Rhinoplasty ("Nose Job") Procedure

Rhinoplasty ("Nose Job") Clinics in London & UK »

What Happens When You Arrive at the Clinic

When you first arrive a member of staff will greet and admit you before showing you to your room where you can unpack and settle in. The admissions process is standard hospital procedure and you will need to fill in a series of forms asking for personal information and the details of you next of kin. Once in your room a nurse will at some point visit to perform a medical check up and take down some details, such as your weight, height, blood pressure as well as blood and urine samples. At some point the surgeon will visit to answer any last minute questions and to help settle any nerves. Additionally if you have not yet signed a consent form then the surgeon will provide one now, you need to sign this in order to give permission to undergo the surgery. You are still able to change you mind if you want to, any time right up until five minutes before the surgery.

The Nose Reshaping Procedure

The rhinoplasty procedure is performed under general anaesthetic in most cases and only rarely under local anaesthetic if the operation is a very minor one. The surgery normally lasts around 90 minutes depending on the type and extent of nose reshaping surgery being performed. Generally speaking there are only two types of nose reshaping procedures: the closed technique, where the surgeon makes a small incision on the inside of the nose, and the open technique, where the surgeon makes a small incision on the skin separating the nostrils (the columella). The closed technique is often preferable as there is little to no risk of external scarring, whereas with the open technique there is the possibility of an unnoticeable yet minor scar on the underside base of the nose. Still many surgeons feel that open rhinoplasty can be the better option in some cases depending on what you want done with your nose, so make sure you discuss thoroughly with your surgeon which method they recommend and which you’d prefer. Both techniques have beneficial and restricting qualities, each more useful depending on the circumstance.

Types of "Nose Job"s

The closed technique involves making a series of small incisions on the inside of the nose which are used to access the bone and cartilage. The surgeon will insert an instrument into these incisions which is used to separate the skin from the nasal structure and remove the cartilage and bone. The structure is then rearranged externally and moulded into the desired shape before being reinserted.

The open technique uses an incision on the outside of the nose made in the small strip of skin separating the nostrils known technically as the ‘columella’. This allows the surgeon to lift off the skin form the tip of the nose and have the least restricted access to the bone and cartilage, allowing them to very precisely shape the cartilage.

Specific Reshaping

Once access has been gained to the nose one way or another, the surgeon is then able to perform specific aspects of the nose reshaping surgery. Depending on how you want your new nose to look the surgeon will perform a number of different methods to achieve the desired outcome.

• Size: The surgeon reshapes the bone and cartilage to reduce the size of the nose. The soft tissues are separated from the bone structure and the actually cartilage is reshaped to produce the form. To make the nose larger implants may be used or cartilage used from other areas of the body.
• Length: The surgeon can alter the size of the septum (the wall separating the two halves of the nose) and the upper lateral cartilage to change the length of the nose. For example, they can trim the septum to shorten the nose.
• Width: The surgeon can alter the width of the bridge of the nose by ‘shaving’ the septum and upper cartilages. The bridge can also be made narrower by cutting the nasal bones and pushing them closer together, a process called ‘infracture.’
• Tip: The surgeon can remove a section of the alar cartilage (cartilage at the tip of the nose) to reduce the appearance of a ‘rounded’ or ‘bulbous’ nose. The tip can also be emphasised by grafting on cartilage from other areas of the body or using an implant.
• Nostrils: The nostrils can be narrowed by a wedge from the columella through a skin incision between them.

For both techniques and any other methods used, once the reshaping has been completed the surgeon will replace the skin over the nose and the incisions are closed up. For this the surgeon will normally use small dissolvable stitches. Any bleeding may be stemmed by inserting soft nasal packing (pieces of gauze used to fill the nostrils) which also helps support the septum and the new nasal structure. However surgeons may try to avoid using nasal packing unless absolutely necessary as it could source a degree of discomfort. A splint will be applied to the new structure as well to help maintain the shape. The nasal packing should be removed within a few days and the stitches and splint within two weeks.

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