Nose Re-Shaping – Rhinoplasty

hump noseNose surgery involves shaping the nose and is one of the most technically challenging cosmetic surgery operations: this operation should only be performed by experienced Consultant Plastic Surgeons.

The benefits of nose surgery include: improved appearance and proportion of your nose, enhanced facial harmony and improved self esteem.

When used for medical reasons rhinoplasty can facilitate improved breathing by correcting anatomical abnormalities in the structure of the nose: these abnormalities can be due to hereditary reasons or caused by trauma.

It is advisable that you first discuss this procedure with your General Practitioner (GP), who may then refer you to the Consultant Plastic Surgeon of your choice. Sharing your expectations with your GP and surgeon is the best way to increase the possibility of achieving your desired outcomes.



Nose surgery can change the following characteristics of the nose:

  • proportional size, in relation to the other facial structures
  • width, at the bridge
  • profile, with visible humps or depressions on the bridge
  • tip, that is large or bulbous, drooping, or too upturned
  • nostrils that are large, wide or upturned
  • asymmetry and deviation
  • obstruction of the nasal passages

Not all of these procedures need to be corrected in each individual. You should inform your surgeon if there is a specific feature about your nose which concerns you.

Surgery of the nose is generally suitable for patients with the following characteristics:

  • your facial growth is complete and you are 18 years of age or older
  • you are physically healthy
  • you stop smoking
  • you have specific, but realistic goals in mind for the improvement of your appearance

It is advisable that you first discuss this procedure with your General Practitioner (GP), who may then refer you to the Consultant Plastic Surgeon of your choice. Sharing your expectations with your GP and surgeon is the best way to increase the possibility of achieving your desired outcomes.

Additional Information

The purpose of your discussion with a Consultant Plastic Surgeon is to evaluate your general health condition and understand your expectations for nose surgery. The surgeon will ensure that you are well informed of the benefits, possible risks and potential complications of the operation. The surgeon shall then make preliminary measurements of your nose to aid the surgery.

Prior to surgery, you may be asked to:

  • Obtain laboratory testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Example of unshapely nose: pronounced nose tipYour rhinoplasty operation should ideally be performed in a major hospital.

Medications are administered for your comfort during the surgical procedure. Either local anaesthesia and intravenous sedation or general anaesthesia is used for patients undergoing nose reshaping. For your safety during the operation, the attending anaesthetist will use various monitors to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

The Consultant Plastic Surgeon shall first make incisions to access the bone and cartilage support system of the nose is accessed. The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, certain amounts of underlying bone and cartilage are removed, added to, or rearranged to provide a newly shaped structure. For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size. The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The tissues are then re-draped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be used.

Rhinoplasty surgery can be performed through a “closed” technique (scar inside the nose) or an “open” technique (scar on the skin at the base of the nose). Your surgeon will guide you to the most appropriate technique in your case. This may be related to the specific abnormality which requires correction.

Most patients remain in hospital for one night following surgery. They should refrain form excessive physical activity for the next 4-6 weeks, avoiding contact sports for 2-3 months. You will return to have your splint removed and/or sutures removed a few days after going home from hospital.

It is very important that you follow the advice of your surgeon which will enhance your recovery. It is critical that there is a Consultant Plastic Surgeon available for post-operative care should you require his/her assistance.

It may take several months for swelling to fully dissipate and up to a year – and sometimes longer – for the outcome of the surgery to fully refine.

Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgical procedure may be necessary to reach the intended aesthetic goal.

The potential complications of rhinoplasty include:

  • Rupture of small surface vessels
  • Infection
  • Poor wound healing
  • Anaesthesia risks
  • Bleeding (hematoma)
  • Nose asymmetry
  • Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
  • Change in skin sensation (i.e. numbness)
  • Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
  • Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
  • Pain, which may be persistent
  • Unacceptable or significant scarring
  • Skin contour irregularities
  • Skin discoloration and swelling
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Possibility of revision or corrective surgery

Please note: that with all procedures there is a possibility of patient dissatisfaction with the outcome.

Allergic reaction to anaesthetic
In very rare cases anaesthetics can cause allergic reactions. The best current estimate is that a life-threatening allergic reaction (also known as anaphylaxis) happens during one in 10,000 to one in 20,000 anaesthetics. Your anaesthetist will choose the drugs for your anaesthetic by taking into account many different factors, in particular, the type of operation, your physical condition, and whether you are allergic to anything.

Most people make a full recovery from anaphylaxis. It isn’t known how many anaphylactic reactions during anaesthesia lead to death or permanent disability. One review article suggests that one in 20 serious reactions can lead to death. This in effect implies that the chance of dying as a result of an anaphylactic reaction during anaesthesia is between one in 200,000 and one in 400,000 anaesthetic procedures.

For additional information regarding this procedure please contact your Consultant Plastic Surgeon.