Rhinoplasty – Nose Surgery

Rhinoplasty is corrective surgery of the nose. Depending on the type of nose and the patient’s wishes, it is either only surgery involving the soft tissue or also one involving the bone of the nose. The procedure is performed under general anaesthesia and takes one to two hours, depending on the given case. A small cast is worn on the nose for 2 weeks after surgery.

Pre-op Assessment

This involves examinations and tests as in the case of any other plastic surgery: a basic urine and blood test, examination of the lungs and heart. You can have your GP do the assessment and he/she may refer you to an internist. Another option is to undergo the assessment at the plastic surgery clinic. The surgery and your state of health will be consulted not only with your plastic surgeon but also with an anaesthesiologist. The examination and consultation are required to check whether you can undergo this procedure. Also, an ENT examination is useful, but not necessary. This depends on the requirements of the surgeon.

Procedure

A rhinoplasty may be performed using the open approach, with a bridging incision running within the soft tissue separating the nostrils. The closed approach involves incisions inside the nostrils, which are absolutely invisible from the outside. The proportions of the nose are altered using a chisel and hammer. The parts of the nose that are removed can also be used as transplant components for shaping the nose. Your surgeon will give you a specific description because the changes made on your nose will be highly individual. The next step is the straightening of a deviated nasal septum. This step helps the patient breathe more freely. After the desired shape of the nose is achieved, tissue is repositioned and stitched. The surgery is completed with packing of the nose and placement of an exterior cast immobiliser.

Recovery

The patient remains at the clinic for 48 hours after surgery, when the packing is removed. Although this surgery can look drastic, no pain is experienced during the post-operation period. The exterior cast immobiliser is worn for one to two weeks after surgery, depending on whether soft tissue or bone was operated on. The plastic nasal cast must then be worn during sleep for the next two weeks. Bruises under the eyes and in the eyes as well as a swelling of the face are aesthetically unpleasant. All these disappear within two weeks of the surgery. A slight swelling of the face remains for another week, but does not prevent the patient from going to work. Pressure massages, especially of the tip of the nose, are required for 2 to 3 months after surgery. Lighter exercise is possible after 3 months and fully after 6 months. At the beginning of recovery, avoid bending forward, refrain from excessive strain and make sure you do not injure your nose.

First Visible Effects

Visible effects can be seen once the cast immobiliser is removed. As time passes, the size of the nose will decrease and its shape will alter slightly, taking the desired form. The final change in the shape of the nose is fully visible one year after surgery.