Rhinoplasty is the procedure which shapes the nose. It can be done to enhance the appearance of the nose or because of blockage to the nasal air-way. A nose that looks better usually functions better as well.
Reshaping of the nose is usually done by means of surgery but in a small percentage injectables may be used to fill out a flat spot or improve the proportions of the nose. This is particularly true with the Asian rhinoplasty.
Rhinoplasty can help people with noses that are too big, misshapen, crooked, or even too small. The rhinoplasty procedure is very much tailored to the individual’s requirements and no two rhinoplasties are the same.
Rhinoplasty is performed under a general anaesthetic as a day patient. Most commonly a small incision at the columella (the tissue between the nostrils) is used to gain access to the bone and cartilage of the nose and to reshape this. Attention is also given to the nasal air-ways to try and enhance breathing.
After the operation a splint is commonly worn on the nose for a week. However bruising around the eyes is quite common and this may persist for ten days or more.
Where the bones of the nose are cut and moved they are somewhat frail for a period of six weeks. Care should be taken during this period to ensure that the nose is not traumatized. Given the complexity of rhinoplasty it is wise to leave the operation until the patient is no longer participating in contact sports. Further injury may undo a lot of the benefit of the rhinoplasty procedure and revisional surgery may be quite difficult.
Rhinoplasty reshapes the cartilage and the bone of the nose and relies on the overlying skin to shrink and fit the new shape there. Patients with heavy skin may find that this takes a long time (more than two years) to occur completely. Conversely patients with fine skin may see that little irregularities are visible through the overlying skin. Thus the nature of your skin will determine to some extent the standard of the result.
In normal activity the nose does not attract a lot of attention from the onlooker. It is only when the nose is misshapen, out of proportion, or crooked that it tends to draw the gaze. Once the nose is reasonably in proportion to the face and of an acceptable shape it genuinely attracts very little attention. For this reason it is said amongst plastic surgeons that the result of a good rhinoplasty is seen in the eyes. By this it is meant that the onlooker is no longer drawn to the features of the nose but simply to the more important interactive parts of the face, the eyes and the mouth.
No rhinoplasty is perfect. Little asymmetries are always present. One nostril is usually larger and higher than the other; the nose may not be perfectly straight; there may be some unevenness to the tip on close inspection. Fortunately once the nose is of reasonable shape and reasonable proportion to the rest of the face these features do not draw attention and are simply best forgotten.
About 10% of all rhinoplasty require a revisional procedure. This is usually discussed and planned at least a year after the first operation. In some cases a simple injectable may be used to fill out a flat spot or adjust the shape. Injectables in the nose usually last a year or more.
In other situation’s surgical revision is recommended. For many patients although they can see the feature being discussed the improvement already achieved is such that they are unfussed by any residual problem as they are well aware of the fact that the nose doesn’t attract much attention once it is in reasonable shape.
Focusing on minor details, asymmetries and irregularities in the nose is likely to lead to a disproportionate amount of unhappiness and frustration as the procedure does not have millimeter precision to it. Just rest assured that once the nose is of reasonable shape and size for your face it will largely become “invisible” and the onlookers gaze is drawn more to your eyes, mouth, and the overall look of your face.