What is the nose reshaping surgery (rhinoplasty) procedure?

Rhinoplasty is usually carried out under a general anaesthetic. There is the standard full general anaesthetic and a newer version called ‘Total Intravenous Anaesthesia (TIVA). This new version is both safe and effective and is becoming very popular with patients as there are fewer ‘after surgery’ effects such as nausea and grogginess traditionally associated with a general anaesthetic.

The choice of anaesthetic will have been discussed beforehand between you and your surgeon.

Rhinoplasty usually takes around one to two hours although this depends on the extent of the procedure.

There are two types of rhinoplasty procedure:

  • Open technique
  • Closed technique
  • The ‘open’ technique involves the incision being made across the vertical strip of skin between the nostrils – ‘outside’ the nose.
  • The ‘closed’ technique involves a series of small incisions being made inside the nostrils.
  • The surgery itself depends on the type of work you are having done on your nose. These can include some or all of the following:
  • Reshaping the bone and cartilage of the nose to reduce its size. Fine incisions are made, soft tissues are separated from the bone structure and the cartilage itself is reshaped.
  • The bridge of the nose can be reduced by ‘shaving’ the septum (the bridge between the nose) and the upper cartilages.
  • Adjusting the size of the septum and the upper lateral cartilage to reduce the length of the nose.
  • Trimming the septum to give a shorter nose.
  • Reducing a ‘rounded’ nose by removing a section of the alar cartilage.
  • Narrowing the nostrils by removing a wedge via a skin incision.
  • Narrowing the bridge of the nose by cutting and the pushing together the nasal bones. This is called ‘infracture’
  • Grafting strips of cartilage (from the ear, septum or ribs) to build up the size of the nose. These can also be used to emphasise the nasal tip or bridge.
  • The surgeon will reshape the cartilage of the nose to the desired shape and reposition the skin over the nose.

Your surgeon will close the incision with a series of small, dissolvable stitches. He or she might insert some soft packing to stop any bleeding. A plastic splint will also be applied to help maintain the shape of your new nose.

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