After the detailed consultation process which has resulted in a clear understanding of your goals, the next stage is the nose job operation itself.
As rhinoplasty is a highly delicate and skilled operation, it’s normal for patients to feel a little apprehensive. Our aim is to make you feel safe and confident throughout your journey which is why our lead rhinoplasty surgeon Mr Rowe-Jones and his consultant anaesthetist will see you in your room before your operation to review everything you wish to talk about.
In the operating room itself, our calm and reassuring team will ensure you’re feeling relaxed and comfortable, as the general anaesthetic takes effect. Once you’re asleep, the operation typically takes around two and a half to three hours – although this can of course vary depending on the complexity of your nasal anatomy and the results we’re aiming for.
You will have a small, light dressing or cast over your nasal bridge and you may have some very fine, dissolvable stitches in the skin between your nostrils. We will administer painkillers before you wake and avoid routinely putting packing in your nose so you are able to breathe easily.
In some cases, patients are able to return home the same day, other cases may call for an overnight stay. Either way, we’ll give you a good run down of how your nose job operation went, and make absolutely sure that everything is in order before you go home to relax. Naturally, we’ll also give you detailed and careful guidance about aftercare, and when we’ll be seeing you next to check on the healing process.
The different approaches to rhinoplasty surgery
Along with primary, secondary or revision and ethnic types of rhinoplasty, there are three broad approaches to nose job surgery.
Closed approach rhinoplasty
This approach is generally used by us for less complex operations on the nose. Cuts are placed inside the nose where they cannot be seen. Through a combination of looking and feeling, the rhinoplasty surgeon’s skill enables him to make appropriate changes to the bone and cartilage under the skin of the nose.
Open approach rhinoplasty
Open approach surgery allows a greater view of the internal structures of the nose and gives us what we believe is greater precision in surgery, enabling us to undertake more complex surgery. In addition to the cuts just inside the nostrils (which cannot be seen), a small incision is made across the skin between the nostrils. This allows better internal access to the nose.
This surgery results in making the patient’s nose smaller. The following outlines classic, traditional steps in the reduction rhinoplasty approach. In most of our cases, these will be modified as part of a more contemporary, sophisticated procedure.
When the bump has been removed, the bridge or roof of the nose is flat, wide and ‘open’ as if the ridge tiles have been removed from the roof of a building. The bridge of the nose is then very carefully examined for little irregularities to smooth off. The hump is removed from the nasal bridge – it is part cartilage from the top of the nasal septum and the upper lateral cartilages – and part bone, from the nasal bones.
The bones are then broken and brought together to close the roof where the bump was removed. The nasal tip cartilages are made smaller by removing very small strips from their upper edges and by making them less bulbous by reshaping them. We are using and pioneering the latest technological advances to increase accuracy and predictability and lower risk in reduction rhinoplasty. We are using powered instruments to remove bone and sculpt bone rather than using chisels and bigger manual rasps. We use the BienAir micro instruments and vibrating crystal piezo technology.