What is a rhinoplasty?
Rhinoplasty is the generic term for an operation to re-shape the nose – in common parlance ‘a nose job’. When combined with a procedure to straighten the septum and restore the nasal airway the procedure is described as a ‘septorhinoplasty’
Why have a rhinoplasty?
Concerns regarding nasal appearance (such as a large nose, poor nasal profile or ill defined tip) can be addressed by rhinoplasty techniques. Equally factors which compromise the nasal airway (such as deviation of the nasal septum, drooping of the nasal tip or a tendency for the nostrils to collapse on deep inspiration) can be corrected with rhinoplasty techniques. Very often functional and cosmetic problems will co-exist.
What’s new in rhinoplasty surgery?
We now have a better understanding of the structural supports of the nose and how the final result slowly evolves over a period of months as the delicate nasal tissues heal. Over-resection of tissues to give an immediate impact will eventually give an unnatural appearance and often causes functional problems as well. My philosophy is to maintain structural integrity and to give a natural, unoperated appearance in harmony with the rest of the face. The use of digital-image-manipulation software is used to demonstrate the likely outcome of the rhinoplasty and to facilitate discussions about the areas of concern.
Which problems can be addressed by rhinoplasty?
Rhinoplasty is sometimes erroneously compared with sculpture. In fact it’s more like pitching a tent! Great care has to be taken to address the underlying structural elements so that the skin and soft tissues will ‘redrape’ appropriately. Clearly the size, shape and consistency of the underlying bony and cartilaginous structural elements, and the quality and thickness of the skin do impose limitations on what can be achieved and these will be discussed at your consultation. Nonetheless it is generally possible to:
- Straighten the nose and improve the nasal profile (either by removing a hump or by filling depressions with sculpted cartilage harvested from within the nose)
- Improve the size and shape of the nasal tip and its relation to the rest of the nose
- Adjust nasal breadth to achieve a more harmonious appearance
- Alter nasal length
- Improve the nasal airway
Is Cosmetic Rhinoplasty right for me?
This is clearly a very personal matter. If you have a particular deformity which is impacting on your self confidence or you have difficulty breathing through your nose it is highly likely that a skilfully performed rhinoplasty can help. This is something that I will be very happy to discuss.
What happens during a consultation?
After establishing exactly what your concerns are and taking a comprehensive medical history I will want to examine your nose to correlate those concerns with the underlying anatomy. This may include an examination of the inside of your nose and an assessment of the airway and tip support.
This is extremely important because factors such as skin type and nasal airway do influence the techniques which should be employed in your rhinoplasty. I will then discuss my findings with you and, if appropriate, discuss any surgery that I think may be necessary. This will often involve the use of image manipulation software and pre and post operative photographs of previous patients. I am very fortunate in having a large number of patients who are happy for their pre and post-operative images to be shown. This means that you can see the actual results achieved for patients with similar concerns to your own. In line with GMC guidelines I do not post these online.
Do I need a letter from my GP?
This is not absolutely necessary but an experienced rhinoplasty surgeon I like to work closely with your doctor, and providing you are agreeable, will write to them after the consultation.
How much will rhinoplasty cost?
If your concerns are purely cosmetic you will be invoiced for your outpatient consultation. However if there is a functional problem or you have recently suffered nasal trauma your medical insurance provider (if you have one) will pay for your consultation. If surgery is required a written quotation will be sent to you, based on your individual treatment needs. In most cases we can offer a ‘Fixed Cost Care’ fully inclusive package price for your operation and hospital stay. If you have any concerns regarding cost, please feel free to ask.
Why do I decline to treat certain patients?
I have a very busy practice and receive a lot of referrals from colleagues. Experience as a rhinoplasty surgeon has taught me that a superlative technical outcome alone does not guarantee patient satisfaction. A successful outcome is much more likely when patient expectations and my assessment of the likely outcome of surgery coincide. Digital-image-manipulation software has greatly aided these discussions. As this is elective surgery patients are also declined when serious co-existing medical conditions make general anaesthesia hazardous.
If surgery is required how long will I need to take off work?
You will generally spend one night in hospital following a rhinoplasty because of the possibility of bleeding. The surgery is not painful but you will feel blocked up (like with a cold) for a week to ten days and your nose will run. There will also be some bruising beneath the eyes which can be camouflaged with makeup. If your job is physically demanding you will require two weeks off but if you wanted you would be able to do paperwork after two or three days.
What about packs and splints?
With meticulous technique, nasal packing is generally not required after a rhinoplasty although you will have a light dressing at the front of the nose which is removed when you are awake and a nasal splint which maintains the position of the nasal bones and is left on for a week.
And follow-up?
After your rhinoplasty, I will review you at one week to remove the nasal splint. In most cases I will see you again two months later and six months after surgery. If you have any concerns additional appointments will be made.
