Mrs Dalia V Nield FRCS(Ed)   FRCS(Eng)

PROCEDURES: Rhinoplasty

Preoperative             Postoperative

What to do?

Discuss it with your GP, if possible, as they know Plastic Surgeons in your area to refer you to. Look in the internet at web sites like BAAPS (British Association of Aesthetic Plastic Surgeons) or Ear Nose and Throat (ENT) Surgeons with special interest in Rhinoplasty. Check that your chosen Surgeon is registered with the GMC (General Medical Council) and is in the Specialist register.
Arrange a Consultation with your Surgeon to be able to make an informed decision to undergo surgery.

Before Surgery

At Consultation a full clinical history is taken regarding your general health, allergies, any treatment you are receiving, history of previous anaesthesias, etc.
Photographs (before and after) are taken and the appropriate surgical technique is decided on. In my practice I develop all my photographs myself, for confidentiality.
The week before surgery, samples are taken (with a cotton bud) from your nose and throat for culture. I am looking for germs like MRSA that can cause severe infections. If MRSA is present, your operation is cancelled, the infection treated, new swabs taken and when clear, we go ahead with surgery. This helps reduce the incidence of infection.
Blood samples are also taken to check your levels, kidney function, clotting, etc.
        
Surgery

This operation is carried out under General Anaesthesia and as an in-patient. Most of the time all done from the inside of the nose, so you do not necessarily have scars outside. This, of course, varies with the selected technique which seems most appropriate for you.
In Rhinoplasty one works both on the bony and the cartilage structure of the nose, altering the supporting skeleton for the skin and thus changing and refining the shape and size of the nose.
At the end of the operation a splint is applied to the dorsum of the nose, to support the bone and reduce swelling. This is removed after few days. There will be swelling and bruising around the eyes. The inside of the nose is packed, the packs are removed the following morning and you can then go home.
I recommend Arnica from the day of surgery and for 2 weeks after to help with the bruising. I use Witch Hazel iced packs to the eyes for 48 hours to reduce swelling.

After Surgery

This is not a painful operation, but it is uncomfortable as there is swelling inside the nose as well as outside and breathing is difficult. It is better not to clean the inside of the nose immediately as this may cause bleeding.
In a week or so, I will see you in my rooms, remove the splint and clean your nose. You will see your new nose, but it will be swollen. The gross swelling and bruising resolves in around 3 weeks, but there will be residual swelling for some 6 months or so.

Complications

Infection and bleeding are common to all surgical operations and can happen here too.
Irregularities and asymmetries can be corrected after all the swelling has resolved. This can happen in about 5% of the cases.
If your operation was a Septorhinoplasty, improvement is always possible but complete straightening of a severely deviated septum or nose can not be guaranteed.

Overall

This is an elegant operation aimed at improving the shape and size of your nose. The resulting nose should blend with your facial bone structure and not be the nose of a “celebrity”.