Rhinoplasty is an operation to correct deformities
of the nose. Although usually requested
by a patient to improve nasal appearance,
it can also be performed to improve nasal
Rhinoplasty is one of the most difficult
cosmetic surgery operations to do because
the difference between good and bad results
can be just a millimetre or two. Because
Rhinoplasty is a challenging, three dimensional
and sculptural operation, after which you
will look different forever, (rather than
younger and fresher), you should give careful
consideration to your choice of plastic
More than any cosmetic operation, Rhinoplasty
has been subject to fashion. In the recent
past, most women and their surgeons thought
it desirable to have an upturned nose. Later,
the trend moved toward a natural, strong
nose with a high bridge and sculpted tip.
Today, the general consensus amongst surgeons
is that no one nasal style is perfect. My
purpose in all this is to try and give you
an attractive nose that looks natural, functions
properly, and is in balance and harmony
with your facial features.
refers to nasal surgery performed for the
first-time, whether for cosmetic or breathing
purposes. It involves remodelling bone and
cartilage to change the nasal framework
and then re-drape the skin over this new
scaffold to give the final result.
My goal in primary rhinoplasty is avoid
an "operated look" by working with you to
match your realistic wishes and my abilities.
Your facial proportions and contour, skin
texture and thickness, as well as any previous
nasal trauma and your individual wound healing
biology all play an important role in what
can be achieved with a Rhinoplasty - as
well as in what should be attempted.
is performed to correct problems that persist
or develop after previous rhinoplasty surgery.
A secondary rhinoplasty is always more difficult
and requires more expertise than the primary
rhinoplasty. This is because the original
(normal) anatomy is no longer intact after
the primary surgery and the original tissue
planes are now filled with scar tissue.
Also many secondary rhinoplasty patients
have an unnatural looking nose that does
not function properly. As with primary surgery,
my goal is to produce a nose that appears
natural, functions properly, and is in balance
and harmony with other facial features.
Commonly asked questions
a good candidate for a Rhinoplasty?
This is best decided
during a consultation, but generally speaking,
the best candidates for a rhinoplasty are
physically and mentally healthy adults who
are seeking improvement in the appearance
of their nose, rather than perfection.
You are likely to be a good candidate if
you are physically healthy, psychologically
stable, and realistic in your expectations.
I generally avoid operating on teenagers
so as to ensure that they have completed
growing and are socially and emotionally
mature. Clearly there will always be exceptions,
but I will endeavour to be sure that surgery
is your choice and is not being sought because
your parents or friends think you need it.
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should I expect from my consultation?
During your consultation,
I will take a full medical history. I will
ask how you would like your nose improved
and what bothers you? Then I will examine
you and your nose and take standardised-view
photographs which will be used to aid us
in discussing the possibilities, limitations
and risks of surgery.
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happens during my Rhinoplasty?
Before surgery, you
will meet and be assessed by your anaesthetist
who will prescribe medications for your
comfort and to lessen anxiety if need be.
On the evening before, or the morning of
your operation I will review what we have
discussed and planned previously and we
will both sign your operative consent forms.
The operation is performed under General
Anaesthesia - you will be asleep.
During your surgery, which I perform usually
via an open approach using incisions that
are mostly hidden inside your nose, I separate
the nasal skin from its scaffold of bone
and cartilage; sculpt and reconfigure your
nose to the desired shape and then re-drape
the nasal skin.
When the surgery is complete, a splint is
applied to help your nose maintain its new
shape during the initial stages of healing.
In some cases, soft splints may also be
placed in your nostrils to stabilize the
septum for a couple of days after surgery.
Depending on what needs to be done, a primary
rhinoplasty may last up to two hours.
When you wake from your operation, you will
have some discomfort and a dull headache
for which you will need pain relief. Your
face will feel puffy and often you will
have black eyes. Most patients stay overnight
in hospital and go home the following day.
about my recovery and return to normal activities?
The swelling and bruising
around your eyes will increase at first,
to peak at the third day after your operation
and it will have resolved usually by 2 weeks
after your operation. You will feel blocked
up, much as if you have a head cold, for
a fortnight or so.
The splint on your nasal bridge and your
stitches will be removed after 7 days. It
is not unusual for patients to tire easily
in the weeks after surgery, and to feel
low and a little emotional, but this passes
for those who experience it, and most patients
are back at work within 2 - 3 weeks of surgery.
In every other respect, you will be able
to move around and function relatively normally.
Generally, you can return to work if your
occupation is sedentary, as soon as you
feel able. Likewise, so long as you can
do so with due care and attention, you can
begin driving within a day or two of discharge
You should avoid blowing your nose for 2
weeks after surgery and should restrict
yourself to light exercise for 2 - 3 weeks
- avoiding lifting anything heavier than
The final appearance of your new nose matures
with time as your body deposits and moulds
scar tissue: you will see the final result
on the nasal bridge after 9 months and at
the tip after up to a year. Depending on
your skin type, some patients experience
the appearance of small vascular, red spots
on the skin surface over the nasal bridge
after Rhinoplasty - these are an unpredictable
association, rather than a complication
of a Rhinoplasty, but they may be responsive
to laser treatment.
Scars inside the nose are invisible under
normal circumstances. The small scar on
the skin between the nostrils, or at the
bases of the nostrils after flared nostrils
have been narrowed, will fade in time to
become barely noticeable. Two or three weeks
after your surgery, such scars will benefit
from friction-free massage (using vaseline,
for instance, to lubricate the massaging
process). Beginning to massage scars two
to three weeks after surgery, will help
them mature, soften and flatten faster than
if left to their own devices. New scars
should be protected from sunlight for 2
years to avoid them pigmenting differently
from the surrounding skin and becoming a
different colour permanently. Factor 15
sun block should be applied whenever they
are exposed - even to a British winter sun.