Nose-Job/ Rhinoplasty

We all know at least one person who have gone under the knife to improve the shape of their nose. Rhinoplasty, or ‘nose job’ is a cosmetic surgery procedure that reshapes the nose, altering the size of the nose to restore balance to the facial features. The nose job is fast becoming one of the fastest cosmetic surgery procedures. It can transform the length, width and shape of your nose and get rid of any unwanted lumps or bumps. Plastic surgery of the nose can also be a corrective procedure for those who have breathing problems, a birth defect or have suffered nose injuries. Although it is quite a complex procedure, the outcome of a rhinoplasty procedure is usually very pleasing.

While men and women of all ages are able to have nose-jobs, the procedure isn’t usually performed on children or teenagers as their nose has not finished growing. An ideal candidate is someone who is unhappy with the shape of their nose but has realistic expectations of what surgery can achieve.

If you have any of the following concerns then you may be a suitable candidate for a nose job:

• A nose that is too large or too small in comparison with other facial features
• A lump or bump on the bridge of the nose
• An overly wide nose
• A large, droopy, bulbous or protruding tip
• Flared or pinched nostrils
• A crooked, asymmetrical or misshapen nose
• A broken nose or nose that has been injured in an accident
• Breathing problems due to nasal structure

Many people believe that a nose job can be the answer to many confidence issues. While a nose job can improve confidence levels, the best candidates for a nose job are well adjusted and otherwise happy with their lives.

Before surgery it's important to speak to your plastic surgeon to ensure you fully understand all the possible risks and complications. Mental and physical preparation is very important in the lead up to surgery.

Many people are surprised at how much a nose-job can alter the shape of the face. This makes the consultation incredibly important as you need to be aware of the drastic change.  You will also need to be realistic about what can be achieved and listen to your surgeon. If you want Halle Berry’s nose and your surgeon tells you it isn’t possible or it won’t suit the shape of our face then you need to listen to his/her advice. If possible, try and find a surgeon who makes use of 3d imaging so they can show you what your nose might look like after the surgery. It’s also good to look at some of the before and after pictures of their previous work so you get an idea of the work they have already done and gage their experience.

Your surgeon should also take you through a consent form; read it carefully before you decide to sign. They should also take you through various precautions that you need to take; don’t smoke for at least 2 months before the operation, avoid aspiring as it thins the blood making postoperative bleeding more likely, have cold compresses at home to minimize swelling and stock up on easy to digest food.

Most surgeons perform a nose job under general anaesthetic, but the procedure can be done under local anaesthetic or sedation. The operation only takes one to two hours and in most cases you can go home the same day.

The surgeon begins by making an incision either inside the nose or across the skin that seperates the nostrils, known as the columella to expose the underlying cartilage and bone. In some cases the nose is broken and reset, alternatively the surgeon ‘shaves’ off or removes cartilage abd bone to create the desired shape.

The surgeon then stitches the skin back into place and applies a splint to help the nose retain its new shape. If your nose is not being made smaller you may only need tape rather than stitches. If stitches are used they will usually be dissolvable and will not require removal. If the surgeon does make a cut across the skin separating the nostrils then you will usually have stitches that will need to be removed around a week after surgery.

How your surgery is performed will depend on the type of nose job surgery you are having.

It’s important to arrange for a friend or relative to pick you up after surgery as you will feel drowsy and unable to drive. It’s also a good idea to get someone to look after you for a few days as you will need to take it easy and not exert yourself. You should ideally stay in bed and keep your head elevated for 24 hours after surgery. For the week after surgery you should also try to sleep with your head and shoulders raised to keep the swelling and bruising to a minimum and avoid bending over as this can increase blood flow to the nose and increase both swelling and post-operative bleeding.

It is normal for your nose to be sore after surgery and you should expect swelling and bruising. Some people even get black eyes after rhinoplasty. Swelling and bruising can be reduced by using cold compresses around the area. You can expect negative effects to subsidise after two or three weeks, but should be aware that it can take several months to fully recover.

The nasal packing will be removed after a few days, and the splint (which covers the nose after surgery) and/or stitches will be removed one to two weeks later.

Quite often with nose jobs you may look worse than you feel and may want to avoid going out in public until the bruising and swelling has subsided. You should be able to return to work after a week even though you may still be slightly swollen or bruised.

It is very important to avoid strenuous activities and contact sports as this may result in the nose being damaged.

If you wear glasses you will have to have them taped to your forehead or propped on your cheeks for around six to seven weeks to ensure your nose heals properly.

It is surprising how much a change in the shape or size of your nose can alter the way you look. The majority of people who have a nose job are more than satisfied with their new look, and feel more confident as a result of the improved aesthetics of the nose.

