Nose Reshaping - Rhinoplasty

About

I have performed over 900 rhinoplasties to date. Every case is performed as an “Open Rhinoplasty”. All structures are clearly seen and accurately adjusted. It is the “Gold Standard”. An ultrasonic “piezotome” is used to reshape the bones of the upper bridge of the nose with minimal trauma. The cartilages of the lower nasal bridge and nose tip are modified and repositioned with “cartilage grafts” taken from the septum further back which are inserted exactly where they are needed. The results are consequently very precise, predictable and permanent. Good communication and trust is necessary to embark on this type of surgery. 

Consultation Process

The consultation is designed to tell you in advance what appearance to expect after surgery. We highlight the features you dislike and how you want your nose to look. The process involves taking photographs and making accurate line drawings which are then modified to show the desired result from the front and the side. The predicted outcome will be based on the shape you want achieve and what is possible. There might be limitations to discuss such as thick skin or asymmetry.

To illustrate how you might look we review photos of my previous results of those whose characteristics resemble yours. These are divided into categories based on starting appearance such as a ‘hump’ a ‘droop’ or a ‘bulbous tip’. Bring photographs to show what you like but be guided by what is realistic and achievable. It is important that both patient (you!) and surgeon (me!) agree on the aims of surgery as well as the limitations. Any breathing problems are also assessed and corrected during surgery.

Operation

An Open Rhinoplasty is performed under General Anaesthetic. An arrow shaped incision is made on the underneath central support (the columella) which then goes around the inside of each nostril. This line is not visible after surgery. The skin of the nose is then lifted up and the structure of the nose is seen. The bone and cartilage structures of the bridge and tip are precisely modified to produce the new shape. It usually takes about 2.5 hours but can be longer. After surgery there is a small plaster cast on the nose which stays for 1 week.

Recovery

Rhinoplasty is not a painful operation but allow 2 weeks for recovery. Expect swelling and bruising which is reduced by sleeping propped up with extra pillows. The plaster cast is removed after one week and any bruising goes after the second week. The new shape is visible but is obscured by swelling. The follow up appointment is at 8 weeks and the result is much clearer. The final appearance is evident many months later and this process is slower in those with thick skin. An open rhinoplasty creates a stable structure which will not change with time. This is in contrast to “closed” rhinoplasty after which results can deteriorate due to movement of cartilage over time creating unattractive problems.

Gallery

See photographs of typical results for this procedure