Rhinoplasty, commonly known as nose reshaping surgery, is a surgical procedure that addresses the outward appearance of the nose together with the breathing function that so often accompanies it. For many people at the decision stage the real uncertainty is not the operation itself, but what happens before and after it. In this article we describe the process from beginning to end, in order.
What exactly does rhinoplasty involve?
The nose is a whole in which bone, cartilage, soft tissue and the structures that direct the airflow inside all work together. In rhinoplasty all or some of these structures are rearranged. The height of the bridge, the angle of the tip, the width of the nostrils and the proportion the nose forms with the face are the points discussed most often.
There are procedures carried out purely for aesthetic reasons, and there are cases in which a functional complaint such as difficulty breathing or a deviated septum accompanies them. In the second case the procedure is usually planned as a septorhinoplasty: the aesthetic reshaping and the opening of the airway are addressed in the same session.
What is discussed at the first consultation?
The first consultation is not where the decision to operate is made; it is where your expectations and the anatomical reality are compared. The following points are usually covered:
- Your expectations: describing in your own words what bothers you about your nose is the most valuable information there is.
- Anatomical assessment: skin thickness, bone and cartilage structure, examination of the inside of the nose.
- Your medical history: previous injuries to the nose, earlier operations, medication you take, allergies.
- What is possible: not every nose is suited to every result. Having this conversation openly is the most important step in the process.
Photographs may be taken at this consultation, and imaging requested if needed. The aim is to base the planning on measurement rather than on guesswork.
Preparation before surgery
Once a date has been set, blood tests and an anaesthetic assessment are usually carried out. Your surgeon will give specific instructions about blood-thinning medication, herbal supplements and smoking; following them has a direct effect on how healing progresses.
How does the day of surgery go?
The procedure is usually carried out under general anaesthetic. Its duration depends on the technique, on the extent of the reshaping and on whether you have had an operation before. At the end of the operation a thin splint is placed on the bridge of the nose; what is used inside the nose, and how long it stays there, depends on the surgeon's preference.
Some patients are discharged the same day, while others stay one night under observation. That decision depends on the procedure and on the person.
What are the first few days like?
The first 48 hours mostly pass with a blocked nose, a mild feeling of pressure and swelling around the eyes. Sleeping with the head raised, applying cold as directed and keeping to the medication your surgeon has prescribed all make this period easier. The splint is usually removed at the end of the first week, and the obvious part of the swelling subsides in the first two to three weeks.
The nose reaching its final form, however, is a process spread over months. Skin thickness is one of the most decisive factors in how long that takes.
What to bear in mind when deciding
- Discuss your expectations from the proportions of your own face, not from a picture.
- If you have any difficulty breathing, be sure to mention it at the first consultation; it can change the plan entirely.
- Learn the timetable of recovery from the outset, and arrange your work, studies and travel around it.
- Do not miss your follow-up appointments. The process ends not with the operation but with the completion of the check-ups.
This article is for general information; diagnosis, treatment and the choice of technique are decided individually only after a medical examination. The timings and processes described here vary from person to person.