Nose Reshaping

Nose reshaping is the operation to reduce or refine the nose, and it is the most frequent facial surgery request. The reason may be simply that the person is self-conscious of a large hump or a prominent tip. Some individuals may have sustained injuries to their nose, which have given rise to unsightly deformities. In either event, prominent nasal humps and tips are frequently associated with more masculine features and therefore if these are present on the nose of the female, may give rise to an overall harsher feminine facial appearance. In the vast majority of cases, men and women alike wish to have a normal nose that will blend into their face rather than dominate their features.

Am I suitable for this surgery?
Only a consultation can establish this. If you require corrective surgery to the nose as a result of a previous rhinoplasty it is important to wait usually at least 1 year before any further surgery is attempted.

Enquiries will also be made as to your breathing patterns and whether you suffer with any nasal obstruction. Many times this can also be addressed at the same time as a nose reshaping. The most common request is to reduce the size and alter the shape of a large nose. We will try always to give a nose that is attractive and proportional in size and shape to the rest of your face.

What does the Operation involve?
The operation is usually performed through incisions inside the nostrils. Occasionally there are external scars, particularly when reducing nostril size (alar base reduction) or if complicated tip work is required. In complex tip surgery, you may require an external incision carefully placed in the columella (the lower middle segment of skin situated between your nostrils) but you will be informed appropriately.

Any bump on the bridge is removed with a delicate chisel to give a new profile. The nasal bones, depending on the circumstances, are then usually broken and reset in a careful way to allow them to meet in the midline and narrow the bridge line. If any breathing difficulties exist, then the septum (structure separating the two nasal compartments) is altered accordingly.

Finally the tip of the nose, comprising of cartilage beneath the skin, is adjusted in size and shape to refine the nose so that it matches the new profile.

What type of anesthetic is used?
Nose reshaping is usually performed using a general anesthetic, and frequently requires an overnight stay in hospital. Occasionally a local anesthetic can be used. In the latter instance then this can be performed as a day case.

How long does it take?
A rhinoplasty takes approximately 1 hour to perform. What happens after the Surgery?
The bridge of the nose is usually protected after the operation by a plaster cast, which is worn usually for about 7 days. During this time you should avoid blowing your nose and any vigorous activity for next three weeks.

What kind of after effects should I expect?
As the nasal bones are usually broken and reset, you should expect to have “black eyes” and some swelling of the face. This usually settles by 2 weeks although as soon as the plaster cast is removed you may, in fact, apply light make up to mask this.

It is very important to realize that even once the plaster cast is removed from the bridge of the nose there will almost certainly be a significant degree of swelling still present. Therefore the shape of the nose at this stage is not the final one. This obvious swelling will rapidly decrease in the ensuing 3-4 weeks. However, it is important to remember that even after this time, the shape of the nose is still not the final one. The process make take up to one year.

Is it painful?
Remarkably enough, pain after this operation is not usually a problem and is easily relieved by an injection in the first few hours and a mild analgesic such as paracetamol as necessary afterwards.

What are the Scars like?
In most instances, all the incisions for a rhinoplasty, are placed within the nostrils and therefore cannot be seen.

What could go wrong?
All surgery carries some uncertainty and risk. When nose reshaping is performed by a qualified Plastic Surgeon, complications are infrequent and usually minor.

Irregularities of skin, bone or cartilage may occasionally appear following surgery. These may show up on the surface as slight depressions, dips of bumps. Although through conservative measures and time, most of these situations improve, additional surgery may be required for correction.

It is also quite possible that surgery on a badly deviated or bent nose may not result in a perfectly straight, well-aligned nose. Many reasons may be responsible for this but it is conceivable, in particularly difficult situations, that two or more procedures may be required to remedy these noses. You will be advised at the consultation what the likelihood of this occurrence will be with you.

How long before I’m back to normal?
Once any plaster cast is removed, you will gradually start to resume your daily activities. This will largely depend on the amount of bruising and swelling you will experience. Most bruising has dissipated by about 2 weeks, although there may be some slight residual bruising present. This can usually be masked quite easily with makeup. Most people are back to work by about 10 days. Although slight swelling may still be present at this time, it is not usually noticeable to the majority of people. By 3-4 weeks most people are back to their normal routine and are enjoying their new nose.

Summary
By changing the most prominent feature on their face into a more desirable shape, many patients gain a feeling of increased self-confidence, improvement in body image, and general wellbeing.