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Rhinoplasty is an operation to reshape the nose; the nose can be straightened, made smaller or bigger, and bumps may be removed. It is also possible to reshape the tip of the nose and pieces of cartilage or bone may be removed from, or added to, the nose to change its shape.

Sometimes the septum, which is the wall which runs down the middle of the nose, is bent; this can be corrected at the same time (a septorhinoplasty) or as a standalone operation (septum surgery).

It is very important that patients have clear and realistic expectations of what they wish to achieve, and the consultation is crucial in ensuring you fully convey these to Mr Fayad. He will then be able to determine whether your expectations are achievable and whether they will suit you. It is important to bear in mind that there are some factors which might influence the outcome of the procedure; i.e. the thickness of the skin differs from patient to patient and can affect the results.

Rhinoplasty procedures typically achieve high satisfaction for patients – somewhere between 90 and 95 per cent of patients are happy with the results – but some patients may want or need a secondary procedure.

What is the operation like?

Rhinoplasty is usually performed under general anaesthetic and it can be performed as either an open or closed procedure. In an open rhinoplasty, a small cut is made into the skin between the nostrils.  In a closed rhinoplasty, the cuts are made inside the nose.

The skin of the nose is gently lifted off the bone and cartilage underneath.  A hairline fracture may be made in the nasal bones to allow the surgeon to change the shape of the nose, and pieces of bone and cartilage can be removed from, or added to, the nose to smooth out any bumps or dips.

There may be some stitches placed inside the nose, but these will dissolve and fall out by themselves after the operation.

What is the recovery like?

It may be necessary to put a dressing in each side of the nose to keep things in place and prevent bleeding. The dressings are called packs, and they will block the patient’s nose up so that they have to breathe through their mouth. Patients may get a little bit of bleeding when the packs come out, but this will settle quickly.

Sometimes small pieces of plastic are placed inside the nose to prevent scar tissue from forming. These are called splints, and they are removed after a week. Patients will have a temporary splint on the outside of the nose for a week or two, and this should be kept dry.

It should not really hurt after a rhinoplasty, but there may be some small discomfort or tenderness for a few weeks. Patients may have some bruising and swelling around the nose and eyes for one to two weeks.

Patients are advised not to blow their nose for about a week, or it might start bleeding. At the onset of a sneeze, the patient should sneeze with their mouth open to protect their nose. Patients may get some blood-coloured watery fluid from the nose for the first two weeks or so – this is normal.

The nose will be blocked both sides like a heavy cold for 10 to 14 days after the operation, and it may take up to three months for the nose to settle down and for the breathing to be clear again.

Rhinoplasty procedures can be performed as day cases, although usually it involves a one-night hospital stay. Most patients need one to two weeks time off work, and they should be careful to abstain from sports for approximately six weeks, where there is a risk the nose might be knocked.

What are the possible side effects and complications?

Sometimes a patient’s nose can bleed after the operation, and packs may need to be placed into the nose to stop it.  Very occasionally, patients need to have another operation to stop the bleeding.  Infection in the nose is rare after this operation, but if it happens it can be serious, so patients should see a doctor if their nose is getting more and more blocked and sore.

Rarely, the operation may leave a hole in the septum inside the nose going from one side of the nose to the other. This can cause a whistling noise when you breathe, crusting with blockage, or nosebleeds. Mostly, this causes no problems at all, and needs no treatment. If necessary, further surgery can be carried out to repair a hole in the septum.

About five to ten per cent of patients need further operations in the future.  Mr Fayad will explain this to you during the consultation.

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