Rhinoplasty (Nose Job)
By: Ali Q ENT
What is a Rhinoplasty?
A Rhinoplasty also known as a Septorhinoplasty is an operation performed to alter the shape of the nose. This surgical procedure can improve the nose's appearance and breathing function at the same time.
'Functional' rhinoplasty is often performed to reverse the effects of trauma or correct a birth/growth defect to improve airflow through the nose, whereas, 'cosmetic rhinoplasty' is usually performed to remove a 'nasal hump', refine the nasal tip or correct nasal asymmetry.
Nasal function and aesthetics are intimately related to one another. A symmetrical and well proportioned nose is more likely to work well in terms of breathing than one which is deviated or asymmetrical.
There are two approaches to rhinoplasty:
'Closed' and 'Open'.
A 'closed' technique avoids the need for visible incisions, it is usually quicker, associated with a shorter recovery time and less bruising/swelling than an 'open' approach. Tip refinement can be more challenging when using a closed technique. This technique is not appropriate in all cases.
An 'open' technique utilises a small incision at the base of the nose to allow better exposure of the nasal dorsum and tip during surgery. Tip refinement surgery is better performed with an open approach. Whilst this procedure is usually longer than the closed technique it is the preferred approach for complicated and revision cases, particularly when cartilage grafts are utilised.
When is a rhinoplasty performed?
What does a rhinoplasty involve?
Functional Rhinoplasty
A blocked nose due to deviation of the nasal septum and bones can result in:
-
Disturbed sleep
-
Snoring
-
Sleep Apnoea
-
Impaired exercise
-
Reduced Quality of Life
When medical therapies fail e.g. nasal steroid sprays, a septorhinoplasty may be considered. Sometimes a septoplasty (straightening of the nasal septum) may be enough, however when deviation is severe, high, anterior or near a critical structure known as the 'keystone area' a rhinoplasty or septorhinoplasty may also be considered. The type of surgery offered is tailored to the problem and patients personal circumstances and expectations.
Cosmetic Rhinoplasty
Rhinoplasty can also be performed to alter the shape of the nose for aesthetic purposes. Common reasons for requesting cosmetic rhinoplasty include:
-
Nasal Hump Removal
-
Upturned or Down turned nose correction
-
Nasal Asymmetry
-
To increase nasal tip definition
-
To make a nose smaller or less wide
Depending on an individuals needs and wishes, both cosmetic and functional rhinoplasty can usually be performed at the same time. Mr Qureishi will always assess your functional and cosmetic concerns when undertaking an assessment for rhinoplasty or septorhinoplasty.
A Rhinoplasty procedure is performed under a general aesthetic and often as a 'day case'. This means that the surgery is performed with the patient asleep (under anaesthesia), with most patients able to go home on the same day as the surgery.
Once asleep, the nose is cleaned, decongested, injected with local anaesthetic and nostril hair is trimmed. Small incisions are then made inside the nose or along the base of the nose depending on the type of procedure planned. Soft tissue is elevated of the cartilage and bone structures of the nose and the specific defects/deformities of the nasal and septal structures are identified. These are then corrected, either by removing, re-aligning or adding tissue. The tissue used can be taken from the nose itself, or occasionally it is necessary to take it from the ear or the ribs. If necessary, the nasal bones may be broken to allow for realignment, this can result in post operative bruising and black eyes. Once a satisfactory result is achieved on the operating table, the wounds are closed and plasters and splints are applied to the nose. This helps to prevent swelling and protects the nose whilst it is healing. Packing is frequently placed inside the nose afterwards.
What are the risks?
All surgical procedures are associated with certain risks and it is important that you understand them before choosing to go ahead with surgery.
Following a rhinoplasty there are certain things that most patients should expect:
-
The need to take 2 weeks off from work to recover
-
Up to 6 weeks avoidance of strenuous exercise
-
Post operative discomfort requiring regular pain killers
-
Risk of short nose bleeds for up to 4 weeks
-
Numb/Stiff Nasal Tip (particularly in open rhinoplasty)
-
Feeling like the nose is more blocked (due to post surgical swelling and packing)
-
Bruising/swelling/skin redness
-
Need to wear a nasal splint for at least 1 week
-
Small scar (in open rhinoplasty) - that may take weeks/months to fade
Otherwise there are some other less likely but potential risks that should carefully be considered and will be discussed before a decision is made to proceed with surgery:
-
Post operative infection
-
Nasal Septal Perforation (Hole in the nasal septum)
-
Numb upper teeth/Lip
-
Failure to resolve all symptoms/concerns
Interested in Rhinoplasty?
If you are interested in a rhinoplasty for functional and/or cosmetic reasons, you can arrange a consultation with Mr Ali Qureishi. He regularly performs rhinoplasty using closed and open techniques for patients with nasal symptoms. He is also experienced in revision and complex nasal surgery when there is a need to use ear or rib cartilage to correct nasal deformities.
Each consultation consists of an aesthetic assessment with photography and detailed endoscopic assessment (when necessary) of the nasal airway followed by an individualised treatment plan tailored to your unique needs and goals. As an ENT surgeon he is trained in both nasal aesthetics and function, meaning he can provide a holistic approach to managing your nasal symptoms, concerns and goals.