Rhinoplasty: everything you need to know about nose jobs
We asked two of our leading cosmetic consultants some of your frequently asked questions about rhinoplasty, more commonly known as a nose job or nose reshaping. Find out everything you need to know about common rhinoplasty techniques, how long it takes to recover, and much more.
Here they share their advice on everything from how the operation works to the recovery period, the risks involved, and the main benefits of rhinoplasty.
“A good nose reshaping can change your life.” - Mr Rajan Uppal
Nose surgery is the most complex operation in plastic surgery. It requires a surgeon with great experience and skill.
Why do you think rhinoplasty is such a popular cosmetic procedure?
Professor Alwyn D'Souza:
No other feature affects our look quite as much as the nose. A long, wide, or big nose can dominate the face, whilst a crooked or humped nose can overshadow pleasing facial features. The tip may be boxy, bulbous with flaring nostrils eclipsing natural facial beauty.
If the nose is not in harmony with the rest of the face or does not work well, it can be altered surgically with excellent outcome, if the surgery is carried out appropriately by an experienced surgeon employing modern rhinoplasty techniques. People of all ages are looking for such improvements, and the answer is within everyone’s reach, hence why rhinoplasty has become such a common, popular procedure.
Mr Rajan Uppal:
Nose surgery is very popular as it is better understood by everyone. There is also better awareness via the media and internet on how to find a good surgeon and what questions to ask. People also no longer feel that nose surgery is only for celebrities or for the well off.
The goal of nose reshaping or rhinoplasty is to improve the nose aesthetically (without creating a "surgical" look) in order to create harmony with other facial features. It can make a significant contribution to increasing one’s confidence and this is another reason why it has become so popular.
“Nose surgery is the most complex operation in plastic surgery. It requires a surgeon with great experience and skill.” – Mr Rajan Uppal
What should a patient consider before undergoing rhinoplasty?
Professor Alwyn D'Souza:
The three main considerations are: motives for considering surgery, the surgeon’s skills and the reputation of the hospital.
Self-motivation, personal desire and general good health to undergo surgery are essential. You should consider surgery because ‘you’ want it, and not to please others. You should have a clear and realistic goal of desired outcome. External pressures (surgeon’s team, friends and peers) should not influence your decision. Independent research using good quality, educational (not marketing) websites is essential.
It is important to have an experienced, skilled and compassionate surgeon who specialises specifically in rhinoplasty surgery, including surgery on the nasal septum and turbinates. Finally, you should be able see your before and would be after results, produced using morphing software at consultation.
Mr Rajan Uppal:
The most important thing is the surgeon. Nose surgery is the most complex operation in plastic surgery. It involves the bones, cartilages and skin of the face as well as a focus on making it look natural rather than a ‘fake’ look. It requires a surgeon with great experience and skill. I often have to correct nose surgery that was performed elsewhere or abroad where it is cheaper.
Anyone who is concerned about their nose should research on the internet and see a specialist nose surgeon. Rhinoplasty is one of the most complicated operations in plastic surgery as it requires great experience and specialist training.
The nose will look swollen, in particular in the tip area for a few weeks to months after surgery and the end result is evident approximately at the end of 12 months.
What is involved in the procedure? What are the most common techniques used?
Professor Alwyn D'Souza:
The growth in skill and training and as well as technology available today has resulted in two basic techniques:
- The open rhinoplasty technique
- The closed rhinoplasty technique
The technique employed depends on, the surgeons training and the desired outcome. Open rhinoplasty involves a cut in the midline partition of the nose called the columella and the rest of the incisions are inside the nose. The main advantage of open rhinoplasty technique is excellent exposure of the nasal tip as well as the rest of the nose. This gives the surgeon complete control over the procedure, particularly tip modification and reconstructing the nasal valve etc.
Closed rhinoplasty is where all the cuts are made inside the nose. This is a procedure where a combination of "see and feel" plays an important part. It is almost like doing an operation through a keyhole. Generally speaking all UK surgeons are trained in closed technique, whilst fewer are trained in open technique.
Mr Rajan Uppal:
Nose surgery is usually done with the patient asleep, although small changes can be undertaken under local anaesthetic or with fillers injections. I use keyhole surgery to avoid scars under the nose which is called "closed rhinoplasty". This requires more experience as most surgeons use the "open" technique which unfortunately gives you a scar under the nose.
