For most people, the nose is the largest and most defining characteristic of their face. A nose that fits in well with your other features can bring balance to your face, while an oversize or awkwardly-shaped nose can seriously harm your face’s overall harmony and aesthetic appeal. Fortunately, rhinoplasty can fix not only these appearance-related problems but also functional issues such as blockages and deviated septums.
A rhinoplasty is a very versatile procedure. It can make your nose smaller and thinner, reduce or eliminate bumps and dips on the bridge, reshape and resize the nostrils, and even add volume where needed using augmentations and grafts. It can also reduce a bulbous or protruding tip and add definition to drooping or insufficient tips to create a more pleasing shape. The resulting improvement in the appearance of your nose can lead to better self-image as well as increased confidence in social situations, which can be life-changing.
Am I a Candidate for Rhinoplasty?
Good candidates for rhinoplasty include anyone who feels that their nose does not fit with the rest of their face due to size or shape. It also includes those with crooked or asymmetrical noses due either to genetics or accident. Ideally, candidates will have realistic expectations and will go into the surgery looking for improvement rather than perfection.
Your rhinoplasty will begin with a consultation with Dr. Clevens in Melbourne. During this meeting, you’ll review your problem areas, and he will evaluate your nose and other facial features to determine what will be surgically possible. Using computer imaging to preview your options, you’ll decide on a course of action and make a plan for the surgery.
Once you’re clear on what you’d like to have done during the rhinoplasty, you may also discuss any additional procedures that you wish to have done at the same time. For example, many patients opt for a chin augmentation together with their nose surgery since the appearance of the chin can greatly influence the perception of the nose.
Dr. Clevens will also discuss with you the details of aftercare and recovery from the procedure as well as any precautions that you should take to minimize the risks of the surgery.
About the Procedure
Most patients prefer to be under general anesthesia so that they are completely unaware of the surgery as it happens, but local anesthesia with intravenous sedation is also a possibility if you have a strong preference. Once you are anesthetized, the procedure will begin.
There are two basic types of rhinoplasty: Closed and open. Dr. Clevens will discuss with you in advance which type you will be having. In a closed rhinoplasty, the incisions are confined to the interior of the nostrils, leaving no visible scars but also restricting surgical access. In an open rhinoplasty, the incisions within the nostrils are joined by another at the base of the nostrils. This allows much better visibility and access for more extensive or more precise jobs, but will leave a nearly-invisible scar at the very base of your nose between the nostrils.
Once the necessary incisions are made, Dr. Clevens will reshape the existing tissue and cartilage, removing excess tissue as necessary. Grafts of cartilage taken from the nasal septum may be added to augment the tip of the nose, and additional fat may be used to add volume. Once everything has been reshaped as needed, the incisions will be closed up, and you’ll be taken off to recover.
After your rhinoplasty, you will experience swelling and bruising around the nose and eyes for up to two weeks. For this reason, most patients plan the surgery at a time when they will be able to avoid work and social events for several weeks. Some minor swelling of the nose may persist for up to a year, but it will not be noticeable to anyone but you.
For the first few days after surgery, your nose will be encased in a nasal splint to protect it from bumps, particularly during sleep. There will also be packing inside the nose to provide structural support while the tissues begin to heal, and you may also require an additional support for the tip of the nose. Depending on the extent of the packing, you may have tubes in your nostrils to assist with breathing. During this initial recovery period, you will need to keep your head elevated as much as possible to prevent swelling.
While you may feel better quickly, you should restrict your activities for the first few weeks. Exercise may cause elevated blood pressure, which will increase your risk of swelling and bleeding. If the rhinoplasty involved your nasal bones themselves, you will also need to wait a few weeks before wearing glasses without special supports.
Possible Risks and Complications
Rhinoplasty will expose you to the same risks as any surgery. These include bleeding, infection, and the possibility of hematomas or scarring. In addition to these normal risks, nose surgery has a few specific ones. The most common complication is blockage caused by swelling in the nostrils. This typically resolves on its own, but may require a minor follow-up procedure. Injury to the septum is also a slight possibility. More rarely, a few patients, in particular those who smoke, may develop skin issues from extensive bandaging or from the grafting materials becoming exposed through the skin.
Q. Does a rhinoplasty provide long-lasting results?
A. Yes, so long as it is performed after the nose has finished its development. This usually occurs by the end of adolescence. Once the nose is done growing, any procedures performed on it will have permanent results.
Q. I think the tip of my nose needs to be augmented, but I don’t have much cartilage in my nasal septum. Is there another place to get the grafting material?
A. While autologous cartilage from the nasal septum typically offers the best result in terms of healing, cartilage can also be taken from the ribs, ear, or other locations. There are also silicone implants available that can leave a natural result, but since these are foreign materials, healing is more troublesome, which is why cartilage is preferred when available. The correct solution will depend on your exact case, so try to wait until after your consultation to decide.
Q. Are there any nonsurgical options to improve my nose?
A. There are some, but they can only do so much. Nonsurgical options mostly consist of injectable fillers that can slightly alter the shape of the nose by adding volume in strategic locations. They can help with slight asymmetry, dips, ski-slope noses, and other mild issues. During your consultation, Dr. Clevens can evaluate your situation and determine if a nonsurgical treatment will be helpful in your case.
Q. Will my nose need to be broken during the rhinoplasty?
A. It depends on the case. In some situations, such as when doing a dramatic narrowing of the bridge, it is necessary to narrow the nasal bones themselves, which requires fracturing and resetting them. In other cases, like modifying the tip of the nose, it is not necessary to break the nose. If your nose does need to be broken during surgery, it will cause some additional bruising and may extend recovery time slightly, but you should not experience much additional discomfort.
Q. Will my new nose look natural?
A. A rhinoplasty can certainly give natural-looking results. The trick is to focus on creating balance with the entire face rather than narrowly fixating on creating a perfect nose, which may or may not fit in with the face. In general, surgeries that concentrate on refining what is already there will leave more natural results than surgeries that attempt to create an entirely new shape.