The nose occupies the centre of the face and is one of the most commonly noticed parts of the face. It also has important functions related to breathing. The nose is made up of bones and cartilages that are joined together to form the shape of a roof. This is supported by a midline wall called the nasal septum that separates the nose into right and left nostrils. The shape of the nose depends on all these structures and the skin covering it, as well as hereditary factors. Nasal deformities are readily noticeable.

Your nose … is it too large, too small, too flat, too pointed? Is it crooked? Do you have trouble breathing from one or both sides of your nose? Or does it simply not fit your face?

Surgery can change the shape of the whole nose or just a small part, making it fit more harmoniously with the rest of the face and improve the function of the nose. The operation is called Rhinoplasty. When rhinoplasty is combined with an operation on the septum, it is called a Septorhinoplasty.

What results can I expect?

Rhinoplasty is by far the most complicated of the facial plastic surgical operations. The thickness and texture of your skin, the strength, shape, and symmetry of the nasal bones and cartilages, healing power of your body following surgery, and, of course, the skill of the surgeon, all have an impact on the outcome. Please note that the end result is not apparent for 9-12 months following surgery and continued changes in the shape of the nose occurs with time.

A rhinoplasty is successful if the patient is happy after surgery. Therefore, if you are considering cosmetic rhinoplasty, you should look at your nose in the mirror carefully and try to determine the areas you find unsatisfactory and what you would like to have changed. If you need your nose to be perfect and if you are expecting surgery to correct all imperfections instead of merely making them better, do not have the surgery, as your expectations of the final outcome may exceed what the surgery can deliver. Some requested changes are more accomplishable than others. In general, however, the majority of the patients are happy with the end result.

Surgical procedure

A full assessment of your nose and facial features is carried out with the aid of photographs during the consultation. The surgery is performed whilst you are asleep. Cuts are made inside and occasionally outside the nose and the skin is lifted off the bone and cartilage underneath. A hairline fracture may be made in the nasal bones to allow the change in the shape of the nose. Small pieces of bone and cartilage may be removed from or even added to the nose to smooth out any bumps or dips. At the end of the procedure all incisions are stitched in place. In some cases, extra cartilage is required to obtain the desired shape of the nose. This cartilage is very occasionally taken from your ear or ribs. The surgeon will discuss this with you when planning the operation. Absorbable dressings are placed inside the nose which disappear after a few days.

After care

After the operation you will have some discomfort but any pain tends to be minimal and controlled with simple pain killers. You may have some bruising and swelling around your nose and eyes for 1 week. Your nose will feel blocked and crusty in the first two weeks after surgery. We advise you to only blow your nose very gently in the first week following surgery and sneeze with your mouth open to protect your nose and minimise the chances of bleeding. You will get some blood stained watery discharge from your nose for the first 2 weeks or so and this is normal. We will give you some drops or a spray to help this. It may take up to 3 months for your nose to settle down and for your breathing to be clear again. Try to stay away from dusty and smoky places for that time. The stitches inside your nose will dissolve and will fall out by themselves.

The skin of the nose is very sensitive to the sun following surgery and it is important that you wear sunscreen (factor 30 or more) and a hat for at least 6 months. The nose may feel a little stiff and numb for up to 3 months, particularly around the tip.

Most people need 1 week off work, especially if the work involves heavy lifting or strenuous activity. You should not play any sports where there is a risk of your nose being knocked, for at least 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 inside the nose is very are but if this occurs it can be serious. The nose gets more and more blocked and sore and you may feel unwell. If this happens, please contact us immediately.

Very rarely the operation may leave a hole in the septum inside the nose and very rarely you may experience some numbness of your teeth, which usually settles with time. Loss of sense of smell may also occur but again is rare.

About 5-10% of patients need further operations in the future to further adjust the shape of the nose.