What is rhinoplasty?
Rhinoplasty operations can increase or decrease the size of your nose, or change its shape. Reduction rhinoplasty makes the nose smaller. Augmentation rhinoplasty is carried out to make the nose larger or to give it more bulk.
Your surgeon will explain the potential benefits of having a reduction rhinoplasty, and discuss the associated risks and alternatives to the procedure.
Reduction rhinoplasty
Reduction rhinoplasty is usually carried out under general anaesthesia, which means you will be asleep throughout the procedure. The operation may be performed as a day-case with no overnight stay in hospital.
During the operation, your surgeon will make cuts inside your nostrils to reach the bone and cartilage. The cartilage is then removed or rearranged to achieve the shape you have agreed with your surgeon. The skin over your nose is left untouched and shrinks down to the new shape.
To keep your features in proportion, it might also be necessary to make your nostrils smaller. This is done by small cuts in the skin of the nostrils, which leave fine scars on each side of your nostrils. Your surgeon will advise you whether this procedure might be necessary.
After the operation, the cut is usually closed with dissolvable stitches. The operation usually lasts 60 to 90 minutes.
Augmentation Rhinoplasty
Augmentation rhinoplasty is also usually carried out under general anaesthesia, and as a day case with no overnight stay in hospital.
Sometimes however, additional bone or cartilage is needed to build up the nose. Bone may be taken from your hip, a rib, the back of your elbow or the surface of your skull. This is called a bone graft. If cartilage is used it may be taken from your ears or from spare cartilage inside your nose. Sometimes artificial implants are used. The skin over your nose often doesn’t need to be cut, but it stretches over the new shape. If a bone graft is needed, you’ll probably need to stay in hospital for one or two nights.
Once the anaesthesia has taken effect, your surgeon will make an incision inside or between your nostrils and reshape the bone. If you are having a graft, an incision will also be made at the site where the bone or cartilage is to be taken from.
After the operation, the cuts will be closed up with dissolvable stitches. The operation usually lasts around 60 to 90 minutes.
After both reduction and augmentation rhinoplasty, there may be some pain, although painkillers will help with this. There will be bruising and swelling, particularly around your eyes, which can take about three weeks to settle. It will take around three months for the swelling in your nose to disappear.
If you have had an augmentation rhinoplasty your nose will feel numb and stiff. The numbness usually disappears within a couple of months, but the stiffness is likely to be permanent and your nose may feel unnaturally hard. Your nose may look also look slightly bigger than you expected. This is deliberate because bone grafts gradually shrink in size during the first year or two. If the bone graft was taken from another part of your body, you will feel some pain and be left with a scar at the place it was taken from.
Rhinoplasty is a commonly performed and generally safe operation. However, all surgery carries an element of risk.
The possible complications of any operation include an unexpected reaction to the anaesthetic, bleeding and infection. It’s also possible for a blood clot to develop in a vein in the legs (deep vein thrombosis, DVT).
With augmentation rhinoplasty, there is a risk that infection could damage the graft or synthetic implant, requiring it to be replaced. There is also a risk that a synthetic implant will protrude through the skin of your nose and need to be removed. About 1 in 10 patients need further surgery as a result of complications from augmentation rhinoplasty.
The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain how any risks apply to you.
As with any cosmetic surgery procedure, it's important that you review your expectations thoroughly with your surgeon before you decide to proceed.
To find out more about having nose re-shaping surgery in a Spire Healthcare hospital, please call our cosmetic surgery team on 0800 434 6644.
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