Closed rhinoplasty incisions are made inside the nose in this way where they are invisible and scar free. To reduce the bump on the nose, certain amounts of bone and cartilage are removed or rearranged to provide a newly shaped nose.
If the patient has a deviated septum (cartilage and/or bone causing obstruction inside the nose), septal surgery, called septoplasty, is also performed. The incision is placed entirely inside the nose. The septoplasty removes portions of cartilage and/or bone that are causing the obstruction. The incisions are closed with fine sutures, followed by placement of a splint to the outside of the nose. The splint helps retain the new shape while the nose heals.
“It is worth noting that the nose will look swollen, in particular in the tip area for a few weeks to months after surgery and the end result is evident approximately at the end of 12 months.” - Professor Alwyn D'Souza
What is the recovery like? How much time should a patient take off from work?
Professor Alwyn D'Souza:
Recovery from rhinoplasty is generally not cumbersome. Immediately after surgery a protective hard cast is placed on the nose, and is removed in 7-10 days. Some surgeons use a pack to reduce bleeding in the first 24 hours. As the anaesthetic wears off, it is important to note that most patients report little or no pain, and any discomfort is easily controlled with mild pain medication.
Your nose will feel blocked, with possibly a dry mouth, because of mouth breathing. You may have some bruising, but not every rhinoplasty patient gets bruising. This settles in 7-10 days. It is worth noting that the nose will look swollen, in particular in the tip area for a few weeks to months after surgery and the end result is evident approximately at the end of 12 months.
Mr Rajan Uppal:
Recovery takes two weeks. My patients go home the same day after surgery with a tape on the nose. They can walk around fine but may get bruising and swelling even after the tape is removed after seven days. Many people go back to work after just one week using make up to cover any bruises. You can exercise after 2-4 weeks.
What are the main potential risks associated with rhinoplasty?
Professor Alwyn D'Souza:
The potential risks of rhinoplasty and complications can be divided into anaesthetic risks and surgical risks. Common risks and complications include, but are not limited to: bleeding, infection, pain, changes in skin colour, poor scars, prolonged swelling, constriction of nasal airways, blocked nose, dry lips and mouth and uneven nostrils as well as cosmetic dissatisfaction. Depression and insomnia may also cause concern. All these settle quickly after surgery.
The risks can be minimised by detailed pre-operative consultation and choosing the appropriate surgical team, understanding the limitation of rhinoplasty, not smoking and reducing alcohol, adopting a healthy lifestyle, as well as following the surgeon’s instructions carefully. Help from friends and family also ensures a positive outcome.
Mr Rajan Uppal:
The main risk is an unnatural look. Some surgeons remove too much from the nose and this leaves it looking strange or a ski-jump. The other risk is not getting exactly what you wanted as the surgeon didn't actually understand what you were after. You will need a surgeon with experience and good reviews online to deliver a good outcome.
Based on your experience, what do you think are the primary benefits of having a ‘nose job’?
Professor Alwyn D'Souza:
In my view, a rhinoplasty when performed well, should result in an un-operated natural looking nose that primarily offers the following benefits:
- Improves nasal airway, thus optimising nasal function
- Improves aesthetics of the nose, thus enhancing facial beauty
- Combination of the above with improved quality of life and social interaction
All these of course have a positive impact on our personal and social life.
Mr Rajan Uppal:
It can change your life. In the same way we think nothing of correcting buck teeth or big ears, a large nose can have a devastating effect on confidence - both socially and at work. Correcting a big nose, removing a bump or a round ball-like end of the nose can transform your confidence and success in life.
My patients tend to smile more after surgery and often come out of their shell. Some have surgery before a wedding when they finally feel it’s time to deal with this issue that has bothered them for years.
Having a nose job with Circle Health Group
There you have it – everything you need to know about rhinoplasty through the eyes of dedicated experts who are highly experienced in performing the surgery.
At Circle Health Group we offer rhinoplasty and a broad scope of other cosmetic procedures to help you regain your confidence. If you want to know more about our treatment options, book your appointment online today or call a member of our team directly.
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