Rhinoplasty, also known as a “nose job”, is a procedure that is used to change the appearance of your nose, improve breathing difficulties through your nose, or both. You may wish to make changes to your nose if you are unsatisfied with its natural appearance. Alternatively, you may require nasal surgery to correct problems that have resulted from previous injury to your nose.

Rhinoplasty can address the following issues:

• Nose size, shape and proportion relative to the face
• Nostril size
• Nasal asymmetry
• Impaired breathing due to structural problems within the nose, such as a deviated septum

The Procedure

Rhinoplasty is performed under general anaesthesia or local anaesthesia with sedation, depending on how complex your surgery is going to be. Hospital admission overnight is often recommended to allow you to recover adequately prior to discharge.

Each rhinoplasty procedure is unique and customised according to each patient’s individual anatomy and expectations. Depending on the how much surgery your nose needs, cuts will be made either inside your nose, on the outside between your nostrils, or at the base of your nose. The external scars will be well-hidden when you are in an upright position.

Through these incisions, the shape and structure of your nose may be altered by removal of excess cartilage, cartilage molding techniques, or bone surgery. To increase the definition and height of your nose, your surgeon may recommend an implant or use of cartilage or bone from other parts of your body such as the ear or rib respectively. At the end of the surgery, the incisions will be closed with sutures.

After the Surgery

Nasal packs will be placed inside your nose before you are awakened from anaesthesia. These packs keep the inside of the nostril clean and act as internal splints for support. You will have to breathe through your mouth until these are removed a couple of days later. Externally, medical tape or a splint is usually applied for at least 1 week for additional support and protection against accidental bumps. You will be taught how to gently clean your external wounds and apply antibiotic ointment regularly. The stitches will be removed after 5 to 7 days.

Nasal congestion or blockage is common after this procedure due to swelling. Pain, bruising, mild bleeding and drainage of old blood with mucous is also normal and will improve over time. During this time, painkillers and antibiotics will be prescribed to control the pain and minimize the risk of infection. Sleeping with your head raised higher than your chest for a few days will also help the swelling to settle faster. You should avoid strenuous activities such as exercise and blowing your nose during the early recovery period. Avoid pressure over your nose for at least 4 weeks after your surgery – you may be advised to tape your glasses to your forehead until your nose has healed. It will take several months to 1 year for the swelling to completely resolve and for the final results to be clear.

Understanding the Risks

As with any major surgery, rhinoplasty carries risks such as:

• Adverse reaction to the anaesthesia
• Seroma (an accumulation of fluid under the skin)
• Hematoma (accumulation of blood under the skin)
• Poor scarring
• Damage to the nasal septum (the structure that separates your nostrils)
• Uneven-looking nose or asymmetry
• Skin breakdown from the implants being exposed through thin skin
• Infection, which may require removal of implants
• Permanent numbness in and around your nose

You may need to undergo an additional surgery to correct some of these problems.

The subject of risks, as well as potential complications of surgery are best discussed on a personal basis between you and your plastic surgeon.