Rhinoplasty (Nose Job)

What is a Rhinoplasty?

Rhinoplasty, or nose reshaping surgery, is an effective option to adjust both form and function with subtle modifications to the size, shape or contour of the nose, for cosmetic or medical reasons.

Medical reasons for a rhinoplasty include a deviated nose caused by trauma or a deviated septum affecting your breathing. With Dr Teixeira’s experience, he has successfully treated patients with correcting the shape or breathing difficulties, and complicated nasal reconstruction work for those who have undergone previous unsuccessful surgeries or significant nasal injuries.

Types of Rhinoplasty and Techniques

Open and Closed Rhinoplasty

There are two main types of incision for rhinoplasty: Open and Closed Rhinoplasty. Closed rhinoplasty involves incisions made only inside of the nose, hidden from view. Open rhinoplasty, on the other hand, involves adding an extra tiny incision on the outside of the nose, on the columella, to maximise exposure of the underlying structures for better reshaping.

Both approaches have their advantages and considerations, and your surgeon will help you determine which one is best suited for your individual needs. It’s essential to keep in mind that every patient’s nose is different and requires a unique approach, so it’s crucial to consult with a qualified and experienced surgeon before making any decisions.

Preservation Rhinoplasty

Preservation rhinoplasty maintains the natural structure of the nose while achieving desired aesthetic changes. It involves careful manipulation of nasal structures, resulting in remodelling without compromising nasal function or stability. This technique generally carries a lower risk of breathing problems as it avoids removing excessive nasal tissue. However, it may not be suitable for addressing significant nasal deviations and asymmetries, and the results can vary widely.

Structural Rhinoplasty

Structural rhinoplasty is often necessary for more significant changes. This approach involves removing, reshaping, or replacing existing nasal cartilages and bones to create a desired appearance. It is effective for complex nasal issues and provides predictable, long-lasting results. Considerations include existing anatomy, medical history, and the surgeon’s expertise.

Hybrid Approach

The hybrid approach combines elements of both preservation and structural techniques. It focuses on preserving tissue on the nasal dorsum while using targeted tissue manipulation for desired results. This method is selectively used when both preservation and structural modifications are beneficial, allowing for a balanced outcome.

Dr Teixeira primarily performs structural rhinoplasty but may use the hybrid preservation technique in selective cases to achieve the best results tailored to each patient’s unique needs.

Other Non-Surgical Alternatives for Nose Reshaping

While nasal fillers are a non-surgical alternative, they come with high risks and require ongoing maintenance. The most serious adverse event is the risk of vascular occlusion, when the filler is injected inadvertently in a vessel. Fillers can also migrate and spread to deeper tissues of the nose, causing lumps and inflammation.

At the end of the day, finding the right balance between preservation and structural approaches is crucial when considering rhinoplasty.

Augmentation Rhinoplasty

Augmentation rhinoplasty is a popular procedure performed to change the height and projection of the nose, particularly for individuals with low, flat, and wide noses, which is more common in Asian and African ethnicities. This procedure involves the use of implants or autologous tissues to augment the nasal dorsum and the nasal tip, as well as reshaping the nasal tip for a refined appearance.

Nasal Implants vs Rib Cartilage Grafts

Implants such as silicone or porous polyethylene implants are commonly used for augmentation rhinoplasty, but there is a risk of infection and implant rejection. To minimise this risk, autologous tissue reconstruction using one’s own cartilage or cadaveric rib cartilage grafts is a superior option in terms of biocompatibility and longevity of the procedure. The use of autologous rib cartilage, in particular, is gaining popularity due to its safety profile with lower risk of infection and rejection.

Revision Rhinoplasty

Revision rhinoplasty, also known as secondary rhinoplasty, is a surgical procedure that aims to improve or correct the results of a previous rhinoplasty. This procedure can be carried out for both aesthetic and functional reasons, such as difficulty breathing.

Minor touch-ups may only require small adjustments, such as correcting a minor bump or asymmetry. However, major redo surgery may be necessary to correct more significant structural issues.

It’s important to communicate clearly with your surgeon about your concerns and desired outcome, as revision rhinoplasty can be more challenging than the initial surgery. It’s also recommended to seek a second opinion for reassurance and to ensure the best possible outcome.

While revision rhinoplasty can be a more complex procedure, it can provide improved results and satisfaction for patients who were not fully satisfied with the outcome of their initial rhinoplasty.

Rhinoplasty is most commonly performed under general anaesthesia, depending on the extent of the surgery and the patient’s preference. A rhinoplasty procedure takes approximately three hours to complete.

Risks and Complications

With any surgery there are potential risks involved.

Some possible risks of rhinoplasty include:

Bleeding
Infection
Scarring (both internal and external)
Irregularities and asymmetries
Changes in skin sensation
Prolonged swelling and nasal stiffness
Difficulty breathing through the nose
Recurrence of issues
Changes in shape and position of the cartilages
Unsatisfactory results requiring revision surgery

General anaesthesia also carries a certain level of risk such as allergic reaction and breathing difficulties, although these risks are quite rare. In addition, general side effects like allergic reactions, swelling, bruising, slow healing, tissue necrosis (especially in smokers) and fluid accumulation may occur.

It’s important to follow all pre and post-operative care instructions provided by your specialist plastic surgeon to reduce the likelihood of complications.

Surgery and Recovery

Understanding the recovery process and what to expect after your rhinoplasty is crucial for a successful outcome. Dr Teixeira will provide you with detailed post-operative instructions to guide you through the recovery period, ensuring your comfort and safety.

Recovery Tips:

Manage Swelling and Discomfort: After the surgery, it is normal to experience some swelling, bruising, and discomfort. Keeping the head elevated, applying cold compresses, and taking prescribed pain medications as directed by Dr Teixeira can help alleviate these symptoms.
Protect Your Nose: To protect your nose during the recovery period, avoid activities that could strain it, such as heavy lifting or vigorous exercise. Be cautious to avoid any trauma or bumps to your nose.
Sneezing and Blowing: Sneeze with your mouth open to reduce pressure on your nose. Avoid blowing your nose during the initial recovery period to prevent damage and facilitate healing.
Assess Swelling and Scarring: Regularly evaluate your progress to assess the degree of swelling and scarring and the need for steroid injections to reduce swelling and minimise scarring.
Rest and Avoid Strain: Give your body time to heal by avoiding strenuous activities and heavy lifting.
Maintain a Healthy Lifestyle: Follow a balanced diet and stay well-hydrated to support overall healing and recovery.

Most patients can return to their normal activities within two weeks after the surgery. However, it is crucial to attend all follow-up appointments with Dr Teixeira to ensure that your recovery is progressing as expected.