Rhinoplasty involves correction and shaping of the internal and sometimes external components or architecture of the nose. It is performed for Aesthetic/cosmetic reasons as well as repair of structural abnormalities.
Rhinoplasty is a well trusted procedure sought by both men and women. Most people considering Rhinoplasty want to bring the size and shape of their nose into better balance with their face. They want a nose that compliments their other features rather than dominating their appearance.
There are many tools available to patients prior to having a Rhinoplasty. During the consultation photographs are taken and a program using “morphing” software is used to produce an appearance of the general improvement of the nose following Rhinoplasty not the exact appearance of the eventual result. Patients are also encouraged to produce images of the types of changes that they hope to achieve or what their nose looked like prior to any injury or the current changes to their nose.
Ultimately clear, accurate communication and an informed patient will help the recovery and eventual result of the Rhinoplasty.
One of the most popular forms of aesthetic surgery, Rhinoplasty is performed by two different incisions and approaches. In closed Rhinoplasty, all incisions required to reshape the tip and bridge of the nose are placed inside the nostrils. As a result there are generally no external scars, unless the sizes of the nostrils are also reduced (Alar base Weir reduction.) In this situation, there may be small scars in the groove between the nostril, cheek and the lip. If the tip of the nose requires considerable reshaping, a small scar under the midline of the nose may also be necessary.
Alternatively an Open Rhinoplasty combines internal incisions as in a Closed Rhinoplasty and a small incision is placed on the Columellar (the bridge of skin between the nostrils). Some surgeons prefer this approach because it provides complete visualisation of the nasal architecture, such as the nasal bones, cartilages and the nasal tip. With an open approach the Cosmetic Surgeon has greater control of these structures and it allows better reshaping and accuracy of the Rhinoplasty surgery.
During your consultation, Dr. Bobby A. Kumar will ask about your general medical history and any previous surgeries or injuries to your nose. He will also want to know how well you are currently breathing through your nose and he performs an examination to view causes of obstruction.
He will be especially interested in why you are unhappy with the appearance of your nose and what results you are hoping to achieve. Typically most patients ask for their noses to be made smaller; infrequently an increase in size is requested and is appropriate.
It is imperative that patients describe completely what they expect and would like from Rhinoplasty surgery. Clear and accurate descriptions and communication is important as this will avoid false expectations of what may be achieved or is possible.
At the same time, you need to be aware that everyone is different and what may work well for one person may not work well for another. For example, skin thickness varies enormously and a small, delicate nose can rarely be made from a large, thick skinned nose.
Types of Rhinoplasty
Reduction Rhinoplasty is commonly requested to reduce the way a larger nose can dominate the profile. This type of Rhinoplasty is commonly requested by both Men and Women. It is however a misconception that simply reducing the size of the nose will produce a positive appearance and outcome. When assessing a patient for reduction Rhinoplasty an insufficient projection of the chin may make the profile of the face appear dominated by a nose which is otherwise small or an average nose. In this case a chin augmentation is the solution with or without a reduction Rhinoplasty.
Augmentation Rhinoplasty (ethnic Rhinoplasty):
Augmentation Rhinoplasty, involves increasing the projection of the bridge and the tip of the nose. This type of Rhinoplasty is more commonly requested by patients from ethnic groups that tend to have a softer cartilage support to the nose and a less defined configuration of the bridge. It is also sometimes necessary in patients that have undergone significant injuries, or multiple Rhinoplasty or nasal procedures. There are several products used to augment and support the nasal tip and bridge; these being bone and cartilage from the patient’s own tissue. Olecranon bone graft from the elbow has proven to be a versatile material that shows excellent tolerance and long term benefits.
Use of silicone Implants to augment the bridge and tip of the nose is a popular and simple procedure to perform; unfortunately it carries higher risks of Infection and revision.
Secondary or Revision Rhinoplasty:
In a number of instances, the outcome of Rhinoplasty is unsatisfactory as a result of technical errors, healing problems, or injuries after the first operation. In other instances, lack of communication in a preparation for surgery, leads to a different perception for the surgeon and for the patient regarding the desired end point of the treatment.
Revision Rhinoplasty surgery requires understanding of the type of changes that the first operation would have created. Revision Rhinoplasty often involves use of grafts, commonly cartilage from inside the nose but also from other areas (elbow, ear), and will often require a longer period of time to settle down.
All Rhinoplasty surgery demands customised solutions from your surgeon. The most important element of achieving a good result is giving patients the time to think through and articulate exactly what they want. This may sound simple and straightforward, but as the detailed planning proceeds, it becomes obvious that most of us need to give it considerable additional thought. For this reason more than one consultation is often needed prior to the operation.
Rhinoplasty is performed in a day only facility and under anaesthesia with an accredited anaesthetist.
It takes many months for the skin to conform to its new shape and for the soft tissue swelling to reduce. The incisions heal well and sutures if internal will dissolve, otherwise external sutures will need to be removed at seven days. Splints internal and external will be removed within a week; the nostrils can be cleaned with saline soaked cotton buds.
The typical side effects are bruising, bleeding and minor pain/discomfort which resolves over several weeks. Rare complications are skin or wound break down or infections which are treated with antibiotics and careful post operative care.