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As one of the most recognisable features of the face, the nose defines our facial appearance. Many men and woman express dissatisfaction with their noses for a number of reasons, including length, width, the presence of humps on the bridge, and breathing problems.
Nose reshaping, also known as rhinoplasty, can address these problems in many patients, and achieve extremely effective results. The best candidates for nose reshaping are patients with thin, non-oliy skin, those who do not regularly use nasal sprays or other nose medications, non-smokers, and those with realistic expectations about the surgery.
The primary aim of nose reshaping is to reduce the size and shape of the bony and cartilaginous framework of the nose, and to re-drape the nasal skin over the altered shape. Occasionally, the patient may only require surgery to correct a deformity of the tip of the nose in what is known as a rhino-tip procedure. It is generally impossible to fully correct a heavy, bulbous nasal tip, over which the skin may be thick and oily.
There are two basic types of rhinoplasty – closed and open (in addition, the internal septum that separates the two sides of the nose may require straightening, a procedure known as septoplasty):
Tiny incisions are made in the inside of the nose, leaving no external scars. The majority of nose re-shaping surgeries are of this type. Whilst popular with cosmetic surgeons and patients, it has the disadvantage that the surgeon does not have as good a view of the operative field as with Open Rhinoplasty, and which limits the ability to remodel the bone, and cartilage.
An incision is made on the inside of the nostrils, and across the divide of skin between the nostrils – the columella. The skin over the nose is then lifted, which allows the surgeon a clear, uninterrupted direct view of the framework of the nose. As a result, it is easier to make more extensive alterations to the shape of the nose and to provide a more sculpted nasal tip. However, there is the slight disadvantage of the tiny scar across the columella (which is generally barely visible with time), and the fact that any swelling may take longer to subside than with the closed method.
Occasionally, patients present with what they consider to be a flat nose, perhaps as a result of injury, previous surgery, or even an inherited or ethnic trait. In order to improve the appearance of a flattened nose, it is necessary to insert some form of additional framework under the skin of the nose to enhance the line of the nasal bridge.
Several options are available for this additional framework, namely using the patient’s own bone (usually taken from the hip, rib, or surface of the skull), the patient’s own cartilage (usually taken from the ears, or from within the nose itself), or using artificial materials, such as silicone implants.
The procedure may be performed under either local anaesthetic with sedation, but most surgeons prefer general anaesthetic. It and usually takes around one hour to 90 minutes, and can be performed as either a day case, or with an overnight stay.
The operation is surprisingly pain-free, and most patients require only simple analgesia, though patients should expect the nose to feel stuffy for several weeks. There may also be visible bruising around the nose and eyes for a few weeks, and areas of the nose, especially the tip, may feel numb for around a month. Following surgery, ice packs may be used to reduce swelling and bruising. For the first few days after surgery, patients are advised to rest quietly, with only gentle activity. Strenuous activity should be avoided for four weeks. More specific advice is included in the relevant patient literature provided by the Hospital.
Expectations of Surgery
Perhaps more than any other cosmetic facial surgery operation, prospective rhinoplasty patients must be completely sure exactly what it is that concerns them about their noses. At the time of your consultation, you should inform your surgeon clearly of these concerns. You may bring in photographs of personalities with an idea that you would like that particular type of nose, but it must be remembered that, even if the surgeon is able to exactly replicate that nose, it may look very different on a different face
At the time of your consultation at the Alexandra Private Hospital, your surgeon will discuss the various options available to you, in line with your specific medical circumstances. You should always feel free to ask your surgeon any questions that you have regarding the surgery, and discuss any areas that may seem unclear. The goal of your surgeon and the Hospital staff is to make your entire experience as comfortable, and worry-free as possible.