Rhinoplasty

What it involves

Rhinoplasty reshapes the bone and cartilage that give the nose its form. It can reduce or increase the size of the nose, change the shape of the tip or bridge, narrow the nostrils, or change the angle between the nose and upper lip. When it is combined with correction of the internal structure of the nose to improve breathing, it may be called septorhinoplasty.

Who may benefit

Rhinoplasty may be suitable for adults whose facial growth is complete and who:

• are bothered by the size, shape or proportion of their nose;
• have a nose that has changed after an injury;
• have breathing difficulty due to the internal structure of the nose;
• are in good general health, do not smoke, and have realistic expectations.

A good surgeon will spend time understanding what you would like to change and why, and will tell you honestly whether that change is achievable and suited to your face.

How it is performed

The operation is usually done under general anaesthesia and takes between one and a half and four hours. It may be performed through incisions entirely inside the nose (closed rhinoplasty) or with an additional small incision across the strip of skin between the nostrils (open rhinoplasty). The surgeon then reshapes the underlying framework, sometimes using cartilage taken from inside the nose, the ear or a rib. A splint is placed on the nose at the end of the procedure.

Potential risks

All surgery carries risk. Your surgeon should discuss the following with you before you consent:

• bleeding, infection and the general risks of anaesthesia;
• swelling and bruising, which can last for weeks, with subtle swelling persisting for up to a year;
• difficulty breathing through the nose;
• numbness or altered sensation of the nasal skin;
• asymmetry or a result that does not meet expectations;
• the possibility that further surgery may be needed.

Recovery

Most people return to desk work within one to two weeks, once the splint is removed and visible bruising has settled. Strenuous exercise and contact sports are usually avoided for at least six weeks. The final shape of the nose emerges gradually as swelling resolves over many months.

Important considerations

• Rhinoplasty is among the most technically demanding procedures in aesthetic surgery. Choose a surgeon with specific training and experience in it.
• Ask to see results of the surgeon’s own patients and how their outcomes are followed up.
• Be wary of promises of a particular “look”, heavily edited photographs or pressure to decide quickly.
• Revision rhinoplasty is more complex than a first operation; it is worth getting the first one right.