Rhinoplasty is the medical term given to nasal surgery to correct deformities in the appearance of the nose. It is more commonly known as a nose job, but actually is a broad term and covers lots of different procedures. The nose has importance both as a cosmetic feature of the face, forming the most focal point of the mid face, as well as a functional organ for breathing, speech and smell. Often patient who have deformities or irregularities of their nose on the outside may also be suffering from similar conditions on the inside. Interestingly, facial proportion is governed by mathematics and there is such a thing as the perfect nose for each face. The nose is such a focal point of the face, even small alterations to either the size or shape can have a dramatic effect on appearance.
An important break through in Rhinoplasty surgery is that of computer simulation. Using a variety of digital techniques, one can alter the size, shape, length and width of the nose to the patient’s preference. Often patients are not sure what is wrong with their nose, they just want it to be changed. The most common complaint being that ‘my nose is too big’. Using computer simulation we can show patient what they can reasonably expect from surgery before they physically have anything done. This plays a very important part in the decision process of how they would like to proceed and if they would like to proceed.
Anyone with concerns about the appearance or function of their nose is a potential candidate for a Rhinoplasty. The pre-operative planning for Rhinoplasty is the most important part of the whole procedure and this requires at least two visits with the Surgeon as well as computer simulation. Functional assessment of how the nose works also needs to be taken into consideration before the procedure.
There are two major types of Rhinoplasty, the so called “open approach”, where incisions are made in the nose to expose the underlying cartilage and bone and a closed approach, which is performed through tunneling techniques through the nostril. The type of approach that is used is dictated on what sort of deformity the patient has. The surgeon will explain the different types of approach to you.
Rhinoplasty is usually done under a general anaesthetic, where the patient is fully asleep.
Complications to the operation include bruising, nose bleeds and wound infection. Because Rhinoplasty combines both surgical skill as well as the art of medicine it is not always a predictable science. Second stage procedures or revision can happen with Rhinoplasty surgery and may be required to achieve a satisfactory result.
You will be admitted to the hospital approximately one hour prior to surgery. Although pre-operative checks will have already been done, this is time for any last minute questions with your Surgeon and Anaesthetist. If you are having IV sedation or a general anaesthetic you may not have anything to eat or drink for 6 hours prior to surgery. The only exception is you may drink water only up to 2 hours before the procedure.
You will be allowed home within approximately 1 hour following your procedure with a person of your choice who must stay with you for a minimum of 24 hours, if you have had IV sedation or general anaesthesia. You will be given a light snack before going home.
After the nose is remodeled a splint is applied to the outside surface which is formed to the individual patient’s nose. This is worn for a week. You will also be given a prescription for pain relief as you will experience some discomfort in the first week. It is important you take regular pain relief for the first 48 hours after the operation.
In the first week after the operation it is quite common to have bruising and blackening around the eyes, with some tenderness and the occasional nose bleed. This will usually settle down within a ten days, when most patients return to work. The true results of the operation evolve over time and it can be many months after the procedure before the swelling has settled.
For the first week you will need to sleep with your head propped up on pillows to help minimise swelling. It is very important to avoid any bending over, heavy lifting, alcohol consumption or vigorous activity for the first 2 weeks.
You will be prescribed an oral antibiotic to take, to cover the risk of infection from the operation.
You will need to come back to the Clinic for a post operative check and any sutures will be removed by the Nurse after 7 days.
Most people are safe to return to work after 1 week.
If you are interested in this procedure you can telephone Zona and book a consultation with Mark. Rajan does not perform rhinoplasty.
In order to accurately record the results of the operation, we require medical photographs to be taken before and after the procedure. These photographs are confidential and will be kept on your patient file. They are a great way of comparing how your nose looks before and after the surgery and you can request copies of the photographs for yourself.
The cost of the procedure varies depending on how long we estimate your Rhinoplasty will take and the extent of the correction. We will discuss costs with you at your consultation and a quote for the procedure will be given after assessment of your nose and a decision on the exact procedure you would like is made.
Mark performs ACC rhinoplasty for trauma and accidental damage. All broken or damaged noses that occur in New Zealand are covered by ACC. This service is provided by surgeons in the private sector. If you have injured your nose in the past and suffer a cosmetic defect or are having problems breathing, talk to your gp and make sure you have an ACC45 form filled out before coming to see us.