People have rhinoplasty, commonly known as a ‘nose job’, for all sorts of reasons. Sometimes it’s to correct a birth defect or injury, or to help relieve some breathing problems, while for others it’s purely aesthetic.
Only you can know the impact of having a nose that you feel is too big or not the right shape. If your nose is making you feel self-conscious and holding you back in life, it may be time to consider plastic surgery.
Rhinoplasty is one of the most common plastic surgery procedures carried out here in the UK and can be used to alter the size of shape of your nose as well as narrow the span of the nostrils or change the angle between your nose and your upper lip. It can be performed on men and women as well as young people, though only on under-16s in exceptional circumstances.
Rhinoplasty is carried out under general anaesthetic and usually takes one to two hours to complete, though more complex operations may take longer.
Most operations are carried out from within the nose although an ‘open’ procedure may be the preferred approach in more complicated cases. We will discuss the right approach for you in your initial consultation.
During the surgery from within the nose, incisions are made inside the nostrils or at the base of the nose, providing access to the cartilage and bone, which can then be sculpted into shape. When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints may be placed inside your nostrils to stabilise the septum, the dividing wall between nasal passages.
If the operation is to remove a hump then a chisel or rasp will be used, then the nasal bone brought together to form a narrower bridge. Cartilage will then be trimmed to reshape the tip of the nose.
The nature of the sculpting will depend on your specific anatomy and the changes you wish to make.
If the surgery involves the narrowing of flared nostrils, we can remove small wedges of skin from their base to create the desired effect.
Before deciding to go ahead with plastic surgery, it is important to be aware that complications can arise including infection, nosebleed or a reaction to the anaesthesia.
When rhinoplasty is performed from inside the nose, there is no visible scaring. When the operation is performed on the outside of the nose, or where the procedure entails the narrowing of flared nostrils, there will be small scars on the base of the nose which usually fade with time.
In a small number of cases it may be necessary to conduct a second operation to correct a small defect which may only become visible once the swelling has subsided from the initial surgery.
During this consultation, we will examine your nose and face and seek to understand what you wish to achieve through surgery.
Several factors influence the results of rhinoplasty such as the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin and your age. We will take all these factors into account before giving you a good idea of what we can achieve, enabling you to make an informed decision about whether surgery is the right step for you to take.
We will need to know at this stage if you’ve had any previous nasal surgery or an injury to your nose, even if it was many years ago. We will also need to know about any allergies or breathing difficulties as well as details of any medication or vitamins you are taking, and whether you smoke.
Please note that we generally wouldn’t advise having rhinoplasty before the age of 16, although there may be some exceptions.
If you do decide to go ahead, it pays to take the time to prepare in advance of surgery – we will give you specific instructions to help you.
For most people, it’s useful to take Arnica tablets for a few days prior to surgery to reduce bruising. You will also need to arrange for someone to drive you home from hospital and perhaps to help you out with everyday tasks for a few days after surgery.
It may be a good idea to get your home cleaned and tidied so that you can rest and recuperate when you get home. You may also like to stock up your fridge so you don’t have to go to the supermarket to buy food.
In the 24-hours after rhinoplasty are perhaps the least comfortable though we will prescribe pain killers as required. In this time, your face will swell, you may develop quite severe bruising around the eyes, your nose may ache and you may have a dull headache. The swelling and bruising around the eyes may increase before it gets better, reaching a peak after two or three days. You can apply cold compresses and ice packs to reduce swelling.
The cast will be removed from your nose after about a week and most of the swelling and bruising should disappear within two weeks.
A little bleeding is common during the first few days following surgery, and you may continue to feel some ‘stuffiness’ for several weeks. It’s best to try not to blow your nose for a week or so while the tissues heal and avoid hitting or rubbing your nose, or getting it sunburned for at least eight weeks. You’ll also need to be particularly gentle with your nose when washing your face or hair, or when using cosmetics.
If you have a nasal packing, it will be removed on the morning after your operation. A splint made of tape and an overlay of plastic, metal or plaster will be applied to help the bone and cartilage of the nose maintain their new shape, though all dressings, splints and stitches are usually removed at the end of one or two weeks.
You should be able to return to school or work within two weeks of surgery, as long as your job is not physically strenuous. We will give you specific guidelines for gradually resuming activities though anything which raises your blood pressure needs to be avoided for two to three weeks.
Your initial consultation is free of charge. It is difficult to give a wholly accurate idea of the cost of your surgery until we have met and fully assessed your needs and goals. At the end you will be given an exact quote which will cover all treatment, appointments and re-admissions or revisions, should that be necessary. The price guide below should give a reasonable idea of the range of prices for your chosen treatment.
Your second consultation is more in-depth, often including a 3D imaging assessment and simulation of outcome, as well as preparation for the day itself. This costs £150 and is included in the cost of your treatment.
|Treatment||Nights Stay||Total cost without planning fee (£150)||Total cost with planning fee (£150)|
|Primary rhinoplasty||One night||£5,344||£5,494|
|Complex/revision rhinoplasty||One night||£5,655||£5,805|
When you attend your initial consultation, we will seek to understand the results you would like to achieve and will give you a good indication of what’s possible. We have found 3-D imaging to be an extremely helpful communication tool to give people a clear idea about what their options are.
If you have a closed rhinoplasty, all scars will be hidden inside the nostril. An open procedure involves a small scar running across the skin between the nostrils (columella). Very occasionally, there may be scars in the corners of the nostrils to reduce nostril size or flair.
A well performed rhinoplasty produces extremely natural results with little or no outward signs of surgery. Other people are unlikely to be as focussed on your nose as you are and, therefore, are surprisingly unlikely to notice any change in shape. If you have discussed your feelings about your nose, those people may be more aware of it and may notice a change.
If the surgery is carried out sympathetically, taking into account the facial proportions, skin characteristics etc. your face will be unchanged. Changes in the size of your nose does not produce side effects in the skin of your cheeks, though alterations in tip position can lead to changes in lip length and smile.