As with all surgical procedures, there are certain stages to the rhinoplasty process which all candidates will experience. First of all there is the initial consultation meeting, at which the options are discussed. From here, individuals decide whether to proceed with their surgery, then there is the process itself and the relevant aftercare.
At the consultation, the qualified professional will discuss the important questions with their potential patient, to establish whether rhinoplasty is a suitable choice. In general, this will usually include a discussion of the candidate’s medical history, including the motivation for wanting the surgery and expectations of its outcome. Any previous procedures to deal with nasal obstructions will be discussed, as will any medications currently prescribed. Certain conditions, like haemophilia, mean that some people may not be eligible for surgery. Typically, at the consultation, there will also be a physical examination. The nasal skin and structure will be examined to determine how the surgery would need to proceed, by taking account of thickness and strength of cartilage and skin. Blood tests may also be performed. In many cases, the practice will also take photographs of the candidate’s full face and profile, in order to describe the anticipated outcomes and to show a before and after image.
Before the surgery goes ahead, some people will need to change their habits. This typically involves stopping smoking, but in other cases can require a candidate to avoid particular medications or to speak with their GP about changing prescriptions for a period of time. It is also important to make adequate provision for immediately after the surgical procedure, as the patient will not be able to drive for at least one day and will need support at home. Any time away from work will also need to be arranged.
The surgery itself will vary significantly depending on the individual patient. The operation can be performed from inside the nasal cavity, or by creating a small incision to the exterior of the nose. The cartilage and bones are readjusted, whether being filed down or augmented, perhaps using harvested cartilage from deep within the nose or from within the ear. More dramatic surgeries use cartilage taken from the ribs. The surgeon will explain their intended process before the operation goes ahead. Rhinoplasty can be performed under general anaesthetic or using a local anaesthesia, depending on the length and complexity of the planned operation.
After the surgery, the patient needs to remain in bed with their head at a higher level than their chest, usually achieved simply by adding extra pillows to their bedding. This helps to reduce the impact of swelling and bleeding. Nasal congestion is common, whilst the internal support structures and dressings can also feel very unusual. The doctor will explain what has happened, then tape a form of splint to the nose to support and protect it during healing. This is usually removed after one week.
During healing, it is important to take care of the area and to behave in a manner which will not cause harm. This means that patients need to avoid strenuous exercise, to take baths rather than showers, to be gentle when brushing their teeth and to take particular care when dressing, so that buttons or other clothing items do not catch on the delicate area. Glasses or sunglasses cannot be worn resting on the bridge of the nose for four weeks following surgery.