Why do people have nose surgery?
Rhinoplasty or nose surgery is one of the commonest forms of plastic surgery. Every year hundreds of thousands of men and women who are unhappy with the shape of their nose apply to have surgery to dramatically improve their appearance and feel more confident. The reasons for surgery are varied. Some people feel that the size of their nose dominates their face and they feel self-conscious. Others dislike the way their nose turns up or perhaps the way a lump spoils their profile. Surgery can redefine the shape to ensure the nose complements the appearance of the face. In some cases people apply for rhinoplasty to repair damage to their nose caused by an accident. A large number of men have surgery to correct an injury that has left them with the appearance of a ‘bruiser’. Some clients of rhinoplasty simply have surgery to improve their breathing. Ultimately most clients of rhinoplasty are looking to greatly improve a level of self-confidence that has been undermined by the appearance of their nose.

Realistic expectations
You must have realistic expectations about what rhinoplasty can achieve for you. It will not change your personality or make people treat you differently. Everyone is individual and nose surgery will not transform you into someone else.
It is critical that you spend time thinking about what you want to achieve from surgery and talk about your hopes with your surgeon. Everyone’s skin and nose type is different and the surgeon will discuss what you can realistically expect to achieve.

What happens during consultation?
The surgeon will ask you whether you have had any facial injuries and if there has been any specific damage to your nose. You will then be asked how you want the appearance of your nose to be changed. Remember every person is different according to skin colour, ethnic background or age. The surgeon will advise you if your expectations are realistic.
The surgeon will also want to know why you want a specific procedure to gain a complete understanding of what you want to achieve from the surgery. It is important that you are completely honest.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks. You have to make an informed decision before signing the consent form so make sure you ask plenty of questions. You want to feel relaxed and confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About the side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparing for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before your general anaesthetic.
• The surgeon and anaesthetist needs to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess you and discuss your queries.
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing processes.
• If you wear glasses consider changing to contact lenses. If this is impractical get a lightweight pair of glasses that can be held in place on your forehead. There can be no contact between your nose and glasses for two weeks.
• Prior to surgery keep the inside of your nose clean to avoid any unnecessary build up of bacteria.
• Bring an overnight bag for your stay and leave your valuables at home. Bring a top that you can comfortably pull over your head without scratching your nose.

What happens during nose surgery?
This depends on the type of procedure you require. However, in all cases you will be placed under general anaesthesia and be treated as an inpatient. Surgery takes place inside the nostrils to ensure there are no external scars. Depending on nature of the procedure surgery can last an hour or two. If you have any questions it is important that you discuss them with your surgeon.

• If you have a nose that droops or is turned up -The direction of the nose is changed by altering the septum between the nostrils.
• If you want the tip of your nose changing - Cartilage inside the nose is sculpted to create a new tip. A tiny cast is then applied to set the nose.
• If you want a nose lump removing - Humps or lumps are removed from inside the nose to give you a new profile. In this case nose bones are reset to complement the new shape and a small cast applied for a week.
• If you want the size of your nostrils reduced - Internal skin is trimmed from both sides of the nostrils to make the base area of the nose smaller.
• If you want implants to change your nose shape - Depending on the procedure required to reshape the nose, skin tissue or cartilage is removed from another part of your body and grafted inside the nose. In some cases artificial implants are added.
• If you require reshaping that needs major surgery - Your surgeon will be more than happy to discuss all the details of the procedure with you.

After surgery

• Your first day is likely to be spent in a recovery room bed being cared for by nursing staff. Your surgeon will visit you and advise you when you can leave.
• Enjoy plenty of rest, keep your head up and as still as possible and avoid any energetic activities that raise your blood pressure.
• You should not drive for two days after the anaesthetic.
• If you have had a drainage tube inserted it will be removed within two days. Bandages are normally taken off after one to five days.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.
• Any discomfort, bruising or swelling should be treated with a mild analgesic like Paracetamol. Do not use aspirin.
• Don’t be surprised at the bruised appearance of your face. You will not look or feel great and some numbness is normal.
• As the soreness wears off your new face shape will be revealed and in a few weeks you will feel better.
• When the dressing is removed you may suffer from a runny nose simply dab it away with a soft tissue.
• Do not rub your nose or blow it for up to two weeks after surgery. You can clean your nose by dabbing it with a wet cottonbud.

Road to recovery

• Continue taking painkillers if you need them.
• Depending on the surgeon’s advice, elastic dressings or bandages may have to be worn for some time.
• If the surgeon recommends that you take medication such as antibiotics, make sure that you complete the course.
• Your treated area is likely to feel sore during the first couple of weeks, so take it easy and get plenty of rest.
• The surgeon will advise you of when you can return to physical activity.
• You surgeon will advise you when you can start sunbathing.
• Your features are likely to appear distorted at first and facial movements may feel strange until the swelling settles.
• If nose bleeds occur there is no cause for alarm. They are common after this procedure and can be treated with a cold compress.
• Do not wear glasses that rest on your nose. Either tape light frames to your forehead or consider using contact lenses.
• The most important thing to remember is that the redefined nose is not the final shape when the dressings are removed. It will take time for swelling to go down and for internal scar tissue to heal.
• You must contact your doctor if you suffer from an abnormally high temperature, severe pain that is not treated with Paracetemol or if you experience severe bleeding.
• If you are in doubt about any of the post operative effects speak to your surgeon.

All surgery carries an element of risk
Most people believe that the benefits of nose surgery far outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthesia. In a minority of cases there may be a problem with fluid loss or an excessive build up of fluid that needs to be drained.

Deciding on nose surgery
It is important that you take your time to make an informed decision about nose surgery. Complications are extremely rare as this is a very common operation, however you must consider any potential outcome.

• After a successful operation you may feel sick due to the anaesthetic and bruises formed by the procedure may take several weeks to heal.
• There will be scars left by the incisions, but these should be located in ‘hidden’ areas. Scars usually fade away but do not necessarily disappear completely. This depends on your skin type. As scars heal the nose shape may change slightly.
• If it was necessary to take a graft from another part of your body for augmentation surgery, you will have a scar.
• An artificial implant may push through the nose skin and have to be replaced.
• It is common to have some difficulty breathing through the nose for the first week after surgery. Very rarely this problem is permanent.
• There is a danger of chest infections following rhinoplasty, especially if you smoke.
• You may experience a reduced sense of smell after the operation which may be permanent.

Complications are rare and depend greatly on individual circumstances such a person’s health and skin type or the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.