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(Nose Job or Nose Reshaping) A nose job (technically called a rhinoplasty) is surgery on the nose to change its shape or improve its function. It can be done for medical reasons — such as to correct breathing problems related to the nose or correct disfigurement resulting from trauma or birth defects. It can also be done for cosmetic reasons, which will change the nose’s shape and appearance.
During an operation, the surgeon makes cuts within the nostrils. In more difficult cases, the surgeon may also make cuts across the base of the nose. The surgeon then reshapes the inner bone and cartilage to produce a more pleasing appearance.
Rhinoplasty to change the shape of the nose is performed either from inside the nostrils (called closed rhinoplasty) or by making a small cut between the nostrils and lifting the skin, as shown opposite (this is called open rhinoplasty). The precise nature of the operation will depend on the area of the nose that is being treated. The scar may be straight, V-shaped or zigzag.
Changing the bridge of the nose
If the bridge of the nose is being operated on, the surgeon removes the bone and cartilage that is causing the ‘hump’. The nose may then be broken so the remaining pieces of bone can be moved closer together to narrow the nose.
Changing the tip of the nose
If the tip of the nose is being operated on, the cartilage that makes up the support under the tip needs to be partly removed or reshaped. This can be done through closed or open.
Changing the length of the nose
Your surgeon will adjust and reduce the septum, to help shrink the tip and reduce the overall length of the nose. Adjusting the cartilage at the tip of the nose can also reduce the length of the nose.
Straightening the nose
This often involves cartilage grafts from the septum of your nose, your ears or the ribs. Although an improvement is expected, a perfectly straight nose is near impossible to achieve.
Rhinoplasty surgery is usually carried out under a general anaesthetic (so you would be asleep).
Risks of anaesthetic:
- Allergic reaction
- Chest infection
- Blood cuts
- Heart attack or stroke
Local anaesthesia procedures can be done in a sterile outpatient setting. General anaesthesia requires hospital admission and surgery in an operating theatre.
The surgical time is usually 3 hours.
2 weeks for light activities, and 6 weeks for all other activities.
There can be some swelling for 6-9 months and sometimes longer.
As with all operations, there are risks involved in having rhinoplasty. Although the risks are unlikely, it is important to weigh them up against the potential benefit of the surgery. Discuss each of them with your plastic surgeon to make sure you understand the potential complications and consequences.
- Swelling, bruising and pain
- Healing problems
- Polly beak deformity
- Increased or reduced sensation
- Damage to deeper structures
- Hole in the septum
- Breathing difficulties
- Altered sense of smell
- Unsatisfactory result
- Skin necrosis
- Change over time
- Allergic reaction
- Wound breakdown
Rhinoplasty surgery is usually carried out under a general anaesthetic (so you would be asleep). The operation usually takes about three hours. You might be given antibiotics to keep the wound clean. Most patients will have an external metal splint to hold the new shape of the nose in place and an internal splint to reduce bleeding, to support the shape and to reduce the risk of tight scars. The internal splint and stitches are usually self-dissolving.
You might go home the same day, or stay in hospital overnight. If you do go home on the same day, a responsible adult should stay with you for the night.
Your nose will feel tight and sore. Simple painkillers should be enough to keep you comfortable. If your nose was broken as part of the surgery, there will be noticeable bruising around the eyes for about seven to10 days, with yellowing around the eyes for 10 to 20 days.
You may have a little bleeding from your nose for the first day or two after your operation. Dab this away gently with gauze or a clean handkerchief. Avoid any activities where you might knock your nose. Activities that increase the blood flow in your face (such as bending down, straining, lifting or having a hot bath) may increase the chance of bleeding.Sleeping with extra pillows to keep your head propped up will help reduce swelling and keep you lying on your back.
Do not blow your nose, and try your best not to sneeze through your nose. If you are going to sneeze, cough it out. Once the dressings have been removed from your nostrils, you can clear your nose by sniffing into the back of your throat. Unless you are told otherwise, it is better to leave any crusts in your nostrils until you have your post-operative review.
You will be out of bed on the same day as your surgery, and doing light activities after two weeks. You should be able to swim after four weeks, although you should avoid strenuous exercise for six weeks. Most patients take at least two weeks off work after the operation, depending on their job. Do not lift heavy things for several weeks, and avoid sex for at least two weeks.
With all activities, start gently.
Do not drive until you feel safe. Check your insurance documents if you are not sure.
You can find more information regarding to this procedure on the BAAPS (British Association of Aesthetic Plastic Surgeons) website.