Rhinoplasty is a common cosmetic procedure which reshapes the nose. The nose can be made smaller, bigger, or altered in proportions to better suit your face. Rhinoplasty can also be used to correct the aftermath of trauma or a birth defect. Surgery can also be designed to help relieve some breathing problems.
Would I benefit from rhinoplasty?
If your nose has been damaged or was never straight or is out of proportion with your face, you may benefit from rhinoplasty. This surgery is best performed on people who are physically healthy and psychologically stable. rhinoplasty will not change your life. Remember to be realistic in your expectations.
What are the risks of surgery?
Complications after rhinoplasty are usually infrequent and rarely troublesome. Nevertheless, there is also a chance of bad reaction to anaesthesia or problems such as infection or bleeding. If the operation is performed through the nostrils there will be no skin scar. In some cases, however, the operation can be performed with more precision and control by means of a small scar across the base of the nose.
This is called open rhinoplasty. These scars are rarely a problem. In 5-10% of cases a second procedure may be required to further improve the appearance of the nose. In other cases, despite further improvement being desired, the tissues of the nose will not permit a substantial alteration. This is particularly true for people with thick skin which does not shrink well after surgery. This can leave the nose looking larger than was desired.
Discuss the potential for improvement with your plastic surgeon and be realistic in your expectations.
How do I plan surgery?
At the initial consultation you will be asked carefully to consider the features of your nose you are unhappy with. Dr Scamp will examine you and then discuss the improvements that he feels are realistically achievable. A photograph will be taken of you. Whilst you may find it useful to bring photographs of a nose you like and you will be able to view results of previous patients of Dr Scamp’s, bear in mind that it is not possible to give you someone else’s nose.
The proportions of your tissues and the rest of your face are unique and will always be a little bit different to anyone else. Dr Scamp will also discuss with you the steps involved with the procedure and the risks involved. The staff will provide you with an idea of the costs and information to read on the surgery. You may be able to claim a portion of the cost of your surgery from Medicare and your private health fund. This is particularly likely to be true if you have breathing problems related to your nose or if you have a history of trauma to your nose or a marked birth defect. It is Dr Scamp’s practice to see you a second time prior to surgery.
If you live some distance away, please contact the office in advance so that the information may be sent to you ahead of time. This means you will be more fully informed at the first consultation and any delays prior to surgery can be reduced.
Preparation for surgery
Dr Scamp aims to reduce your bleeding and bruising to a minimum and to hasten your recovery. To assist him in this avoid aspirin, high dose Vitamin E and arthritis pills for at least two weeks prior to surgery. Make sure you have sufficient time off after surgery to allow smooth recovery.
Where will the operation be performed?
Most rhinoplasty operations are performed in a day theatre. However, if you wish to stay the night in hospital this can also be arranged. In general, the relatively low level of discomfort after surgery favours rhinoplasty as a day procedure.
What sort of anaesthetic will I have?
Your rhinoplasty will be performed under general anaesthesia. In addition once you are asleep the nose is infiltrated with a long acting local anaesthetic. This ensures the minimum degree of discomfort after surgery.
What is done at the operation?
Rhinoplasty takes between one and two hours depending upon the degree of complexity of the nasal deformity. Either through the nostril or through the small incision mentioned above at the base of the nose, the skin is freed off the bone and gristle (cartilage) framework of the nose. This bone and cartilage is then sculpted to the desired shape.
The middle wall of the nose (the septum) may also be reshaped. This can help to improve breathing difficulty. If your septum is particularly twisted, or if there are other major breathing problems, Dr Scamp commonly works in unison with an Ear Nose & Throat surgeon who specialises in these obstructions. This means that both the appearance of your nose and the breathing can be improved at one operation.
Commonly, small pieces of cartilage are taken from your nose and shifted to another part to improve the shape of the tip or the profile of the nose. These “grafts” can help give a significant improvement to the shape of your nose. At the end of the operation the small incision that is used to perform the procedure is sutured closed. A dressing is applied to the nose and a plastic splint is applied to the outside to help maintain the desired shape. Small packs may be placed in the nostrils and these are removed two hours after surgery.
This means that you will go home without any packs blocking your nose.
Expect a dull headache and a puffy, swollen feeling about your nose in the first 24 hours after surgery. You will be provided with some pills for pain but in general there is little discomfort after rhinoplasty. Use ice packs to control the puffiness around your eyes and sleep propped up so that your face swells less. It is best to rest quietly for the first 24 hours. While you will feel better on the second and third post-operative days the swelling may increase, especially around your eyes. Continue to use the ice packs to take down this swelling. Seven days after surgery you will return to Dr Scamp’s office and the splint will be removed from your nose. The swelling will not be completely resolved but with a little care and makeup you should be quite presentable 7-14 days after surgery.
Getting back to normal
Avoid blowing your nose forcefully for approximately six weeks after surgery. The bones are fine and may be displaced by excessive force. Whilst you may feel well enough to return to work two days after surgery the splint and swelling may make this a problem if you work in a “face to face” situation. In general, it is best to allow yourself at least a week off after this operation if you are dealing with the public. Avoid strenuous exercise for 2-3 weeks after surgery and avoid contact sports for at least six weeks. Even heavy glasses may have an effect on the shape of the nose if worn too soon after surgery.
The new you
While you will be able to see the improved shape of your nose immediately after the splint is removed, you won’t see the final results for quite some months. Small degrees of swelling persist for 3-6 moths and subtle changes in the shape of the cartilage and shrinkage of the skin can take up to a year. If there is something about your new nose that alarms you, by all means let Dr Scamp and his staff know. It may just be a passing phase as much of the reshaping of the nose continues to occur in the months after surgery.
If you are one of the 5 to 10% who does require a second operation this won’t be clear for 3-6 moths after surgery. The second procedure is usually performed a year after surgery when the tissues have settled and are much easier to work with.
Contact Dr Scamp’s office for further information on this surgery on 07 55391000.