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RHINOPLASTY

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The nose is a central feature of the face and hence one of the most commonly noticed parts of the face. It is often said that an unsightly nose can distract ones attention of the eyes, the window of the soul! However it does have important functions related to breathing.

The nose can have a multitude of deformities based on the structure of the bones and cartilages that make it up and skin that covers it. It is supported by a midline partition called the nasal septum also composed of bone and cartilage that separates the nose into right and left sides and that can also affect the shape and position of the nose.

Surgery can change the shape of the nose either by changing a small deformity or the whole nose if it is all afected so that it can fir making it fit harmoniously with the rest of the face. This is the operation called Rhinoplasty when combined with surgery on the septum, it is called Septorhinoplasty.

What results can I expect?

Rhinoplasty is one of the most skilful of operations performed in the field of cosmetic surgery. The thickness and elasticity of the skin, the strength, shape, and symmetry of the nasal cartilages, the own body's healing power healing power and of course not to mention the skill of the surgeon, all have the result of the surgery. Results are not final until one year after surgery as the nose continues to reform in this period.

Surgical procedure

The nose is fully assessed prior to operation once and possibly again and pictures are taken and discussion of the realistic end result is made with the surgeon. The operation is carried out under general anaesthesia and usually takes one to two hours depending on the amount of work needed to be carried out. The nasal deformity is usually approached from the inside (closed technique) where no incisions or scars are obvious from the outside. However occasionally the nose is approached from the outside (open rhinoplasty) so as to lift the skin off the underlying bone and cartilage and this is useful when there are deformities of the tip or redo procedures. Sometimes the nose needs to be "augmented' or "filled in" or needs better support in which case extra cartilage is required and this is taken from your ear or ribs. The surgeon will discuss this with you before the operation should it be necessary. At the end of the procedure all incisions are stitched in place and temporary cast is placed on the outside of the nose for 7 days to support the nose.

Postoperative care

After the operation you may have minimal discomfort but pain is not a feature of this operation. You may have some bruising and swelling around your eyes for a week or so. Your nose will feel blocked and crusty in the first couple of weeks after surgery. You should refrain from blowing your nose in the first 2 weeks following surgery and sneeze with your mouth open to protect your nose and minimise the risk of bleeding. You may get some blood stained watery discharge from your nose for the first few days which is normal. You will be prescribed some decongestants for 5 days and some saline drops to help clear the nose of its mucous. Normally it takes about 6 weeks for the nose to feel normal but it can continue remoulding for up to 1 year where the end postoperative result will be apparent.

It is important to avoid the strong sun in the first 6 months or at least take precautions (sun creams against it)..Sometimes the nose tip may feel numb after the operation but this subsides in the next few months..

Two weeks of sick leave is usually advised after the operation where one should avoid all strenuous physical activity so as to avoid bleeding which is a known risk. Sports and training should be avoided for 6 weeks.

Possible complications

Occasionally, your nose can bleed after the operation and we may have to put packs back into your nose if bleeding is excessive.

Infection is rare.

Rarely a hole may be left in the septum inside the nose which very frequently remains unnoticed and again rarely one may experience some numbness of the tip of the nose and/or the upper teeth, which often settles with time. Loss of sense of smell is very rare.

About 5-10% of patients may need another revision operation to correct the defect.

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