The term rhinoplasty is derived from the German “rhinoplastik” which means “changing the shape of the nose”. Rhinoplasty is one of the most technically challenging surgery and requires a keen eye for detail. The technique involves first accessing the bone and cartilage support of the nose. This is achieved through incisions made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, the underlying bone and cartilage is reduced, augmented or rearranged to create a newly shaped structure. For example, if the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size. If the bridge of the nose has a prominence, this can be reduced to yield a more pleasing profile. If any portion of the nose appears disproportionately small, implants or autogenous grafts such as cartilage or soft tissue grafts can be placed to create better harmony. Cartilage grafts can be taken from the nose septum, the ear or the ribs depending on what shape cartilage is required and how much cartilage is needed.
Once all the required steps are completed, wound closure is achieved using dissolving sutures for the internal incisions and non-dissolving sutures for the columellar incision. Nasal packs may be used to help shape the nostrils and these will be removed within 48 hours. Most patients will have some small amount of intermittent bleeding during the first few days after surgery, and should avoid blowing their nose during the first week after surgery to avoid interrupting healing. Patients should rest with their head elevated and avoid vigorous physical activity for approximately a month after surgery.
Rhinoplasty scars heal well and are difficult to see. Possible complications of rhinoplasty include bleeding, infection and loss of shape or symmetry over time. If grafts are used, these may reabsorb over time. Post operative swelling might be noticeable for two to four weeks after surgery. There may be a transient loss of smell and sometimes an alteration in taste. Some patients who have narrowing of their nasal bridge carried out may notice a reduction in airflow through the nose, while others may find their breathing more audible.