INTRODUCTION

• Procedure: The surgical enhancement or reshaping of the nose.
• Duration: 1 to 2 hours
• Anaesthesia: general.
• Side Effects: Temporary discomfort, swelling (black eyes), bruising.
• Risks: Slight asymmetry/contouring, scarring. Infection, stuffiness, loss of sensitivity, increased sensitivity, haematomas, skin discolouration.
• Recovery: Back to work: seven to 10 days. Strenuous activities, alcohol: about three to four weeks. Bruising and swelling gone: several weeks.
• Duration of Results: permanent

 B

The Best Candidates

To be a good candidate for nose reshaping you must have realistic expectations about what the procedure can do for you. It's important to understand that the procedure can enhance your appearance and self confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for nose reshaping should be physically healthy, psychologically stable and realistic in expectation.

Planning Your Surgery

The initial consultation with your surgeon is very important. The surgeon will need your complete medical history, so check your records ahead of time and be ready to provide this information. Be sure to inform your surgeon if you have any allergies, if you're taking any vitamins, medications (prescription or over-the-counter), or other drugs and if you are a smoker.

During the consultation your surgeon will discuss with you the different available options. How you want your nose to look and feel is planned ahead of time. There are many options available, each procedure will be customised to your needs.

Rhinoplasty can change:

• Nose size, in relation to the other facial structures
• Nose width at the bridge
• Nose profile, with visible humps or depressions on the bridge
• Nasal tip, that is large or bulbous, drooping, or too upturned
• Nostrils that are large, wide or upturned
• Nasal asymmetry and deviation.

 P

The Surgery

Step 1 – Anaesthesia

Most patients are placed under a general anaesthetic for this procedure. You will be asleep for the duration of the procedure and will not experience any pain or discomfort.

Step 2 – The incision

There are 2 main options possible for this procedure, they are:

a) Closed Procedure - This is when the incisions are hidden inside the nose.

b) Open Procedure - This is when the incision is made across the columella, the narrow strip of tissues that separates the nostrils.

Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Step 3 – Reshaping the nose structure

The nasal structures of the nose can be reduced or augmented by the use of grafted cartilage from other parts of the body, such as the septum and the ear.

Step 4 – Correcting a deviated septum

This can be corrected by straightening the inside of the nose allowing for improved breathing.

Step 5 – Closing the incision

When the underlying structure of the nose is sculpted to the desired size and shape the tissue and nasal skin are re-draped and the incisions are closed. If any additional incisions are required, they will be placed in the natural creases of the nose, making them almost undetectable.

 E

Most Common Risks

• Small capillaries may form on the nose (these can generally be removed with laser).
• Infection.
• Prolonged or poor wound healing.
• Anaesthesia risks.
• Bleeding (haematoma).
• Asymmetry in shape and or contouring.
• Increases or decreases in sensitivity.
• Nasal airway alterations may occur after a Rhinoplasty or Septoplasty that may interfere with the normal passage of air through the nose.
• Nasal septal perforation (a hole in the nasal septum) may develop but is a rare occurrence. Additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may not be possible to correct this complication.
• Persistent pain (controlled through medications).
• Scarring.
• Skin discoloration and swelling.
• Sutures may spontaneously surface through the skin, become visible or produce irritation requiring removal.

Getting Back To Normal

After surgery, particularly during the first twenty four hours, your face will feel puffy, your nose may ache and you may have a dull headache. You can control any discomfort with pain medication as prescribed by your surgeon. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day.

You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling. Most of the swelling and bruising should disappear within approximately two weeks. Some subtle swelling, unnoticeable to anyone but you and your surgeon will remain for several months.

A little bleeding is common during the first few days following surgery and you may continue to feel some stuffiness for several weeks. Your surgeon will probably ask you not to blow your nose for a week or so, while the tissues heal.

If you have nasal packing, it will be removed after a few days improving your comfort. By the end of one or two weeks, all dressings, splints, and stitches should be removed.

In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be looking better. In fact, many patients feel depressed for a while after plastic surgery. This is quite normal and completely understandable.

Rest assured that this stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within a week or two, you'll no longer look as if you've just had surgery.

Your new Look

While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.