Nose Reshaping (Rhinoplasty)

Rhinoplasty is an operation to reshape the nose.  It can reduce or increase the size, change the shape of the tip or the bridge, narrow the span of the nostrils or change the angle between the nose and the upper lip.

Who is suitable for rhinoplasty?

Rhinoplasty is often undertaken on patients for aesthetic reasons, to enhance appearance, to reduce or re-shape the nose to increase self-confidence and self-esteem. If you are unhappy with the shape of your nose, rhinoplasty might address this, providing you are realistic about your expectations. Rhinoplasty can provide an improvement or enhance your nose, it cannot provide an ‘ideal’ nose.

Rhinoplasty can also be used to correct birth defects or to improve breathing difficulties caused by natural obstructions in the nose. Your doctor might recommend rhinoplasty if your have difficulty breathing because of restricted nasal passages or excess nasal cartilage.

What to expect at the initial consultation

At a first consultation, Mr Fleming will ask you to tell him in your own words what it is that you wish to change about your appearance. It is important to be honest and forthright as surgery is always tailored to your specific needs and expectations. Do bear in mind, however, that it is not possible to achieve unrealistic expectations.

In addition,Mr Fleming will take a full medical history including any previous surgery, cosmetic or non-cosmetic, previous hospitalisation, chronic medial problems, medication and allergies, whether you smoke or not, the reasons for wanting the procedure and your goals and aspirations.

The examination will concentrate on your proposed treatment, but also assess your general fitness and suitability for surgery. Routine photographs will be taken.

Following the assessment, Mr Fleming will discuss all available options and formulate an operative plan, including type of surgery and anaesthesia to be used, venue for surgery and costs. Any risks and possible complications will also be discussed with you.

It is important that you are clear what your surgery will entail. Well informed patients cope better with surgery and you have the right to ask any question you want and expect your surgeon to answer with honesty and without the use of jargon. Consent for surgery will also be taken.

Where does the surgery take place?

Mr Fleming can arrange for you to be admitted as an inpatient to either:

• Parkside Hospital, Wimbledon, SW19
• St. Anthony’s Hospital, Cheam, Surrey
• The New Victoria Hospital, Kingston

A Consultant Anaesthetist will meet you prior to surgery.  The surgery takes approximately two hours and you will need to stay in hospital overnight.

What can go wrong?

If performed by a fully qualified and accredited Plastic Surgeon in a proper operating theatre under sterile conditions on a relatively fit and healthy patient, rhinoplasty is a safe procedure.  In general, complications are rare. However, as with any surgical procedure, there are certain risks and complications and these will be explained to you at your consultation.

How long does it take to recover?

You should be able to go home the day following your surgery, although please arrange for someone to collect you – you will not be able to drive yourself. You may need to wear a splint on the nose to maintain the new shape.  This will be applied in the operating theatre and secured with tape.  You may have packs inserted into each nostril, but these will be removed before you are discharged from hospital.

It is advisable to make arrangements for help at home during your convalescence, which should be at least one to two weeks, especially if you have young children.

Swelling and bruising may increase over the first two to three days before it starts to reduce. Cold compresses can be applied to make you feel more comfortable. Sitting in an upright position will help to reduce swelling.

If you have stitches, these will be removed by a Plastic Surgery Dressings Nurse approximately one week after surgery, along with any splints and dressings.

Return to work is usually after one to two weeks, depending on how you feel. Your nose and face may remain bruised and swollen for approximately two weeks, but this should gradually improve over this period. Less noticeable swelling will remain for several months after the surgery and is part of the healing process. You should be aware that it can take 12 months for the final result to be visible.

Contact sports should be avoided for four to six weeks following surgery.  Avoid strenuous activity which may increase your blood pressure for approximately four weeks. 

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