Nose reshaping (rhinoplasty)

There is a theory that says that ideally the nose is positioned between the two lines that run down from the inner corner of the eye, that the middle line is straight and that the nose base line is no wider than the distance between the inner corners of the eye.

In some cases the differences from this ideal are such that they are experienced as disturbing.
Some people find that a nose with a bump disturbs a beautiful face. The nose is often also considered to be in disproportion with the rest of the face: too big, too small, too long or too wide. In these cases the problem is an aesthetic one.

Physical problems too can be a reason for a nose correction. The shape of the nose can be such that it causes stuffing or is responsible for headaches. If this is a persisting problem, plastic surgery can offer a solution. The nose shape can also change with age. As one gets older the cartilage becomes thinner and elasticity lessens.

Nose correction surgery is an invasive form of plastic surgery because of the complexity of this organ. The enormous psychological impact on one’s self image caused by a change in shape of the nose makes it a very emotional experience. Careful analysis of the current shape as well as the complaints leading to the decision is therefore required in order to obtain the best possible results.

Nose reshaping surgery is a cosmetic surgical treatment which allows changing size and shape of the nose. The nose correction can be anything in between a simple small correction at the nose tip or nostrils to a complex form of surgery at the nose bridge or even the entire nose.

Age is an important factor. A cosmetic surgeon will generally only advise a nose correction when the face is fully grown, this is usually around the age of eighteen. There is no top age limit. As years go by cartilage becomes thinner and its elasticity decreases, changing the way the nose looks. A nose correction can therefore also be performed at a later age.

As a receding chin emphasizes the size of the nose, the surgeon sometimes advises considering a chin implant to solve the problem of a nose that looks too big.

Surgery

There are two procedures for cosmetic nose reshaping:

  • Closed rhinoplasty does not leave any visible outer scars, but is limited in possibilities for changing the nose tip.
  • Open rhinoplasty allows a much better view of the cartilage structures of the nose. This allows for a much more precise reshaping of the nose tip. The small scar will disappear after a few weeks. With this procedure the swelling will last longer as lymph draining is more disturbed.

To reduce the size of the nostrils, skin tissue is removed at the lower end. Stitches are applied exactly within the fold between nose and cheek so they will not be visible afterwards.

Post surgery

Two tampons are placed inside the nose to absorb any bleeding. These need to remain in place for at least 24 hours. Usually a splint bandage is applied which will need to stay for 7 to 10 days. During this period you are able to take a shower.

Because of the tampons in the nose you will need to breathe through the mouth. As this causes a dry mouth and throat, it is important to drink sufficiently. When the tampons have been removed, the nose can be cleansed carefully and treated with some ointment. The mucous membrane will still be swollen so it is normal that your nose is still stuffed for a while. A salt solution can help. You are advised not to blow your nose the first two weeks. Gently sniffing in and ‘out’ with open nostrils is allowed.

Swelling around the eyelids and the lower face with bruising is normal. Swelling can be more outspoken on one side, even if the nose surgery was symmetric. Sleeping on two pillows and sitting upright and walking around during the day encourages the blood saturation. This helps swelling and discolouring to disappear as fast as possible. After two to three weeks the discolouring will usually have disappeared and most patients are able to resume their normal activities.

Taking medication is only allowed on doctor’s orders as some medication thins the blood. For pain relief a paracetamol tablet usually suffices. The first few weeks it is not practical to wear clothing which needs to be pulled over the head. Bending down, lifting and serious efforts put too much pressure on the head and are to be avoided.

It is best to be careful with sports the first three months. Wearing glasses will in the beginning only be possible when they are attached to the forehead with a strip. Finally you need to know that the nose tip can be senseless up to a year after surgery. This will disappear spontaneously.

Risks

When carried out correctly nose correction surgery normally does not cause any problems. Yet it needs to be said that there are the same risks that go with any form of surgery. If a client has abnormal loss of clear red blood, he or she needs to contact the plastic surgeon. This is also the case when the nose is still completely stuffed after two days, when body temperature is above 38 °C after 48 hours or when the contour of the wound should become red and swollen. Risks that are specific for nose correction surgery are a lasting numb feeling of the nose tip and a lessened or total loss of sense of smell. The large variation of problems as well as the large variation of surgical solutions makes that nose reshaping is considered as one of the more difficult operations in plastic surgery.

Result

The improved nose shape can be seen relatively soon. The result still improves after a few months when the swelling will have completely disappeared. The initial feeling of disappointment some people have after this kind of surgery is then forgotten. One has to bear in mind that nose corrective surgery does not show immediate results. When one is aware of this and when the expectations one has are realistic, then one is usually very happy to have undergone the nose operation.