Rhinoplasty is the operation to modify the appearance of the nose. This modification involves reshaping and repositioning of the nasal bones and cartilage to achieve an appearance for the nose to be in harmony with the rest of the face. The secret for a successful rhinoplasty is realistic expectations on the part of the patient and awareness that the final result will be at least 12 months after surgery.
REASONS FOR SURGERY:
Dr Wallace performs Rhinoplasty for the following reasons:
• To improve the appearance of the nose
• To straighten a crooked nose
• To reconstruct a damaged nose
• As part of a combined procedure with Septoplasty to open a blocked nose
RISKS OF SURGERY:
This surgery is associated with a low risk of complications and so it is a very popular cosmetic procedure. The specific risks of Rhinoplasty of which you should be aware are:
• Bleeding from the nose or epistaxis is normal for several days after surgery. Late or ‘secondary’ bleeding is unusual and management of this problem is not difficult.
• Infection is rare but almost patients feel as though they have contracted an head cold. True infection is associated with throbbing pain and red swelling of the nasal tip. Fever may develop. Antibiotics would then be necessary. Contact Dr Wallace or your GP promptly if any of this happens.
• An imperfect result is not unusual and patients must expect improvement and not perfection. Very large noses, very crooked injured noses and those with very thick skin may require a second procedure after the primary rhinoplasty to achieve the best possible result.
General Anaesthesia is the routine for this operation. Anaesthetic sleep time is approximately 60 to 90 minutes followed by 45 minutes in the recovery room.
Dr Wallace performs Rhinoplasty via incisions inside the nostrils. Occasionally, an external incision at the base of the nostrils or columella is necessary. The nose is reshaped with sculpture of cartilage, cutting, rasping and re-positioning of nasal bones. There are over 100 steps and the procedure is tailored to achieve as closely as possible the pre-planned final result. The incisions are closed with dissolving stitches and nose is supported by an external plaster and possibly an internal plastic splint.
Dr Wallace visits at the hospital early the following morning. Some patients will have stayed in hospital overnight while most will have gone home on the day of surgery. There will be moderate to severe external swelling and bruising but little or no pain. The swelling and bruising subsides quickly over 3 to 7 days. An office appointment with Dr Wallace is scheduled for one week later and most patients take this week off work. The cost of this appointment and a review at 6 weeks is included in the surgical fee.
At your first post-op visit to the office, the external plaster and internal splints will be removed and your breathing will be much improved immediately. One week later, most casual acquaintances would not know that you have had nasal surgery. However, it takes 12 – 18 months to achieve the final result. Dr Wallace recommends follow up visits in the office at 3, 6 and 12 months post-op and gives all his patients important written post-op care instructions.
The operation of Rhinoplasty is sometimes combined with other procedures. The most common combination is with a Septoplasty to realign the internal support of the nose, nasal turbinate cautery to deal with the effects of hay fever or rhinitis and Sinus surgery for treatment of sinusitis.
The vast majority of patients will be glad that they put themselves through the minor discomfort of a Rhinoplasty. Satisfaction rate is very high and only an occasional patient will feel the need to request revision surgery. Important points to remember are that the aim must be improvement in appearance and not perfection and that the final result takes 12 to 18 months to achieve.