Sam Orkar, Consultant Plastic Surgeon
Face & Neck Surgery

Rhinoplasty (Nose Job)

What is a rhinoplasty?

It is an operation done to reshape the nose. It usually involves reducing aspects of the nose like a hump on the dorsum or a big tip. Occasionally it involves enhancing certain areas (augmentation rhinoplasty).

Cosmetic Rhinoplasty is performed for those who naturally have concerns about certain aspects of their nose. Rhinoplasty can also be performed following injuries resulting in deformity or functional problems.

How is it performed?

The operation is performed under a general anaesthetic and you will usually stay overnight. It can be performed using either an open or closed approach.

The closed approach is performed through incisions on the inside the nostrils. Through these incisions the skin is lifted up and necessary adjustments to the bone or cartilage are made. The incisions are then closed with absorbable sutures.

The open approach is performed by lifting the skin up following an incision across the columella and up into the nostrils. The skin is lifted up as a sleeve, adjustments are made to the bone and the cartilage and the skin is then placed back. Very fine sutures are used to close the skin incision. The scar across the columella though visible tends to settle quite well with time and becomes barely perceptible. If you need a lot of modelling to be performed for the tip, or if you have had previous operations or if you have bad deformities from injuries, then the open technique may be most appropriate for you. I will discuss with you at your consultation what approach will best suit you. It may be necessary to use cartilage grafts, which are usually obtained from the septum of the nose, occasionally from the ear and more uncommonly from the ribs.

There will be a plaster of Paris (POP) moulded around the nose to protect it and a light Vaseline gauze pack in the nostrils.

What about postoperative care?

The gauze pack will be removed the next day before you go home.

You will need to sleep propped up on 2-3 pillows for 1-2 weeks.

The POP will be removed after 7-10 days. The sutures on the columella are removed at the same time if used.

Do not blow your nose and always sneeze with the mouth open in the first 3 weeks.

There may be bruising and swelling that should go down rapidly in the first three weeks. Try not to arrange important social engagements within this period. However it will take 6-12 months for swelling to fully go. You will do well to avoid contact sports for six weeks at least.

You may be able to feel bony irregularities but if these are not readily visible, they are better left alone.

What are the risks?

Occasionally, bruising and swelling may last longer than usual.

Some patients may experience a temporary loss or reduction of sensitivity to smell.

There may be alteration or loss of sensation to the tip of the nose. This tends to improve with time but may not recover completely.

If there are visible irregularities, minor adjustments may be required usually 6-12 months after the initial operation. Infection can occur but is fortunately uncommon.

Bleeding is rare. It may need to be stemmed with nasal packs.

Did you know!

It is important to look at the whole balance of the face as for example; a small chin may make the nose look bigger than it really is.

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Face and/or Neck Lift

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Rhinoplasty (Nose Job)

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