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Introduction
Rhinoplasty, commonly known as a "nose job" or a nose re-shaping operation, is an umbrella term used to describe nose surgery involving a number of different techniques, for a variety of different reasons. People usually have rhinoplasty for either cosmetic reasons or functional reasons, or both. In aesthetic or cosmetic rhinoplasty, surgery is aimed at improving the shape of the nose, whereas in functional nose surgery, the primary goal is to aid breathing or correct a deformity that's been causing side effects such as headaches, nasal blockage, sinus trouble etc. Cosmetic rhinoplasty can be combined with functional nose surgery thus improving both the internal structure of the nose and the outward appearance.
All kinds of aspects of the nose can be altered with rhinoplasty, such as making it appear straighter, smaller, narrower, broader, altering the angle of the nose in relation to the upper lip, changing the shape of the nasal tip, and many more options too numerous to mention. The middle of the nose can be changed to make it smaller or larger and a dip can be created before the tip. Humps and bumps can be reduced or eliminated. Alternatively noses can be made to appear perfectly straight in profile, or just smaller altogether, although nasal tip surgery is slightly more complicated. Nasal tips can be reduced, enlarged, rotated upwards or downwards, or projected forwards or backwards.
Speak to your rhinoplasty specialist for details about your individual nose surgery. Every nose is different so each operation is unique to the person and involves a completely unique set of circumstances. Sometimes it may not be possible to make a really big nose small, but the balance between the tip of the nose and the bridge can be altered to make it more in proportion. Considerable changes can be achieved to the appearance while maintaining normal nasal function, and most patients are delighted with their new nose. Modern surgical techniques mean that a nose job is very safe with most people undergoing their surgery without any complications at all. This fact sheet of information about nose surgery will help you understand the issues involved and what to expect from the operation. For more a detailed discussion please refer to your rhinoplasty specialist.
Why Have A Rhinoplasty?
Having a nose that stands out as abnormally large, twisted, or disproportionate can cause anxiety, distress and social trauma due to bullying and teasing in the playground. A nose that sucks in at the tip when breathing, is too small, or has internal structures that limit breathing capacity, can be altered to improve function and relieve breathing.
Both types of rhinoplasty, aesthetic and functional, may involve removing or altering excess bone and cartilage. Sometimes it's necessary to make an augmentation of the nose using either a graft from a donor, or from another site within your body, and possibly excising some skin (in the case of nose reduction surgery).
Often people desire a nose job in order to bring their nose into harmony with their overall facial structure and improve their appearance. Insufficiencies can be corrected and adjustments made so that the nose becomes the shape the patient has always wanted.
Some people inherit deformities or oddly shaped noses, other are injured during sports, or through accident, and need their noses reconstructed. Others have internal nasal problems that make breathing difficult or obstruct the flow of air, causing headaches and sinus trouble. Whatever the reason, the goal of nose surgery is to improve the existing condition and bring either form or function into line with the patient's needs.
By the age of sixteen your nose is fully developed and you can see what its shape and structure is going to be like for the rest of your life, barring accident or injury. If you are desperately unhappy with this, getting a rhinoplasty operation may be the answer. As the shape of your nose is defined by genetics you can easily find out who is to blame! Talking to a rhinoplasty specialist will give you a good idea about what is possible and what isn't. It's very important to be realistic in your expectations about nose surgery. It cannot give you happiness or success, it merely alters the shape, structure, or appearance of your nose. If there are problems in your life before the surgery they will still be there afterwards. Understanding this, and the general limitations of rhinoplasty, makes you a good candidate for nose surgery, and you are very likely to be happy with the result.
Cosmetic nose surgery is designed to improve an existing condition or enhance your quality of life by relieving you of a specific problem. It is non-urgent, and you should be in good physical and mental health before undertaking this procedure. You should also make sure that you are quite clear about what you don't like about your nose, and how you need it altered, and can explain this intelligibly to a rhinoplasty specialist.
What Does a Rhinoplasty Involve?
Your rhinoplasty specialist may be limited in what he or she can do according to the nasal shape, skin texture and thickness, chin, lip and forehead angle, any previous surgery, and the patient's general ability to heal along with their age, weight, and general health. The goal of rhinoplasty is not to give people an obviously operated nose, but to maintain harmony with the face as a whole, allowing the nose to blend in normally and not stand out as peculiar. Many people might feel that the nose jobs undertaken by some members of the famous Jackson family are too extreme and obvious.
During nose surgery, small incisions are made in the nose, usually inside the nasal passages where they will never be noticed. Occasionally, thin, inconspicuous incisions are also made on the columella, the strut of skin separating the nostrils, in order to give the rhinoplasty specialist a better view and improved access. The operation is performed through these incisions. Soft tissues are then separated from the underlying structures and the re-shaping of the bone or cartilage can begin.
If you're having your nose reduced in size the bone and cartilage will be re-shaped and the skin left untouched. If the size of the nostrils also needs to be made smaller, further cuts may be made on the outside leaving fine scars, but these will usually heal to almost invisible lines. If the nose shape needs to be strengthened or increased it may be necessary to use a small bone implant. This can either be taken from a site on the patient's own body, such as the hip, a rib, or the back of the elbow, or it can be harvested from a donor. If cartilage needs to be added the graft sites include the ears, spare nose cartilage, or sometimes artificial implants are used.
After the operation the surgeon will close the incisions with dissolvable stitches and may insert soft packing to help prevent bleeding. You may also have a plastic splint on the outside of your nose for a few days to maintain the shape and protect it from damage.
The type of your skin, your age, the shape and nature of your nose and requirements for surgery will influence surgical choice. For more information about nose surgery please speak to your rhinoplasty specialist.
Side Effects and Potential Risks of Rhinoplasty
As with all operations involving general anaesthetic there is a very slight risk of adverse reaction to the medication, bleeding (haematoma) and breathing difficulties. Many people feel dizzy and unwell after surgery due to the anaesthetic, although the drugs used today are making this less and less common.
More specific risks of rhinoplasty include nose infections, a temporary loss or reduction in sensitivity to smell (although this is rare), a slight reddening of the skin (but this is very rare and usually only happens if you've already had previous nose surgery). Sometimes swelling around, or on, the nose at the time of surgery, disguises underlying irregularities or deformities. These can be missed by the rhinoplasty specialist during the operation and only become apparent some time later. This is more likely if you've had an accident or injury and require surgery quickly.
If your nose surgery has required a graft from a site on your body you may be sore and tender at the graft site for up to two weeks. You may also have a slight scar.
After the operation it is not unusual that you'll experience difficulty breathing through the nose, and you will be advised not to cough or stifle sneezes for a week after your nose surgery. Difficulty breathing through the nose is most noticeable when the nose has been made smaller and while swelling persists, but as soon as this settles down and you are used to the new shape and size of your nose, breathing becomes easier.
It's important to realise that rhinoplasty cannot guarantee a perfect result, and unpredictable cartilage or bone healing could cause irregularities which are either felt and/or are visible on the outside. Only 5% of patients undergoing rhinoplasty will need a revision. Most people undergo the procedure without any complications at all.