be removed and general advice on recovery and scar management to speed up your progress will be given. The splint is generally left in place for about a week.
Typically, another review appointment will be made thereafter to see the final result.
Most of the bruising and swelling settles in the first 2 weeks and many patients are able to return to normal activities at that stage. Sometimes, things can take a little longer to settle (particularly in patients undergoing more extensive procedures) and it may be wise to allow a little longer just in case. It is quite common for the nose to feel blocked, a little like a cold, after the procedure until the swelling settles. Swelling around the tip of the nose can take a little longer to settle than swelling towards the top.
Safety and potential risks of a rhinoplasty / nose job procedure
Fortunately, the risk of significant, long lasting complications in nasal reshaping surgery is very small. There are some problems which can develop though these tend to be temporary and short term.
- Bleeding can occur postoperatively and is usually minor in nature like a mild nosebleed. This usually settles by itself over a few days. Rarely, more significant bleeding can occur which might it necessary to seal off some small blood vessels inside the nose. It is seen more commonly in patients taking blood-thinning medication such as aspirin and other non-steroidal painkillers such as ibuprofen (Brufen) or diclofenac (Voltarol). These medications are therefore best avoided pre and postoperatively.
- Some disturbance of smell and a feeling of blockage in the nose is common in the early period and settles fairly quickly in the vast majority of patients.
- Numbness– some numbness in the area of the lifted skin at the tip of the nose is normal after this type of surgery and will usually slowly return to normal after surgery. A feeling of “pins and needles” is normal as this sensation recovers.
- Infection – Infection is rarely seen in nose-reshaping surgery and routine antibiotics are not required post-operatively. However, as with all surgical procedures, infection occasionally occurs and antibiotics are sometimes needed.
- Slow healing – When a small external scar is required, this usually heals very well and quickly. Occasionally the wound may be slow to heal. This is fortunately rare even in smokers who are the patients at slightly higher risk of this problem. In a very small proportion of patients the scar can thicken somewhat - usually in the first couple of months (hypertrophic scars) and may need some additional treatment to encourage it to settle.
Summary
For the appropriate patient, nose-reshaping can give very pleasing, long-term results. With careful planning and attention to detail, dramatic changes to overall facial appearance.. Mr Hamilton will be happy to discuss your suitability for these procedures at you consultation and to give an honest and friendly opinion on the results which might be achieved.