Rhinoplasty Nose Job - Nose Reshaping

A rhinoplasty/nose job is perhaps one of the most common types of cosmetic procedures performed today. Nose reshaping surgery is employed for repair of injuries, such as a broken nose, and for those conditions of developmental nature that are essentially family in origin, for example a crooked nose. Corrective nasal surgery can be performed on all age groups, including the young and the elderly.

Click here to read a first person account of Rhinoplasty Surgery.

Benefits of Nose Reshaping

The nose is the central facial feature and therefore has a huge impact on the overall aesthetic beauty of the face. A nose that dominates or is out of kilter with the rest of the features, draws the eye. How cosmetic rhinoplasty surgery can help is to:

For those who have avoided having their photograph taken because of unhappiness with their nose, it gives a sense of freedom to just relax and be themselves, without having to be self conscious.

      Pre Rhinoplasty                                   Few Weeks Post Rhinoplasty

Nose Reshaping

Changes in the nasal contour are made by removing, shifting, or altering the underlying bone and cartilage structures. The skin over the surface of the nose can then be moulded or draped over a new foundation to achieve the desired result. This form of nose reshaping is performed from inside the nose leaving no external scars except in special circumstances. One might consider this procedure similar to raising or lowering the central support of a tent, resulting in change of its out-side appearance.

The nature of the individual's skin might influence the final result of a nose job. Thinner skin can easily drape over the new contour, while thicker skin is more difficult to control and will not adapt as easily to the new form. A change can be made in the operation to compensate this variable, but a new set of limitations may then appear. The nasal passages cannot be narrowed beyond a certain point during nose surgery, since some of the underlying framework must be preserved.

The surgeons attempt to achieve a delicate balance, leaving sufficient framework to permit normal breathing capacity while removing excess or distorted anatomical parts. In addition, the cosmetic surgeon cannot direct attention to the nose without considering the other facial features.

Flaring of the Nostrils

Flaring of the nostrils is treated by excising a small strip of skin and nose lining from the entrance to the nose. This is called a Weir excision. The incision is placed in the junction of the nose and cheek so that it is difficult to see and leaves minimal scarring.

Nevertheless, problems can arise. The scar can become heavy, and if it contracts a notch may appear at the nostril rim. Sometimes, it is difficult to get both nostrils exactly the same so there is asymmetry. Because this makes the nostril smaller breathing may be a little more difficult after rhinoplasty surgery.

Narrowing of the Nasal Bones

If the bridge of the nose is wide the cosmetic surgeon will narrow it by fracturing the bone on each side and moving it closer to the centre.

During rhinoplasty surgery you will probably have a splint placed on the outside of the nose and a pack in the inside which will be removed after a few days.

Complications of Nose Reshaping

In most cases of Rhinoplasty, patients are happy with the outcome. However this is probably one of the most difficult cosmetic surgery operations and as such has potential complications. Secondary surgery is needed on about 10-15% of patients.

After all operations there is bruising and swelling which is normal in all surgery but can persist for several weeks after a nose job. This lasts about two weeks but can continue for a month or more. An unusual cause of swelling after rhinoplasty is the development of a small cyst.

Remember that the human body is asymmetrical and even after surgery both sides of the body will look different. All surgery requires an incision and therefore will leave a scar. In most patients the scar heals well, but in a small number of people the scar remains thick and heavy. At the time of surgery the small nerves that supply feeling to the skin are damaged. This may cause changes in sensation including numbness.

Although uncommon, bleeding and infection are risks and can be serious. You will have pain and discomfort after rhinoplasty/nose job surgery. The pain usually only lasts for a few days. One per cent of all operations lead to major complications. This is a surgical procedure and as such potentially serious complications such as a blood clot or embolus or an unexpected response to drugs or anaesthetics can occur.

Beside the complications that can develop after any surgery, there are problems that are specific to nose reshaping surgery. These include thinning of the septum of the nose, difficulty breathing and the need for secondary surgery.

Infection is rare after Rhinoplasty

However, it can occur. Many doctor's provide antibiotics around the time of surgery. A serious but rare complications of injection is the development of blood clots in the veins close to the brain, called cavernous sinus thrombosis.

Damage to the tear ducts can be caused during bone fracturing which may cause persistent tearing.

Septal perforation is the development of a hole between the right and left sides of the nose on the inside. It can occur when surgery is performed on the septum such as with a submucous resection or septoplasty for septal deviation it is more common when the patient has used cocaine.

Difficulty with smelling(anosmia) is common in the first few weeks after rhinoplasty surgery but usually resolves. However in a small number of cases the loss of sense of smell can be permanent.

Abnormal appearance and shape are probably the commonest reason for dissatisfaction after nose surgery. This can be due to many factors. When bone heals callus forms and may cause irregularity. Sometimes cartilage is trimmed and may bend in a unpredictable way and impair the result. In some cases the amount of cartilage or bone removed will be too much or too little and in these cases a less than perfect result is obtained.

Healing
The recovery process takes one to two weeks and people can generally go back to work then.