Augmentation Rhinoplasty

What can be done?

To help improve the appearance, of a flattened nose it is necessary to introduce some,additional frame work underneath the skin,to help raise and straighten, the bridge-line. This operation is called Rhinoplasty Augmentation. There are various materials, used for additional frame work such as bone, cartilage(gristle) and a range of manufactured materials,to show that they have been well tolerated by the body. Augmentation Rhinoplasty, has certain advantages, as well as disadvantages.

The additional frame work is usually done into the nose through a cut, either inside the nostrils or in the strut of skin between the nostrils. If a bone graft, is necessary, or is used then it would be taken from the crest of the hip,rib or back of the elbow, or either from the outer surface of the skull,without causing any kind of weakness of the donor bone. If cartilage is used, then it is usually taken from the shell of one or both ears , or from the cartilage inside the nose, which is spare for the procedure.

If the nose has been, flattened by the injury, it is quite common for the plate of the bone which is separated in two halves of the nose to be buckled as well, which makes breathing difficult,this can often be corrected at the same time as augmentation rhinoplasty,by straitening the buckle out , however sometimes it is advisable to have this done, as a separate operation beforehand.

In case there is a severe collapse of the nose, skin graft may also be necessary to achieve a satisfactory reconstruction.

What are the consequences?

It would take up to 3 weeks, for the bruising and swelling on the face and around the eyes to settle. During this time, your nose is likely to be covered with a firm splint. Once the swelling subsides you will find that your nose feels rather stiff and numb, this will gradually lessen during the next few months but the stiffness is likely to be permanent. If a bone graft is done then you would be left with a scar which may be noticeable if it is on you hip or chest

What are the risks?

Shortly after the surgery your nose could bleed, for about a week to 10 days, which would require, some treatment in the hospital. It is quite common for there to be some difficulty with breathing through the nose, during the first week after the operation which disappears, as the swelling settles. Sometimes the difficulty persists and can be permanent. If there is an infection it can affect the success of the operation.

If a manufactured implant has been used, or a graft from a bone or cartilage, either way it should be possible for you to have reconstruction operation , after the infection is cleared. If an implant is used, it is likely to extrude through the skin of the nose or its lining and need to be removed, this can happen after a long time, and if a large implant has been used or if the nose is accidentally injured, then there is about 10% risk that you may need further surgical treatment for one or more of these complications were you will have this operation done.

What to expect?

If it is only a small implant, that needs to be inserted, the this procedure can be done without general anaesthesia, in this case you have local anaesthesia which is administered locally, into your nose to make it numb and you not need to stay in the hospital. If it is a larger reconcustrction , then a bone graft from the hip, or chest in this case general anaesthesia is required, and maybe up to a week in the hospital. After the operation is completed, you will probably have the dressings in your nostrils, for a day or two , which will prevent you from breathing through the nose.

You would have a firm splint over the nose, for the first week, you would have a little pain, however if you do a bone graft taken from your hip, then you could expect this to be quite painful for about 10 days, especially when you walk. The surgeon will give you pain medications will ease the pain.

What you should do when you go home?

There would be some minor bleeding from your nose, for the first day or two after the operation and you would just need to dab it gently with a gauze, or a clean cloth. Keep your head up as much as possible, and try to avoid having a hot bath. Do not try to blow your nose and try your best not to sneeze through your nose.

Once the dressing are removed, from the nostrils, you can clear your nose by sniffing into the back of your throat if you wish. Unless you are advised otherwise, it is better to leave any crusts in the nostrils until you see your surgeon for removal of the splint 1-2 weeks after the operation.

To be off work, will depend on the extent of the operation, there would be some initial swelling and bruising, which will probably subside in the first two weeks , for you to feel normal again.

It would take at least 3 months for your nose to look normal after the reconstruction, or may be longer, there may be some unevenness, of contour which is common during the first few months till it settles.