I usually recommend that
patients wait until they are at least 15 or 16, and possibly older for
boys, before undergoing rhinoplasty. This is because the nose may not
be fully developed at a younger age.
Rhinoplasty is sometimes performed in conjunction with nasal septum
surgery for airway problems. During your consultation you will be asked
about your medical history, breathing problems, allergies that may
cause nasal stuffiness, and if you are a chronic user of a nasal spray.
During the initial consultation, you may be asked to look in a mirror
and point out exactly what you would like to see improved. It is not a
good idea to have a rhinoplasty if you do not know what it is about
your nose that bothers you.
In evaluating you for rhinoplasty, a routine and painless examination
of your internal nasal structures will be performed. Your skin quality
as well as the size and shape of your nose and its relationship to your
other facial features will be carefully studied.
Some of the common indications/reasons why people request a rhinoplasty
- your nose appears too large for your face
- there is a bump on the nasal bridge when viewed in profile
- your nose seems too wide when viewed from the front
- the nasal tip droops or plunges
- the tip is thickened or enlarged
- your nostrils are excessively flared
- your nose is off-center or crooked
- previous injury has made your nose asymmetrical
A rhinoplasty can usually enhance self image and people who undergo the
procedure for that reason are usually happy with the outcome. It is
also important to understand that the shape of your nose can be changed
to a degree, but the extent to which that can be done is dependant on
the initial shape of the nose. Mostly problematic areas can be improved
and refined rather than give you a totally different nose.
There are generally two approaches to a rhinoplasty. The first approach
is called a “closed rhinoplasty” where the incisions are all made
inside the nostrils. The second approach is called an “open rhinoplasty
where there are incisions made inside the nostril as well as across the
tissue separating the nostrils which is called the columella. There are
different indications to these approaches and the choice between them
depends on your nose and the goals set out for the procedure.
Through these approaches various reshaping procedures can be performed
- decreasing a dorsal hump
- refining the nasal tip
- elevating a drooping nasal tip
- refining the lateral nostril walls
- refining the columella
- refining the bony upper part of the nose
You may not need all the above procedures and it is important to
understand what the exact operative plan is for your nose.
After the procedure, you will have a nasal splint in place which covers
your nose. In some cases, there will be a need to insert nasal plugs in
the nostrils but these will be removed 24 hours after the surgery.
The first couple of days after surgery, you should restrict your
activities and sleep with your head elevated. This will help to
minimize swelling and reduce the possibility of minor bleeding, which
is not uncommon.
Generally, bruising around the eyes and cheeks is most apparent during
the first three days following surgery. Most discoloration will
disappear within a week. A few days after surgery, you can begin to use
makeup as a concealer, if desired. Noticeable swelling may last for
several weeks. You may need to continue wearing the nasal splint for up
to a week, during which time you should avoid getting it wet.
The goal of rhinoplasty is a nose that looks natural and blends
harmoniously with your other facial features.
Complications are usually rare but some that may occur include:
- Anaesthetic complications
- Bruising and long-term swelling
- Unattractive scarring
- Septal perforation
- Patient dissatisfaction / unsatisfactory results
- Numbness of the nose
- Overcorrection of the problematic area such as the dorsal
- Nasal obstruction
- Damage to deeper structures such as nerves and tear ducts
These complications may require further surgery.
In general, a rhinoplasty is a very rewarding operation.