What can be done?

Rhinoplasty, reduces, the size of the frame work of the nose over which the skin is draped, but the skin is not touched. The frame of the nose which is made up of the bone in the upper half and gristle(cartilage) in its lower half is approached from underneath the skin, through the cuts which are made inside the nostrils. In order to straighten the nose and bring its bridge closer to the face, its “ridge”is cut away, to restore a new 'ridge” or bridge-line the two sides of the nose are brought together by cutting the bones of the nose where they join onto the cheek bones. Due to the elasticity of the skin, the overlaying skin shrinks down to the smaller frame.

This procedure, effectively narrows, the width of the nose,and makes the nostrils wider, it may be also necessary to narrow them as well by cutting out a small piece of the skin in the floor of the nostril which would leave a fine scar on each side of the nose. There is a possibility to shorten the nose, by slimming down a bulky tip and reducing the amount of cartilage, which shapes the end of the nose. If you do have some problem breathing through the nose, it may be possible to improve this at the same time by adjusting to lie of the plate of the bone which separates one half of your nose from the other.

This is referred to as a Septoplasty. It is noted that, the size of the nose as a feature of the face is influenced by the proportions of the other features,of the face such as the chin and the cheek bones, and to “normalise” the appearance of the face, as it may be advisable to alter these features as well, either at the same time a rhinoplasty, or during a separate operation.

What are the consequences?

There would be some bruising and some swelling, particularly around the eyes, which can take up to three weeks to completely disappear. You would need to wear a firm splint over your nose during part of this time. By the end of the 3 weeks, the swelling would have settled for you to look normal than others, and as if you had not had any surgery at all.

You would be self concious for sometime, and also anxious to see your new appearance,and how your nose looks. It takes a few days for your mind to adjust itself to your new look. It takes about 3 months or more for all the swelling, to subside. After the surgery is completed, if there are minor changes to be made,like the shape,do not be worried ,the shape will improve with time. You may experience some numbness, and find that your nose is a little stiff,for a few months particularly at the tip.

What are the risks?

This procedure is carried out under general anaesthesia, and there is a small risk of the chest getting infected, this happens with people who smoke. There is also a small risk that the infection could complicate the operation. You can minimise, this risk , by ensuring that you are free from viral infection or cough , cold or sore throat at this time of the operation, and need to check with your surgeon.

Shortly after the operation, there is a risk of nose bleed, or after a week to about 10 days, which may require 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.

In some cases it, is most likely that after the swelling goes down, that the nose still does not look right, however in these cases, the surgeon would carry out a second operation, to the residual problem of the appearance, but not until the swelling has subsided after the first operation. Most surgeon, usually wait for a year for this to happen. This may also involve additional expense.

What to expect

This operation is carried out under general anaesthesia, and need to be in the hospital at least over night. The operation is painless, and it is unlikely that you will need anything other than mild painkillers afterwards. It become, uncomfortable because you will probably have dressings in each nostril for a day or two which would prevent you from breathing through the nose. There would be a firm splint over your nose to hold the bones in their correct position.

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 is removed, from the nostrils, you can clear your nose by sniffing. It is best otherwise,to leave any crusts in the nostrils, until you see the surgeon to remove the splint after about 1-2 weeks.

The surgeon would advise you to take 2 weeks off from work ,until the bruising has gone.