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Q&A on Rhinoplasty (nose job) with Mr Irfan Khan

03 March 2017

Rhinoplasty (nose job) is an operation requiring a lot of expertise and experience. Mr Khan is a full member of British Society of Rhinoplasty Surgeons (BSRS); British Society of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS); and British Association of Aesthetic Surgeons (BAAPS). Mr Irfan Khan has a special interest in rhinoplasty and has gained vast experience performing this operation in the last 9 years of private practice. We spoke to him and got him to answer up some of the most frequently asked questions about the procedure. This information will be useful for anyone considering having a Rhinoplasty in the future.

Am I suitable to have a Rhinoplasty?

“A Rhinoplasty can be done to improve the appearance of your nose and/or to improve any breathing difficulties. You need to make an initial appointment and have a consultation with me so we can discuss your concerns regarding your nose. A lot of care and thought is then taken to suggest which procedure is most suitable for addressing your concerns and how your new nose may fit into the rest of your face. “

How is a Rhinoplasty done? 

“A full Rhinoplasty is done under general anaesthesia. This is one of the most delicate and complicated operations that we do. The nose consists of a skeleton framework made up of bone and cartilage. A Rhinoplasty involves making changes to this skeleton framework allowing the skin to drape over it to give a new shape. I refer to Rhinoplasty as ‘a surgery of millimetres’ where a few millimetres being taken off from the bone and cartilage makes all the difference to create the desired new shape. To achieve this precision, a lot of expertise and experience is required. “

I’m worried, will it be very painful?

“This is a usual and understandable concern. Especially as sometimes reshaping of the nose can involve removal of a bony hump or breaking of a nasal bone to make it narrow. I ensure that the adequate post-operative care is given after this procedure. Therefore, the appropriate painkillers will be given to you and often after the first 24 hours paracetamol on its own is enough.”

Will I have lot of bruising and how long will it last?

“As mentioned before, due to the need for bony work, bruising is inevitable. However, I use very fine surgical instrument to break the nasal bone so that the damage is very precise and localised. This technique causes little bruising which usually settles in a week to ten days. You will be encouraged to sleep in an elevated sitting position or with a few pillows under your head for the first few days to minimise any bruising.”

Will I have a plaster on my nose?

“In order to allow the broken nasal bone to reset in a new position, a splint is put on which is removed in seven to ten days. Like any bony fracture, nasal bones take three months to heal. Therefore, during this time you have to be very careful to try not to injure the nasal bone. For example, avoid contact sports during this time but you can do other exercises after two to three weeks.”

Will I have a scar?

"This will depend on what changes need to be made to your nose and this is something that I will discuss in the first consultation with you. For any significant work to the nasal tip, I use an open Rhinoplasty technique. This means that a small cut is created under your nose and the skin is lifted off to adjust the underlying skeleton. This scar heals very well and is not noticeable in nine to twelve months. “

Will my nose be blocked and will my smell change?

“You may experience an initial altered sense of smell with the occasional offensive odour. However, this is not permanent and settles down to normal in a few weeks. This initial altered sensation of smell occurs due to crust formation inside the nose. This can also cause some difficulty breathing completely from your nose during this time. I will give you a nasal spray or drops to put in your nose to soften this crust so that it comes out easily. After three weeks you will be able to blow your nose and these crusts will then clear. Your throat may become dry due to breathing through mouth and frequent small sips of water can be helpful.”

Will I be able to see change in shape of my nose straight away?

“Once the splint comes off after seven to ten days, you will be able to see the major changes made. However the nose is susceptible to a significant amount of swelling after surgery, which can take sometimes up to a year to completely settle down. Therefore, as the swelling improves, the changes made to the nose will become more and more apparent.”

Are there any risks and complications after this surgery?

“The normal risks and complications that can come with any operation are also relevant for a Rhinoplasty. These could be both from the operation and from the general anaesthesia. Whilst complications can occur, I take a lot of precautions to avoid these. Your safety is always the top priority, and these risks will be discussed with you before the operation when you come to see me in clinic.”

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