What is a Rhinoplasty?

Rhinoplasty surgery describes operations that alter the shape of the nose. There are many different types of rhinoplasty operations. Rhinoplasty can be performed either for aesthetic or reconstructive reasons. Most commonly, for aesthetic reasons, a person does not like the external shape of their nose. Some people wish to adjust the ‘ethnic’ shape of their nose. The nose forms the central feature of the face. We inherit characteristics of our nasal shape from our parents but these may be modified by injury or previous surgery. The nose ceases to grow at about the age of 16 and surgery is usually best carried out after this age.

Reconstructive rhinoplasty operations are often performed to improve the airflow inside the nose, or to reconstruct missing parts of the nose either following the removal of tumours, following accidents, or due to congenital problems.

The anatomy of the nose is more complicated than it may seem from the outside. It is a complex arrangement of outside skin, supported by a cartilage and bone middle framework, and a specialised inner lining which is important for warming and moisturizing the air we breathe. Rhinoplasty surgery is itself complex because it must respect the balance and interplay between these different structures. Surgery may involve reducing or rearranging these tissues, or may require the use of bone or cartilage grafts from elsewhere in the body to rebuild the existing structure.

Rhinoplasty surgery can address various aspects of nasal form and function including the size and shape of the nose, size and shape of the nostrils or tip, relationship between the nose and the upper lip and deviation of the nasal bridge as well as any breathing difficulties.

Rhinoplasty surgery may be done through incisions made on the inside of the nose alone, sometimes called ‘endonasal rhinoplasty’, or may require an additional incision on the strip of skin between the tip of the nose and the upper lip (the columella). Surgery that requires an incision on the columella is described as ‘open rhinoplasty’. The scar on the columella, when healed, is usually very difficult to see. In general, the more complex the surgery, the more likely it is that the ‘open’ approach will be used. When the nostrils are to be narrowed or made smaller, additional small incisions are made in the creases where the nose and upper lip or cheek meet. These usually also heal with fine scars.

Every person’s nose is different, and aesthetic rhinoplasty surgery must be tailored for each patient. Only after careful consultation and examination of the nose is it possible to plan together, the type of rhinoplasty surgery that will be performed.

The harmony in profile between the nose and the chin is also very important. In a few people it is necessary to consider modifying the profile of the chin when considering reshaping the nose. For example, what at first appears to be a prominent nose, may in fact really represent a relatively small chin. After appropriate consultation the correct operation can be planned for each person. Mr Kirkpatrick may use specialist computer manipulation of photographs to help in planning the type of rhinoplasty that is appropriate for you.

It may not be possible to address all the problems of your nose and you should think carefully about which aspects concern you most. You will have the opportunity at the initial consultation with Mr Kirkpatrick to discuss these problems. He will be able to tell you what is realistic and what can be achieved.

How long will I need to stay in hospital?

Although many people will prefer to stay overnight after surgery, often patients are able to go home the same day after rhinoplasty surgery. Mr Kirkpatrick will guide you depending on your own particular circumstances.

How long does it take to recover from rhinoplasty surgery?

Although there is some minor discomfort after rhinoplasty surgery it is not usually painful. There may be some bruising and swelling of the lower eyelids. This has most often settled by two to three weeks when it should be possible to return to work. There is usually some swelling of the inside lining of the nose leading to a feeling of nasal ‘stuffiness’. This may take up to six weeks to settle.

How long does rhinoplasty surgery last?

Rhinoplasty results are usually life long, although the effects of ageing remain unchanged over time. Mr Kirkpatrick will be able to guide you as to what you may expect to be achieved.