Nose reshaping (rhinoplasty)

What to think about before you have nose reshaping

Whether purely aesthetic or plastic, rhinoplasty corrects a visible defect on your nose or part of your nose, regardless of any functional or respiratory discomfort.

The correction aims to respond to different reasons for consultation: a nose that is too long, ethnic nose, too big, deviated, crooked, humped, drooping, etc. Rhinoplasty allows for the modification of the nasal pyramid, the tip, the nostril wings or to remodel the aesthetics of the nose.

Nose reshaping surgery allows the plastic surgeon to modify the bone, the cartilage, the naso-labial and naso-frontal angles, and to refine the tip, including the nostrils.

Rhinoplasty can be performed on all women and men who wish to improve the general appearance of their face. The procedure can be scheduled as early as the end of childhood (minimum age 16).

During your first consultation for a nose job with the plastic and aesthetic surgeon, you will explain the defect(s) you wish to correct. After a careful examination of the quality of your skin, the shape of your nose, its imperfections, and your facial morphology, the plastic surgeon will evaluate the possibilities of correction and present you with your treatment plan.

The objective will be to obtain the most natural result possible in harmony with your facial features.

Choosing a surgeon

You should take at least two different opinions, and check the surgeon’s reputation by asking and taking testimonials of people who have been through this experience. The practitioner must be experienced and do rhinoplasties regularly. The patient, on his side, must feel confident and listened to. He or she must also express his/her request freely, without the surgeon trying to impose his/her choice.

What nose reshaping involves

The technical procedure is usually performed inside the nostrils without a visible scar. In the particular case of reduction of the nostrils (ethnic nose, flared nostrils…), a small scar hidden in the nostril fold is made. A cast is put in place to stabilize the correction.

Upon awakening, on the operating table and then in the recovery room, the nostrils are temporarily blocked and any periorbital hematomas may be present. You will return to your room about two hours after the surgery and will be taken care of by a nurse.

You will be able to have a drink or even a snack two hours after the rhinoplasty.

The nurse will gently remove the pads from the nose. This episode is always anxiety-provoking but not painful, just like all the post-operative procedures. A small amount of bleeding is possible, but it will stop very quickly. The return home is then possible, of course, accompanied.

Recovery

After a nose job, whether you’ve been through a nose augmentation or a nose reduction, a feeling of severe congestion can appear around the face, like when you have a bad cold or sinusitis. This discomfort lasts about five days.

Swelling around the eyes begins the day after the procedure and lasts until the fifth day. Bruising around the eyes may persist until the tenth day. This varies depending on the type of skin and the amount of work done on the upper bony region of the nose.

The post-operative care, includes an antibiotic treatment, an analgesic treatment -paracetamol and anti-inflammatory drugs-, and a medication to protect the stomach. A more powerful analgesic based on codeine is also prescribed, to be used only in case of strong pain, which is rare.

Post-operative care is very simple. The next day, you will start washing your nose with small doses of physiological serum. This will allow you to evacuate the secretions from the nose.

You can sleep in a semi-sitting position for the first few days to reduce the swelling of the eyes. In addition, ice packs can be applied around the eyes to help decongest.

Your breathing through the nose will be difficult. However, the nose will not be completely blocked because I do not use wicks.

You will have a post-operative appointment for the removal of the outer resin splint and the silicone splints inside the nose. This will take place 7 to 10 days after the procedure.

What could go wrong

Fortunately, real complications are rare following a rhinoplasty performed properly. In practice, the vast majority of procedures are carried out without any problems and patients are fully satisfied with their results.

However, despite their rarity, you should be aware of the possible complications:

• Bleeding: this is possible in the first few hours but usually remains very moderate.
• Hematomas: they may need to be evacuated if they are large or too painful.
• Infection: despite the natural presence of microbes in the nasal cavity, it is very rare.
• Unattractive scars: they can only concern external scars (when they exist) and are only very rarely so unsightly as to require a new surgery.
• Skin lesions: although rare, they are always possible, often because of the nasal splint.
• Perforations of the septum, in case of suffering of the nasal mucosa, which can lead to wheezing and the formation of crusts.
• Olfaction disorders: they are most often transient and have exceptionally been described as definitive.

In conclusion, one should not overestimate the risks, but simply be aware that a surgical intervention, even apparently simple, always involves a small amount of risk.

Imperfections in results may be caused by a misunderstanding of the goals to be reached or may occur due to unusual scarring phenomena or unexpected tissue reactions such as spontaneous skin redraping or retractile fibrosis. These small imperfections, if they are not well tolerated, can eventually be corrected by a surgical touch-up, which is generally much simpler than the initial operation, both from a technical point of view and in terms of postoperative follow-up. However, such a touch-up cannot be performed before several months in order to act on stabilized tissues that have reached a good level of scar maturation.