Having a more symmetrical nose can make you look far more attractive. It is a well-established rule that facial symmetry equals how attractive a person is viewed to be by others. If your nose is off centre or asymmetrical it can make you look less attractive. A nose job can easily correct this and imrove the balance of your face.

Many people feel physically and mentally better after having a nose job. A large or over prominent nose can distract from other facial features and can result in teasing or bullying, particularly through school.

Nose jobs aren't always for aesthetic reasons; a number of people opt for a nose job for functional benefits. Some people suffer from breathing difficulties as a result of the shape of their nose. A nose job can help open the nasal passages, allowing you to breath more easily.  It can also help with birth defects such as cartilage deviation or nasal asymmetry and can alleviate symptoms that may affect the entire circulatory system.

There are two main types of nose job surgery: closed rhinoplasty and open rhinoplasty.

Closed Rhinoplasty

This involves having Incisions made inside the nostril, where they will be completely invisible after healing. This type of surgery usually heals quickly and has a faster recovery time. A closed rhinoplasty still allows the surgeon to remove bone and cartilage but it is not suitable when more extensive work is required.

Open Rhinoplasty

This involves a small incision being made between your nostrils as well as inside the nose. This type of surgery allows the surgeon more flexibility and visibility during the procedure but is a more invasive form of surgery and therefore has a longer recovery period and more associated swelling and bruising.

Revision Rhinoplasty

In some cases you may need to have additional surgery to achieve the desired result or may opt for further surgery if you are dissatisfied with the original outcome. This is known as revision rhinoplasty. You may also need to undergo revision rhinoplasty if your nose is injured or damaged. Secondary rhinoplasty procedures may be more difficult to perform than traditional rhinoplasty surgery if the septum was partly removed or altered during the first procedure. It can also cause problems if the cartilage and bone has been removed, if the skin is thicker and more difficult to work with because of scar tissue or if you airway has been impeded during the initial surgery. The best way to avoid this is to communicate properly with your surgeon during the consultation period and choose a surgeon who is experienced in rhinoplasty surgery.

The Non-Surgical Nose Job

In some in stances it may not be necessary to have surgery. Many cosmetic doctors and nurses now offer a non-surgical alternative to rhinoplasty using dermal fillers. The filler can be used to correct minor deformities in the nose including smoothing out small lumps or dents in the nose and correcting minor asymmetry. While fillers will not be able to correct any major deformities this procedure is a more affordable option for those who only require minor correction and involves very little recovery time. The results can last between 6 and 18 months depending on what type of filler your practitioner uses. Visit our Dermal Fillers section to find out more.

Like any cosmetic surgery procedure, rhinoplasty involves an element of risk. The major risks of any surgery are post-operative bleeding, infection, and reactions to medications or anesthesia. Having the procedure done under general anaesthetic carries an additional risk.

Risks that are specific to nose job surgery include:

*Burst blood vessels that can lead to red spots and small scars on the underside of the nose
*The need for a revisionary or secondary procedure

A very small percentage of people may have to have a second minor procedure to achieve the desired results. In many cases this is because they are dissatisfied with the original result. Revision rhinoplasty may also be necessary if the nose is injured in the future.

Temporary post-surgery side effects can include:

-Bruising and swelling

-Post-operative pain

-Black eyes

-Numbness

-Difficulty breathing through your nose

-Scarring

-Heavy nose bleeds (this may require hospital treatment so contact your surgeon if this occurs)

-Temporary loss or reduction in sensitivity to smell (there is a small chance that this could be permanent)

-Damage to the septum

There is also a risk that you may develop post surgery depression, especially if you are not happy with the results of your operation. Because there can be considerable swelling after surgery, it is not easy to tell what the final result will look like for some weeks or even months. It is important to remember that it will take time to fully recover and only then will you be able to see the final result.

The cost of rhinoplasty varies depending on the surgeon you choose and on the extent of surgery you are having but the procedure usually costs between £2,000 – £3,500.

Surgeons that have extensive experience and are highly recommended for nose surgery will normally charge a higher price however it is worth investing in someone with a lot of experience in this type of surgery as it can be quite complex and involves a lot of skill.

In some cases rhinoplasty is available on the NHS but this is highly unlikely if it is purely for cosmetic reasons. If you need reconstructive surgery or surgery because of breathing problems you may be able to get it through the NHS. The best way to find out is to speak to your GP.

Click here to see some great before and after pictures. These can give you a good idea of what can realistically be achieved.

If you're unsure about choosing your surgeon, myfacemybody.com is a really informative website that allows you to see videos of surgeons in your area and their surgeries.