The nose is a focal point of any face. Slight deviations to one side, a hump on the bridge, a bulky tip or simply a nose that appears too large for the face can result in poor facial harmony. Whether the nose has been broken or just developed that way, the shape and size can be altered by a rhinoplasty.
The shape and size of the nose can be reduced or augmented by the insertion of small pieces of cartilage to give an appearance that suits the overall shape of the face and the chin. The procedure can also be used to correct any nasal deviation and may alleviate difficulty breathing from either nostril.
Rhinoplasties take between one and a half and three hours depending on the extent of the deformity and are carried out under general anaesthetic. The incisions are made either within the nostrils (endonasal approach) or with an additional incision through the columella, which is the column of skin that lies between the nostrils (open approach). Occasionally, additional very small incisions may need to be made on the side of the nasal bridge next to the eyes.
If the shape of the nose needs to be enhanced or strengthened, small pieces of cartilage are introduced into the nose and sutured into place. This cartilage may need to be harvested from the back of the ear or occasionally from a rib.
Sometimes, to straighten the nose and assist breathing, the ridge of cartilage that separates the nostrils within the nose needs to be realigned. This is called a septoplasty.
Medication that may increase postoperative bleeding such as Aspirin or non-steroidal anti-inflammatory drugs such as Voltarol or Ibuprofen should be avoided for four weeks before surgery. Smoking is not advised before a rhinoplasty or septoplasty and you should make every attempt to stop at least four weeks before surgery to minimise the risk of wound healing problems.
At the end of the procedure there may be a small plaster over your nose, fixed in place with tape over your forehead and cheeks. You may have bruising around your eyes and you may have difficulty breathing through your nose due to the presence of nasal packs. The plaster does not usually prevent the wearing of glasses.
The procedure usually requires one night in hospital. The nasal packs are removed the following day before you go home. The plaster on the nose is removed after a week.
Bruising and swelling may persist for four to six weeks after the procedure. Some bleeding from the nose can occur in the early postoperative days and it is important to avoid sneezing or blowing the nose for a few weeks. It may not be possible to completely correct some nasal asymmetry. Very occasionally, the nasal scars do become thick and prominent.